Zinc deficiency

1. ZINC DEFICENCY – EPIDEMIOLOGY, PUBLIC
HEALTH SIGNIFICANCE, CLINICAL
MANIFESTATIONS OF ZINC DEFICENCY, ZINC
SUPPLEMENTATION IN PREGNANCY,
FLUOROSIS
Presented by,
Bhagyalakshmi vinod
2nd Dc MSc. Dietetics and food service management

2. INTRODUCTION
• Zinc, a nutrient found throughout your
body, helps your immune system and
metabolism function.
• Zinc is also important to wound healing
and your sense of taste and smell.
• With a varied diet, your body usually gets
enough zinc. Food sources of zinc include
chicken, red meat and fortified breakfast
cereals.

3. • Zinc is required for
numerous processes
in your body,
including
• Gene expression
• Enzymatic reactions
• Immune function
• Protein synthesis
• DNA synthesis
• Wound healing
• Growth and
development

4. ZINC DEFICENCY- EPIDEMIOLOGY
• Zinc deficiency in humans is caused by reduced dietary intake, inadequate absorption,
increased loss, or increased body system use. The most common cause is reduced
dietary intake.
• The Recommended Dietary Allowance (RDA) for adults 19+ years is 11 mg a day for
men and 8 mg for women.

5. • Zinc deficiency affects about 2.2
billion people around the world.
• Severe zinc deficiency is rare, and is
mainly seen in persons with
acrodermatitis enteropathica.
• Although severe zinc deficiency is
rare, it can occur in people with rare
genetic mutations, breastfeeding
infants whose mothers don’t have
enough zinc, people with alcohol
addictions, and anyone taking certain
immune-suppressing medications.

6. • Symptoms of severe zinc deficiency
include impaired growth and
development, delayed sexual
maturity, skin rashes, chronic
diarrhea, impaired wound healing,
and behavioral issues
• Milder forms of zinc deficiency are
more common, especially in children
• Symptoms of mild zinc deficiency
include diarrhea, decreased
immunity, thinning hair, impaired
taste or smell, dry skin, and
impaired wound healing .

7. • Those at risk of zinc deficiency include :-
• people with gastrointestinal diseases like
Crohn’s disease
• vegetarians and vegans
• people who are pregnant or breastfeeding
• people with sickle cell anemia
• people who are malnourished, including
those with anorexia or bulimia
• people with chronic kidney disease
• people with alcohol use disorder

8. DIETARY RECOMMENDATIONS
• Adding zinc rich foods to diet.
• The foods with the highest concentration
of zinc are proteins, especially animal
meats, the highest being oysters.
• Beef, pork, and lamb contain more zinc
than fish. The dark meat of a chicken
has more zinc than the light meat. Other
good sources of zinc are nuts, whole
grains, legumes, and yeast. Although
whole grains and cereals are high in
zinc, they also contain chelating
phytates which bind zinc and reduce its
bioavailability.

9. FOOD SOURCES
• Many animal and plant foods are naturally
rich in zinc, making it easy for most people
to consume adequate amounts.
• Foods highest in zinc include
• Shellfish: oysters, crab, mussels, lobster,
and clams
• Meat: beef, pork, lamb
• Poultry: turkey and chicken
• Fish: sardines, salmon
• Eggs

10. • Legumes: chickpeas, lentils, black
beans, kidney beans, etc.
• Nuts and seeds: pumpkin seeds,
cashews, hemp seeds, etc.
• Dairy products: milk, yogurt, and
cheese
• Whole grains: oats, brown rice, etc.
• Certain vegetables: mushrooms, ,
peas, asparagus, and beet greens

11. PUBLIC HEALTH SIGNIFICANCE
• Public health is the science of
protecting and improving the health of
people and their communities. This
work is achieved by promoting healthy
lifestyles, researching disease and
injury prevention, and detecting,
preventing and responding to
infectious diseases.

12. • The professionals with
public health certification
formulate safety standards
for schools, offices, and
medical facilities to minimize
the risk of employees
towards falls and injuries.
• They also use epidemiology
principles for improving
public health measures and
health awareness of
individuals.

13. • Public health practice helps to educate people about the
harmful effects of tobacco and alcohol.
• Health measures motivate individuals to improve their
eating habits and engage them in meditation and exercise.

14. STRATEGIES FOR PROMOTING ZINC
NUTRITION
• The three major categories of nutrition-focused zinc intervention
strategies are:
• Dietary diversification and modification
• Zinc fortification
• Zinc supplementation

15. Dietary diversification and modification
• Dietary diversification or modification has the potential to
prevent deficiencies of zinc and other coexisting limiting
micronutrients simultaneously, without risk of antagonistic
interactions.
• Both cereal staples and household diets can be manipulated
to enhance the content of micronutrients and/or alter the
levels of absorption modifiers to improve micronutrient
bioavailability.

16. STRATEGIES
• Increase production & consumption of Zn-rich foods
• Reduce phytate via household processing
• – soaking; germination; fermentation
• Exclusive breastfeeding to 6 months – infants.
• Promote safe & appropriate complementary foods at 6
months.

17. ZINC FORTIFICATION
• According to the World Health Organization (WHO) and the
Food and Agricultural Organization of the United Nations
(FAO), food fortification is the process that improves the
nutritional quality of food by deliberately adding essential
micronutrients and vitamins to it.
• Fortification of staple foods with zinc has the potential to
improve the zinc nutrition of populations, resulting in better
health outcomes, such as improved childhood growth and
reduction in infectious morbidity.
• Some ready-to-eat breakfast cereals are fortified with zinc.

