Stunting was positively correlated with the estimated prevalence of inadequate zinc

Stunting was positively correlated with the estimated prevalence of inadequate zinc intake. The mean prevalence of stunting in countries identified as being at low, moderate and high risk of inadequate zinc intake were 19.6 , 28.8 and 43.2 , respectively. However, in low- and middle-income countries, the mean prevalence of stunting was greater than the mean estimated prevalence of inadequate zinc intake (19.6 ), and country-specific changes in the prevalence of stunting over time were not associated with parallel changes in the prevalence of the estimated risk of inadequate zinc intake. It is likely that the prevalence of zinc deficiency is higher in children under five years of age than in the general population, owing to higher nutrient density needs and rates of infection among infants and young children in low- and middle-income countries. As a result, we would expect the prevalence of stunting in a population to be higher than the estimated prevalence of inadequate zinc intake based on the adequacy of zinc in the FG-4592 site national food supply. In addition, both indicators only provide suggestive evidence of zinc deficiency and the causes of childhood stunting are multi-factorial, which may provide some explanation for the considerable variability around the “best-fit” line. The use of FAO food balance sheets to estimate the adequacy of zinc in national food supplies provides valuable suggestive evidence of the risk of inadequate zinc intake in respective Fexaramine site populations, and thus the population risk of zinc deficiency. As the adequacy of zinc in the national food 1527786 supply may be more likely to reflect the risk of zinc deficiency among adults, the inclusion of information on the prevalence of childhood stunting (more likely to be reflective of child risk of zinc deficiency) may provide a more comprehensive estimate of a population’s risk of zinc deficiency when using indirect indicators [1,9]. Direct indicators of population zinc status, including plasma zinc concentration and dietary zinc intake, need to be assessed as part of nationally representative nutritional assessment surveys. As this information becomes available, these data can be used to further refine and validatethe use of FAO food balance sheets and stunting prevalence to estimate the risk of inadequate zinc intake in populations.Supporting InformationFigure S1 Relationship between the absolute change in 15857111 the estimated prevalence of inadequate zinc intake and the change in the prevalence of stunting. Stunting (low height-for-age) data are for children under five years of age in138 low- and middle-income countries between 1990 and 2005. The solid line represents the regression line. (TIF) Table S1 Regional classifications.(DOCX)Table S2 National data on mean daily per capita energy, zinc, phytate and absorbable zinc contents of the national food supply, and estimated prevalence of inadequate zinc intake for 188 countries from 1990?2005. Estimates were calculated using the composite nutrient composition database, IZiNCG physiological requirements, the Miller Equation to estimate zinc absorption and an assumed 25 inter-individual variation in zinc intake. (XLS) Table S3 Percent change in per capita energy, zinc and phytate content of the national food supply, and percent of dietary zinc obtained from animal source foods (ASF) for countries with a .5 absolute reduction in the prevalence of inadequate zinc intake between 1990 and 2005. (DOCX) Table S4 Percent change in per capita ener.Stunting was positively correlated with the estimated prevalence of inadequate zinc intake. The mean prevalence of stunting in countries identified as being at low, moderate and high risk of inadequate zinc intake were 19.6 , 28.8 and 43.2 , respectively. However, in low- and middle-income countries, the mean prevalence of stunting was greater than the mean estimated prevalence of inadequate zinc intake (19.6 ), and country-specific changes in the prevalence of stunting over time were not associated with parallel changes in the prevalence of the estimated risk of inadequate zinc intake. It is likely that the prevalence of zinc deficiency is higher in children under five years of age than in the general population, owing to higher nutrient density needs and rates of infection among infants and young children in low- and middle-income countries. As a result, we would expect the prevalence of stunting in a population to be higher than the estimated prevalence of inadequate zinc intake based on the adequacy of zinc in the national food supply. In addition, both indicators only provide suggestive evidence of zinc deficiency and the causes of childhood stunting are multi-factorial, which may provide some explanation for the considerable variability around the “best-fit” line. The use of FAO food balance sheets to estimate the adequacy of zinc in national food supplies provides valuable suggestive evidence of the risk of inadequate zinc intake in respective populations, and thus the population risk of zinc deficiency. As the adequacy of zinc in the national food 1527786 supply may be more likely to reflect the risk of zinc deficiency among adults, the inclusion of information on the prevalence of childhood stunting (more likely to be reflective of child risk of zinc deficiency) may provide a more comprehensive estimate of a population’s risk of zinc deficiency when using indirect indicators [1,9]. Direct indicators of population zinc status, including plasma zinc concentration and dietary zinc intake, need to be assessed as part of nationally representative nutritional assessment surveys. As this information becomes available, these data can be used to further refine and validatethe use of FAO food balance sheets and stunting prevalence to estimate the risk of inadequate zinc intake in populations.Supporting InformationFigure S1 Relationship between the absolute change in 15857111 the estimated prevalence of inadequate zinc intake and the change in the prevalence of stunting. Stunting (low height-for-age) data are for children under five years of age in138 low- and middle-income countries between 1990 and 2005. The solid line represents the regression line. (TIF) Table S1 Regional classifications.(DOCX)Table S2 National data on mean daily per capita energy, zinc, phytate and absorbable zinc contents of the national food supply, and estimated prevalence of inadequate zinc intake for 188 countries from 1990?2005. Estimates were calculated using the composite nutrient composition database, IZiNCG physiological requirements, the Miller Equation to estimate zinc absorption and an assumed 25 inter-individual variation in zinc intake. (XLS) Table S3 Percent change in per capita energy, zinc and phytate content of the national food supply, and percent of dietary zinc obtained from animal source foods (ASF) for countries with a .5 absolute reduction in the prevalence of inadequate zinc intake between 1990 and 2005. (DOCX) Table S4 Percent change in per capita ener.