Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T23:24:05.874Z Has data issue: false hasContentIssue false
  • English
  • Français

Is zinc a limiting nutrient in the diets of rural pregnant Malawian women?

Published online by Cambridge University Press:  09 March 2007

Janet-Marie Huddle ,
Rosalind S. Gibson  and
Timothy R. Cullinan
Janet-Marie Huddle
Affiliation:
Division of Applied Human Nutrition, University of Guelph, Guelph, Ontario N1G 2W1, Canada
Rosalind S. Gibson*
Affiliation:
Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, New Zealand
Timothy R. Cullinan
Affiliation:
Department of Community Health, College of Medicine, University of Malawi, Blantyre, Malawi
*
*Corresponding author:Professor R. S. Gibson, fax +64 3 479 7958, email Rosalind.Gibson@stonebow.otago.ac.nz
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Pregnant women consuming plant-based diets are at risk of Zn deficiency; Zn requirements for fetal growth and maternal tissue accretion are high. Therefore we have studied, at 24 and 33 weeks gestation, the Zn status of eighty-seven pregnant rural Malawian women (mean age 22·7 years) who consume maize-based diets, using anthropometry, dietary intake data, plasma and hair Zn concentrations, and infection status via serum C-reactive protein, leucocyte count, and malaria blood smear. Of the women, 12% were stunted (height-for-age Z score < -2 SD) and 20% lost weight over the 9-week period; weight gain averaged 0·13 kg/week. Mean plasma Zn concentration declined significantly from 24 to 33 weeks (7·9 (SD 2·2) v. 6·6 (SD 2·0) μmol/l; P < 0·0003). Both plasma and hair Zn values were very low; nearly 50% of the women had both plasma and hair Zn values below acceptable cut-off values. No significant differences in biochemical Zn indices existed between those who tested positive and negative for infection. Cereals (mainly maize) provided more than two-thirds of mean energy intake compared with less than 5% from flesh foods. As a result about 60% of the subjects had dietary phytate: Zn molar ratios greater than 15, and more than 35% had inadequate Zn intakes based on probability estimates and WHO basal requirements. Biochemical evidence of Zn deficiency was attributed in part to low intakes of poorly available Zn. The anthropometric, biochemical, and dietary data together indicate that Zn deficiency may be a factor limiting pregnancy outcome in rural Malawian women.

Keywords

ZincPregnancyMalawi
Type
Human and Clinical Nutrition
Information
British Journal of Nutrition , Volume 79 , Issue 3 , March 1998 , pp. 257 - 265
Copyright
Copyright © The Nutrition Society 1998