18. ZINC SUPPLEMENTATION
• Zinc supplements are often used to help
treat and prevent zinc deficiency.
• Different zinc supplements contain varying
concentrations of elemental zinc.
• There are several forms of zinc supplements
that affect your health in unique ways.
They’re generally available in capsule,
tablet, and lozenge form. Avoid zinc-
containing nasal sprays, as they may affect
your sense of smell.

19. • Excess zinc can interfere with the absorption of iron and
copper.
• High doses can also cause nausea and even vomiting.
• Therefore it is important not to take supplemental zinc
unless it is known that the diet is low in foods containing
zinc or a zinc deficiency is confirmed.
• The Recommended Dietary Allowance (RDA) for adults 19+
years is 11 mg a day for men and 8 mg for women.
• Pregnancy and lactation requires slightly more at 11 mg and
12 mg, respectively.

20. CLINICAL MANIFESTATIONS OF ZINC DEFICENCY
• The clinical manifestations in severe cases of zinc
deficiency include
• bullous-pustular dermatitis – rare skin condition
that causes large, fluid-filled blisters. They develop
on areas of skin that often flex — such as the lower
abdomen, upper thighs or armpits.
• Alopecia -Alopecia areata is a disease that
happens when the immune system attacks hair
follicles and causes hair loss.
• Diarrhea

21. • Emotional disorder
• weight loss
• intercurrent infections – disease that
intervenes during the course of another
disease. A patient with AIDS may
develop an intercurrent bout of
pneumonia.
• hypogonadism in males; it is fatal if
unrecognized and untreated. Condition
in which the body doesn’t produce
enough of the hormone that plays a key
role in masculine growth and
development during puberty
(testosterone) or enough sperm or both

22. • A moderate deficiency of zinc is characterized by
- growth retardation and delayed puberty in adolescents
- hypogonadism in males
- rough skin
- poor appetite
- mental lethargy
- delayed wound healing
- taste abnormalities, and abnormal dark adaptation.

23. • In mild cases of zinc deficiency in human subjects, we have
observed –
- oligospermia – low sperm count
- slight weight loss
- hyperammonemia – metabolic condition characterized by
raised levels of ammonia, a nitrogen-containing compound.
Patients may present with a loss of appetite, vomiting,
lethargy, and behavior abnormalities associated with
hallucinations, sleep disorders

24. ZINC SUPPLEMENTATION IN PREGNANCY
• Getting enough zinc during pregnancy is important for the
baby’s health and for the mother.
• Baby needs zinc for cell growth and brain development.
• This essential mineral also helps support your immune system,
maintain your sense of taste and smell, and heal wounds.
• Pregnant women require 11 milligrams (mg) of zinc per day.
• Foods that contain zinc include red meat, shellfish, poultry,
pork, dairy products, fortified cereal, beans, and nuts.

25. • Baby needs zinc for
cell growth and for
the production and
functioning of DNA –
the body’s genetic
blueprint.
• Zinc is also involved
in energy production
and is essential for
brain development.

26. FLUOROSIS
• Fluorosis is a condition that results in
white or brown speckles on your teeth.
• It’s caused by overexposure to fluoride
in the early years of life, when your
permanent teeth are developing.

27. • It is caused by successive exposures
to high concentrations of fluoride
during tooth development, leading to
enamel with lower mineral content
and increased porosity.
• There are two types of fluorosis, and
they have different symptoms and
side effects.
• Skeletal fluorosis
• Dental fluorosis

28. SKELETAL FLUOROSIS
• Skeletal fluorosis affects the
bones and joints.
• It is caused by prolonged
exposure to excessively high
levels of fluoride.
• This can occur through
inhalation of dust or fumes or
digestion through drinking
water or contaminated tea
leaves.

29. DENTAL FLUOROSIS
• It is caused by exposure to high levels of fluoride during the
first eight years of life, before the eruption of a child’s adult
teeth.

30. SYMPTOMS OF DENTAL FLUOROSIS
• Mild: The most widespread form of fluorosis
in also the least detectable. In mild cases,
hypomineralization of the tooth enamel
occurs, which simply means that the enamel
has patches or lacework of opaque, bright
white areas that don’t have the same luster as
regular enamel.
• Moderate: In some cases, the teeth develop
yellowish or brown stains, giving the teeth a
dull or even translucent appearance.

31. • Severe: The rarest and most
extreme type of fluorosis not
only has severe staining, but
also causes a number of pits or
small holes to form in the
surface of the teeth. Teeth with
severe fluorosis are usually
structurally weak and can even
be poorly formed.

32. CAUSES
• Dental fluorosis is caused by taking in too much fluoride over
a long period when the teeth are forming under the gums.
• Only children aged 8 years and younger are at risk because
this is when permanent teeth are developing; children older
than 8 years, adolescents, and adults cannot develop dental
fluorosis.

33. • Fluoride occurs naturally in water.
Natural fluoride levels above the
currently recommended range for
drinking water may increase the
risk for severe fluorosis.
• A major cause of fluorosis is the
inappropriate use of fluoride-
containing dental products such as
toothpaste and mouth rinses.
Sometimes, children enjoy the
taste of fluoridated toothpaste so
much that they swallow it instead
of spitting it out.

34. PREVENTION
• For children ages 3-6, use no more than a pea-sized amount
of fluoride toothpaste.
• Many cases of fluorosis can be prevented by keeping children
from swallowing fluoride products like toothpaste. Keep an
eye on your child’s brushing to help minimize the amount of
toothpaste that gets swallowed.
• Do not use fluoride mouth rinses for children under six
unless advised to do so by a dentist or other health
professional.

35. • Dietary Fluoride
Supplements:
• Use dietary fluoride
supplements only as
prescribed by a physician
or a dentist. Fluoride
supplements are
recommended for children
between 6 months and 16
years old living in non-
fluoridated areas and at
high risk of developing
tooth decay.

36. THANK YOU!!