Zinc Deficiency and Stunting

  • Valeria Galetti
Living reference work entry


This chapter reviews key aspects of human zinc nutrition providing an insight on the etiology of zinc deficiency and current policies on the assessment of the risk of zinc deficiency in populations using stunting rates and other indicators. Zinc is an essential trace element in human nutrition, and it is critical to various basic molecular functions. Zinc depletion of the organism thus virtually affects any organ system in the human body, and it encompasses a number of diverse biochemical changes resulting in a generalized metabolic dysfunctions. Marginal zinc deficiency mainly occurs when zinc intakes from the diet are inadequate to provide for increased requirements, increased losses, decreased absorption, or decreased utilization. This form of zinc deficiency carries most of the public health significance of zinc deficiency. Marginal zinc deficiency adversely affects physiological, biochemical, and immunological functions. Typical signs are growth retardation, hypogonadism in male adolescents, rough skin, poor appetite, mental lethargy, abnormal dark adaptation, abnormal neurosensory changes, and delayed wound healing. A more severe form of zinc deficiency can be inherited or acquired due to iatrogenic-induced zinc-free diet or severely impaired intestinal uptake. Acrodermatitis enteropathica is a rare autosomal recessive genetic disorder that results in impaired zinc absorption. In population surveys, the risk of zinc deficiency is considered to be elevated and of public health concern when the prevalence of low serum zinc concentrations is greater than 20%, the prevalence of inadequate intakes is greater than 25%, or the prevalence of stunting is at least 20%. In such cases, an intervention to improve population zinc status or increase dietary zinc intake is recommended. Approximately 17.3% of the world’s population are at risk of inadequate intake of absorbable zinc, with the highest risk carried by countries in South and Southeast Asia, sub-Saharan Africa, and Central America. The global mortality burden due to zinc deficiency is of 116,000 deaths per year, the second most important cause of mortality due to micronutrient deficiency after vitamin A deficiency.


Zinc Zinc metabolism Zinc requirements Zinc deficiency Zinc intake Inadequate zinc intake Zinc status Plasma zinc Serum zinc Dietary zinc Stunting Height-for-age 



Acrodermatitis enteropathica


Confidence interval


Disability-adjusted life year


Estimated average requirement


Ethylenediaminetetraacetic acid


Endogenous fecal zinc


Food and Agriculture Organization


Height-for-age z-score


International Atomic Energy Association




Institute of Medicine


International Zinc Nutrition Consultative Group


Plasma/serum zinc


Randomized controlled trial


Recommended dietary allowance


Relative risk or rate ratio


Standard deviation


Unabsorbed fecal zinc


Tolerable upper level of intake


United Nations Children’s Emergency Fund


Weight-for-age z-score


World Health Organization


Weight-for-height z-score


Gene expressing for a Zip transporter


Zinc transporter, transports zinc into the cytoplasm


Zinc transporter, transports zinc out of the cytoplasm


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.ETH Zurich, Laboratory of Human Nutrition, Institute of Food, Nutrition and HealthZurichSwitzerland

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