References

Apgar, J (1985) Zinc and reproduction. Annual Review of Nutrition 43, 43–68.CrossRefGoogle Scholar
Apgar, J (1992) Review: zinc and reproduction: an update. Journal of Nutritional Biochemistry 3, 266–278.CrossRefGoogle Scholar
Arnaud, J, Preziosi, P, Mashako, L, Galan, P, Nsibu, C, Favier, A, Kapongo, C & Hercberg, S (1994) Serum trace elements in Zairian mothers and their newborns. European Journal of Clinical Nutrition 48, 341–348.Google ScholarPubMed
Bindra, GS, Gibson, RS & Thompson, LU (1986) [Phytate][calcium]/zinc ratios in Asian immigrant lacto-ovo vegetarian diets and their relationship to zinc nutriture. Nutrition Research 6, 475–483.CrossRefGoogle Scholar
Breskin, MW, Worthington-Roberts, BS, Knopp, RH, Brown, Z, Plovie, B, Mottet, NK & Mills, JL (1983) First trimester serum zinc concentrations in human pregnancy. American Journal of Clinical Nutrition 38, 943–953.CrossRefGoogle ScholarPubMed
Brown, KH, Lanata, CF, Yuen, ML, Peerson, JM, Butron, B & Lonnerdal, B (1993) Potential magnitude of the misclassification of a population's trace element status due to infection: an example from a survey of young Peruvian children. American Journal of Clinical Nutrition 58, 549–554.CrossRefGoogle ScholarPubMed
Campbell-Brown, M, Ward, RJ, Haines, AP, North, WRS, Abraham, R, McFadyen, IR, Turnland, JR & King, JC (1985) Zinc and copper in Asian pregnancies – is there evidence for a nutritional deficiency? British Journal of Obstetrics and Gynaecology 92, 875–885.CrossRefGoogle ScholarPubMed
Cavan, KR, Gibson, RS, Graziosos, CF, Isalgue, AM, Ruz, M & Solomons, NW (1993) Growth and body composition of periurban Guatemalan children in relation to zinc status: a crosssectional study. American Journal of Clinical Nutrition 57, 334–343.CrossRefGoogle Scholar
Davies, NT, Carswell, AJP & Mills, CF (1985) The effect of variation in dietary calcium intake on the phytate-zinc interaction in rats. In Trace Elements in Man and Animals, pp. 440–442 [Mills, CF, Bremner, I and Chesters, JK, editors]. Slough: Commonwealth Agricultural Bureau.Google Scholar
Ferguson, EL, Gadowsky, SL, Huddle, J-M, Cullinan, TR, Lehrfeld, J & Gibson, RS (1995) An interactive 24-h recall technique for assessing the adequacy of trace mineral intakes of rural Malawian women; its advantages and limitations. European Journal of Clinical Nutrition 49, 565–578.Google ScholarPubMed
Ferguson, EL, Gibson, RS, Thompson, LU & Ounpuu, S (1989 a) The dietary calcium, phytate, and zinc intakes, and the calcium, phytate and zinc molar ratios of a selected group of East African children. American Journal of Clinical Nutrition 50, 1450–1456.CrossRefGoogle ScholarPubMed
Ferguson, EL, Gibson, RS, Thompson, LU, Ounpuu, S & Berry, M (1988) Phytate, zinc and calcium contents of 30 East African foods and their calculated phytate: zinc, Ca: phytate, and [Ca][phytate]/[Zn] molar ratios. Journal of Food Composition and Analysis 1, 316–325.CrossRefGoogle Scholar
Ferguson, EL, Gibson, RS, Weaver, SD, Heywood, P, Heywood, A & Yaman, C (1989 b) The mineral content of commonly consumed Malawian and Papua New Guinean Foods. Journal of Food Composition and Analysis 2, 260–272.CrossRefGoogle Scholar
Food and Agriculture Organization/World Health Organization/United Nations University (1985) Energy and Protein Requirements. WHO Technical Report Series no. 724. Geneva: WHO.Google Scholar
Frisancho, AR (1990) Anthropometric Standards for the Assessment of Growth and Nutritional Status. Ann Arbor: The University of Michigan Press.CrossRefGoogle Scholar
Gibson, RS (1990) Principles of Nutritional Assessment. New York: Oxford University Press.Google Scholar
Gibson, RS & DeWolfe, MS (1979) The zinc, copper, manganese, vanadium and iodine content of hair from 38 Canadian neonates. Pediatric Research 13, 959–962.CrossRefGoogle ScholarPubMed
Gibson, RS, Smit-Vanderkooy, PD & MacDonald, AC (1989 a) Seasonal variations in hair zinc concentrations in Canadian and African children. Science of the Total Environment 84, 291–298.CrossRefGoogle ScholarPubMed
Gibson, RS, Smit-Vanderkooy, PD, MacDonald, AC, Goldman, A, Ryan, BA & Berry, M (1989 b) A growth-limiting mild zinc deficiency syndrome in some Southern Ontario boys with low height percentiles. American Journal of Clinical Nutrition 49, 1266–1277.CrossRefGoogle ScholarPubMed
Goldenberg, RL, Tamura, T, Neggers, Y, Copper, RL, Johnston, KE, DuBard, MB & Hauth, JC (1995) The effect of zinc supplementation on pregnancy outcome. Journal of the American Medical Association 274, 463–468.CrossRefGoogle ScholarPubMed
Hambidge, KM & Droegemueller, W (1974) Changes in plasma and hair concentrations of zinc, copper, chromium, and manganese during pregnancy. Obstetrics and Gynecology 44, 666–672.Google Scholar
Hambidge, KM, Krebs, NF, Jacobs, MA, Favier, A, Guyette, L & Ilke, DN (1983) Zinc nutritional status during pregnancy: a longitudinal study. American Journal of Clinical Nutrition 37, 429–442.CrossRefGoogle ScholarPubMed
Hunt, IF, Murphy, NJ, Cleaver, AE, Farafi, B, Swenseid, ME, Coulson, AH, Clark, VA, Laine, N, Davis, CA & Smith, CJ (1983) Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. American Journal of Clinical Nutrition 37, 572–582.CrossRefGoogle ScholarPubMed
