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Health SA Gesondheid (Online)

On-line version ISSN 2071-9736
Print version ISSN 1025-9848

Health SA Gesondheid (Online) vol.15 n.1 Cape Town  2010




Prevalence of zinc deficiency among primary school children in a poor peri-urban informal settlement in South Africa



Folake O. SamuelI, II; Abdulkadir A. EgalI; Wilna H. Oldewage-TheronI; Carin E. NapierIII; Christine S. VenterI, IV

IInstitute of Sustainable Livelihoods, Vaal University of Technology, South Africa
IIDepartment of Human Nutrition, Faculty of Public Health, University of Ibadan, Nigeria
IIIDepartment of Food and Nutrition Consumer Sciences, Durban University of Technology, Steve Biko campus, South Africa
IVSchool of Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom campus, South Africa





This cross-sectional study assessed the risk of zinc deficiency in randomly selected children, aged between 7 and 11 years, living in a poor, peri-urban informal settlement in South Africa. Dietary intake of 149 respondents was evaluated by 24-hour recall and quantitative food frequency questionnaires. Anthropometric and biochemical indices of a subset of 113 were determined. Descriptive statistics, analysis of variance and Pearson correlations were computed using the Statistical Package for Social Sciences, version 14.0. Anthropometric data were analysed using the World Health Organization Anthro plus version 1.0.2 statistical software. Dietary data were analysed with FoodFinder® version 3. The mean age of the children was 9.0±1.1 years. Few zinc-rich sources appeared in the diet that was predominantly plant-based. Mean dietary zinc intake was 4.6±2.2 mg/day. The mean value of serum zinc was 66.4±21.5 µg/dL, with 46% of the children having values less than the 70 µg/dL cutoff. The findings indicate a high risk of zinc deficiency and suboptimal zinc status for the majority of this study population of children, possibly as a result of low consumption of food sources with high bioavailability of zinc, which invariably is a direct consequence of poverty and food insecurity.

Keywords: deficiency; diet; poverty; vulnerable; zinc; prevalence


Die doel van hierdie dwarsdeursnitstudie was die bepaling van die risiko van 'n sinktekort in 'n ewekansige steekproef van 7 tot 11 jaar-oue kinders, woonagtig in 'n arm, voorstedelike informele woonbuurt in Suid Afrika. Dieetinnames van 149 respondente is geëvalueer deur 24-uur herroep en kwantitatiewe voedselfrekwensie vraelyste. Antropometriese en biochemiese indikatore van 'n kleiner steekproef van 113 is ook bepaal. Beskrywende statistiek, analise van variansie en Pearsonkorrelasies is bepaal deur die Statistical Package for Social Sciences, uitgawe 14.0. Antropometriese data is geanaliseer deur die statistiese program, Anthro plus, uitgawe 1.0.2, van die Wêreld Gesondheid Organisasie. Dieetdata is met behulp van FoodFinder® uitgawe 3 geanaliseer. Die gemiddelde ouderdom van die kinders was 9.0±1.1 jaar. Min sinkryke voedselbronne is in die hoofsaaklik plantryke dieet waargeneem. Die gemiddelde sinkinname was 4.6±2.2 mg/dag en die gemiddelde serumsinkwaarde was 66.4±21.5 µg/dL, met 46% van die kinders se waardes onder die 70 µg/dL afsnypunt. Die bevindings dui op 'n hoë risiko vir sinktekort en suboptimale sinkstatus vir die meerderheid van hierdie kinders, moontlik as gevolg van die swak inname van voedselbronne met hoë biobeskikbare sink, wat gewoonlik 'n direkte gevolg van armoede en huishoudelike voedsel insekuriteit is.



