Primary prevention

Data on primary prevention of zinc deficiency are limited; however, oral supplementation may be considered for people at high risk of zinc deficiency (older people, people with chronic disease, vegetarians) before zinc stores are depleted.[35]​

Fortification of foods with zinc may improve the serum zinc status of populations if zinc is the only micronutrient. Combination with other micronutrients may make little or no difference to the serum zinc status.[36] Importantly, the effects of fortification of foods with zinc on outcomes including zinc deficiency, children's growth, cognition, work capacity of adults, or on haematological indicators are unknown and further research on the effect of zinc fortification on these outcomes is needed.[36]

There is some evidence that supplementation with zinc may benefit child growth, particularly in areas where deficiency is common.[37][38] [ Cochrane Clinical Answers logo ] [Evidence A]​​​​​​​​ However, antenatal supplementation with multiple micronutrients did not have an impact on zinc status in a study that compared zinc levels at baseline and at 32 weeks of pregnancy.[39] There is insufficient evidence to support the use of zinc supplementation to improve pregnancy or neonatal outcomes. Finding ways to improve women's overall nutritional status, particularly in low‐income areas, will do more to improve the health of mothers and babies than supplementing pregnant women with zinc alone.[40] [ Cochrane Clinical Answers logo ] ​​​ However, a 2020 systematic review found a positive impact of zinc supplementation on growth parameters such as weight for age and weight for length in infants less than 6 months of age.[41] [ Cochrane Clinical Answers logo ] ​ ​Prioritising zinc-rich foods (e.g., meats, beans, zinc-fortified infant cereals) from age 6 months onwards is important to support adequate zinc status.[42] Additionally, routine supplementation in at-risk children appears to have beneficial effects on growth and mood disorders.[43][44]​​ In low-income countries, zinc supplementation in children aged 2 months to 59 months is associated with a reduction in the incidence of pneumonia and diarrhoea.[45][46]​ Enteral supplementation of zinc in preterm babies is likely to improve weight gain, height, and possibly mortality in the short-term;​ however, the effect of this on long-term development and growth is unclear.[47]

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