Kirksey, A, Wachs, TD, Yunis, F, Srinath, U, Rahmanifar, A, McCabe, GP, Galal, OM, Harrison, GG & Jerome, NW (1994) Relation of maternal zinc nutriture to pregnancy outcome and infant development in an Egyptian village. American Journal of Clinical Nutrition 60, 782–792.CrossRefGoogle Scholar
Kuhnert, BR, Kuhnert, PM, Lazebnik, N & Erhard, P (1988) The effect of smoking on the relationship between maternal and fetal zinc status and infant birth weight. Journal of the American College of Nutrition 7, 309–316.CrossRefGoogle ScholarPubMed
Kushner, I (1993) Regulation of the acute phase response by cytokines. Perspectives in Biology and Medicine 36, 611–622.CrossRefGoogle ScholarPubMed
Lockitch, G (1993) Handbook of Diagnostic Biochemistry and Hematology in Normal Pregnancy. Ann Arbor: CRC Press.Google Scholar
Lohman, TG, Roche, AF & Martorell, R (editors) (1988) Anthropometric Standardization Reference Manual. Champaign, IL: Human Kinetic Books.Google Scholar
McMichael, AJ, Dreosti, IE, Gibson, GT, Hartshorne, JM, Buckley, RA & Colley, DP (1982) A prospective study of maternal serum zinc levels and pregnancy outcome. Early Human Development 7, 59–69.CrossRefGoogle ScholarPubMed
Mbofund, CMF & Atinmo, T (1987) Trace element nutriture of Nigerians. World Review of Nutrition and Dietetics 51, 105–139.CrossRefGoogle Scholar
Merchant, K, Martorell, R & Haas, JD (1990 a) Consequences for maternal nutrition of reproductive stress across consecutive pregnancies. American Journal of Clinical Nutrition 52, 616–620.CrossRefGoogle ScholarPubMed
Merchant, K, Martorell, R & Haas, JD (1990 b) Maternal and fetal responses to the stresses of lactation concurrent with pregnancy and of short recuperative intervals. American Journal of Clinical Nutrition 52, 80–88.CrossRefGoogle Scholar
Nagra, SA, Jannat, A, Farooqi, MI & Anwar, J (1988) Hemoglobin, serum calcium, copper, magnesium and zinc during the first trimester of pregnancy in Pakistani women. Ecology of Food and Nutrition 22, 307–312.CrossRefGoogle Scholar
National Statistical Office, Malawi (1994) Malawi Demographic and Health Survey 1992. Zomba, Malawi: National Statistical Office.Google Scholar
Oberleas, D & Harland, BF (1981) Phytate content of foods: effect on dietary zinc bioavailability. Journal of the American Dietetic Association 79, 433–436.CrossRefGoogle ScholarPubMed
Okonofua, FE, Isinkaye, A, Onwudiegwu, U, Amole, FA, Emofurieta, WA & Ugwu, NC (1990) Plasma zinc and copper in pregnant Nigerian women at term and their newborn babies. International Journal of Gynaecology and Obstetrics 32, 243–245.CrossRefGoogle ScholarPubMed
Sarram, M, Younessi, M, Kyorvash, P, Kfoury, GA & Reinhold, JG (1969) Zinc nutrition in human pregnancy in Fars province, Iran. American Journal of Clinical Nutrition 22, 726–732.CrossRefGoogle ScholarPubMed
Scholl, T, Hediger, ML, Fischer, RL & Shearer, JW (1992) Anemia vs iron deficiency: increased risk of preterm delivery in a prospective study. American Journal of Clinical Nutrition 55, 985–988.CrossRefGoogle ScholarPubMed
Solomons, NW (1981) Zinc and copper in human nutrition. In Nutrition in the 1980's: Constraints on our Knowledge. Progress in Clinical and Biological Research, vol. 67, pp. 97–127 [Selvey, N and White, PL, editors]. New York: Alan R. Liss.Google Scholar
Swanson, CA & King, JC (1983) Reduced serum zinc concentration during pregnancy. Obstetrics and Gynecology 62, 313–318.CrossRefGoogle ScholarPubMed
Swanson, CA & King, JC (1987) Zinc and pregnancy outcome. American Journal of Clinical Nutrition 46, 763–771.CrossRefGoogle ScholarPubMed
Tamura, T & Goldenberg, RL (1996) Zinc nutriture and pregnancy outcome. Nutrition Research 16, 139–181.CrossRefGoogle Scholar
Tuttle, S, Aggett, PJ, Campbell, D & MacGillivray, I (1985) Zinc and copper nutrition in human pregnancy: a longitudinal study in normal primigravidae and in primigravidae at risk of delivering a growth retarded baby. American Journal of Clinical Nutrition 41, 1032–1041.CrossRefGoogle ScholarPubMed
Valdes-Ramos, R (1992) Zinc: a perinatal point of view. Progress in Food and Nutrition Science 16, 279–306.Google ScholarPubMed
Veillon, C, Patterson, KY & Reamer, DC (1985) Preparation of a bovine serum pool to be used for trace element analysis. In Biological Reference Materials, Availability, Uses, and Need for Validation of Nutrient Measurement, pp. 167–177 [Wolfe, WR editor]. New York: John Wiley & Sons.Google Scholar
Vir, SC, Love, AHG & Thompson, W (1981) Zinc concentration in hair and serum of pregnant women in Belfast. American Journal of Clinical Nutrition 34, 2800–2807.CrossRefGoogle ScholarPubMed
Watts, DH, Krohn, MA, Wener, MH & Eschenbach, DA (1991) C-reactive protein in normal pregnancy. Obstetrics and Gynecology 77, 176–180.CrossRefGoogle ScholarPubMed
WHO (1996) Trace Elements in Human Nutrition and Health. Geneva: World Health Organization.Google Scholar
Wolfe, SA, Gibson, RS, Gadowsky, SL & O'Connor, DL (1994) Zinc status of a group of pregnant adolescents at 36 weeks gestation living in Southern Ontario. Journal of the American College of Nutrition 13, 154–164.CrossRefGoogle ScholarPubMed