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Adams, C.L., Hambidge, M., Raboy, V., Dorsch, J.A., Sian, L., Jamie L. et al., 2002, 'Zinc absorption from a low-phytic acid maize', American Journal of Clinical Nutrition 76(3), 556-559.         [ Links ]

Black, M.M., 1998, 'Zinc deficiency and child development', American Journal of Clinical Nutrition 68, 464S-469S.         [ Links ]

Black, M.M., 2003, 'Micronutrient deficiencies and cognitive functioning', Journal of Nutrition 133, 3927S-3931S.         [ Links ]

Brown, K.H., Wuehler, S.E. & Peerson, J.M., 2001, 'The importance of zinc in human nutrition and estimation of the global prevalence of zinc deficiency', Food and Nutrition Bulletin 22(2), 113-125.         [ Links ]

Burtis, C.A. & Ashwood, E.R. (eds.), 1999, Tietz textbook of clinical chemistry, 3rd edn., W.B. Saunders & Company, Philadelphia.         [ Links ]

Caulfield, L. & Black, R.E. 2004, 'Zinc deficiency', in M. Ezzati, A.D. Lopez, A. Rodgers & C.J.L. Murray (eds.), Comparative quantification of health risks: Global and regional burden of disease attributable to selected major risk factors vol. 1, pp. 257-279, World Health Organization, Geneva.         [ Links ]

Cavan, K.R., Gibson, R.S., Grazioso, C.F., Isalgue, A.M., Ruz, M. & Solomons, N.W., 1993, 'Growth and body composition of periurban Guatemalan children in relation to zinc status: a cross-sectional study', American Journal of Clinical Nutrition 57, 344-352.         [ Links ]

Charlton, K.E., Bourne, L.T., Steyn, K. & Laubscher, J.A., 2001, 'Poor nutritional status in older black South Africans', Asian Pacific Journal of Clinical Nutrition 10(1), 31-38.         [ Links ]

Dannhauser, A., Bester, C.J., Joubert, G., Badenhorst, P.N., Slabber, M., Badenhorst, A.M. et al., 2000, 'Nutritional status of preschool children in informal settlement areas near Bloemfontein, South Africa', Public Health Nutrition 3(3), 303-312.         [ Links ]

Department of Health, 2002, Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No. 54 of 1972), 'Regulations relating to the fortification of foodstuffs', viewed 8 November 2006, from        [ Links ]

Engelbrecht, K. & Du Rand, P., 2001, 'Status of frail elderly black people in informal settlements', South African Continued Medical Education Monthly 18(10), 828-833.         [ Links ]

Faber, M., Jogessar, V.B. & Benadé, A.J.S., 2001, 'Nutritional status and dietary intakes of children aged 2-5 years and their caregivers in a rural South African community', International Journal of Food Science and Nutrition 52(5), 401-411.         [ Links ]

Gibson, R.S., 1994, 'Zinc nutrition in developing countries', Nutrition Research Reviews 7, 151-173.         [ Links ]

Gibson, R.S., 2005, Principles of nutritional assessment, 2nd edn., Oxford University Press, New York.         [ Links ]

Gibson, R.S., 2006 'Zinc: The missing link in combating micronutrient malnutrition in developing countries', Proceedings of the Nutrition Society 65(1), 51-60.         [ Links ]

Gibson, R.S. & Ferguson, E.L., 2000, 'An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries', viewed 12 August 2007, from        [ Links ]

Gibson, R.S., Manger, M.S., Krittaphol, W., Pongcharoen, T., Gowachirapant, S., Bailey, K.B. et al., 2007, 'Does zinc deficiency play a role in stunting among primary school children in NE Thailand?', British Journal of Nutrition 97(1), 167-175.         [ Links ]

Guansheng, M., Ying, J., Jianhua, P. & Frans, K., 2005, 'Phytate, calcium, iron and zinc contents and their molar ratios in foods commonly consumed in China', Journal of Agricultural and Food Chemistry 53, 10285-10290.         [ Links ]

Hotz, C. & Brown, K.H., 2004, 'Assessment of the risk of zinc deficiency in populations and options for its control', Food and Nutrition Bulletin 25(1), S94-S200.         [ Links ]

