Gibson Rosalind S
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.
Proc Nutr Soc. 2006 Feb;65(1):51-60. doi: 10.1079/pns2005474.
The first cases of human Zn deficiency were described in the 1960s in the Middle East. Nevertheless, it was not until 2002 that Zn deficiency was included as a major risk factor in the global burden of disease, and only in 2004 did WHO/UNICEF include Zn supplements in the treatment of acute diarrhoea. Despite this recognition Zn is still not included in the UN micronutrient priority list, an omission that will continue to hinder efforts to reduce child and maternal mortality, combat HIV/AIDS, malaria and other diseases and achieve the UN Millennium Development Goals for improved nutrition in developing countries. Reasons for this omission include a lack of awareness of the importance of Zn in human nutrition, paucity of Zn and phytate food composition values and difficulties in identifying Zn deficiency. Major factors associated with the aetiology of Zn deficiency include dietary inadequacies, disease states inducing excessive losses or impairing utilization and physiological states increasing Zn requirements. To categorize countries according to likely risk of Zn deficiency the International Zinc Nutrition Consultative Group has developed indirect indicators based on the adequacy of Zn in the national food supplies and/or prevalence of childhood growth stunting. For countries identified as at risk confirmation is required through direct measurements of dietary Zn intake and/or serum Zn in a representative sample. Finally, in at risk countries either national or targeted Zn interventions such as supplementation, fortification, dietary diversification or modification, or biofortification should be implemented, where appropriate, by incorporating them into pre-existing micronutrient intervention programmes.
人类锌缺乏的首批病例于20世纪60年代在中东地区被描述。然而，直到2002年锌缺乏才被列为全球疾病负担的主要风险因素，并且直到2004年世界卫生组织/联合国儿童基金会才将锌补充剂纳入急性腹泻的治疗。尽管有了这种认识，但锌仍未被列入联合国微量营养素优先清单，这一疏忽将继续阻碍在发展中国家降低儿童和孕产妇死亡率、抗击艾滋病毒/艾滋病、疟疾及其他疾病以及实现联合国改善营养的千年发展目标方面所做的努力。造成这种疏忽的原因包括对锌在人类营养中的重要性缺乏认识、锌和植酸食物成分值匮乏以及难以识别锌缺乏。与锌缺乏病因相关的主要因素包括饮食不足、导致过度流失或损害利用的疾病状态以及增加锌需求的生理状态。为了根据锌缺乏的可能风险对各国进行分类，国际锌营养咨询小组已根据国家食物供应中锌的充足程度和/或儿童生长发育迟缓的患病率制定了间接指标。对于被确定为有风险的国家，需要通过对代表性样本中的膳食锌摄入量和/或血清锌进行直接测量来加以确认。最后，在有风险的国家，应酌情通过将国家或有针对性的锌干预措施，如补充、强化、饮食多样化或改良，或生物强化，纳入现有的微量营养素干预计划来实施。