Hotz, C. & Gibson, R., 2001, 'Assessment of home-based processing methods to reduce the phytate content and phytate/zinc molar ratio of white maize (Zea mays)', Journal of Agricultural and Food Chemistry 49, 692-698.         [ Links ]

Hugo-Hamman, C.T., Kibel, M.A., Michie, C.A. & Yach, D., 1987, 'Nutrition status of pre-school children in a Cape Town township', South African Medical Journal 72, 353-355.         [ Links ]

International Zinc Nutrition Consultative Group (IZiNCG), 2007, 'Determining the risk of zinc deficiency: Assessment of dietary zinc intake', IZiNCG Technical Brief 3, 1-4.         [ Links ]

Institute of Medicine, 2003, Dietary reference intakes, food and nutrition board, National Academy Press, Washington D.C.         [ Links ]

Labadarios, D., Steyn, N.P., Maunder, E., MacIntyre, U., Gericke, G., Swart, R. et al., 2005, 'The National Food Consumption Survey (NFCS), South Africa, 1999', Public Health Nutrition 8(5), 533-543.         [ Links ]

Labadarios, D., Swart, R., Maunder, E.M.W., Kruger, H.S., Gericke, G.J., Kuzawayo, P.M.M. et al., 2008, 'Executive summary of the National Food Consumption Survey Fortification Baseline (NFCS-FB-I), South Africa, 2005,' South African Journal of Clinical Nutrition 21(3, suppl. 2), 245-300.         [ Links ]

Langenhoven, M., Kruger, M., Gouws, E. & Faber, M., 1991, South African food composition tables, 3rd edn., Medical Research Council, Cape Town.         [ Links ]

Lestienne, I., Icard-Verniere, C., Mouquet, C., Picq, C. & Treche, S., 2005, 'Effects of soaking whole cereal and legume seeds on iron, zinc and phytate contents', Food Chemistry 89, 421-425.         [ Links ]

MacIntyre, U.E., Venter, C.S. & Vorster, H.H., 2001a, 'A culture-sensitive quantitative food frequency questionnaire used in an African population: 1. Development and reproducibility', Public Health Nutrition 4(1), 53-62.         [ Links ]

MacIntyre, U.E., Venter, C.S. & Vorster, H.H., 2001b, 'A culture-sensitive quantitative food frequency questionnaire used in an African population: 2. Relative validation by 7-day weighed records and biomarkers', Public Health Nutrition 4(1), 63-71.         [ Links ]

MacIntyre, U.E., Venter, C.S., Vorster, H.H. & Steyn, H.S., 2001c, 'A combination of statistical methods for the analysis of the relative validation data of the quantitative food frequency questionnaire used in the THUSA study', Public Health Nutrition 4(1), 45-51.         [ Links ]

Mahmoodi, M.R. & Kimiagar, S.M., 2001, 'Prevalence of zinc deficiency in junior high school students of Tehran City', Biological Trace Element Research 81(2), 93-103.         [ Links ]

Manary, M,J., Hotz, C., Krebs, N.F., Gibson, R.S., Westcott, J.E. & Broadhead, R.L., 2002, 'Zinc homeostasis in Malawian children consuming a high-phytate, maize-based diet', American Journal of Clinical Nutrition 75, 1057-1061.         [ Links ]

Mazariegos, M., Hambidge, K.M., Krebs, N.F., Westcott, J.E., Lei, S., Grunwald, G.K. et al., 2006, 'Zinc absorption in Guatemalan schoolchildren fed normal or low-phytate maize', American Journal of Clinical Nutrition 83, 59-64.         [ Links ]

McIlrath, L. & Slabbert, T., 2003, 'Sedibeng Economic Regeneration Summit', Sedibeng Municipality, Vanderbijlpark.         [ Links ]

Oelofse, A., Van Raaij, J.M.A., Benadé, A.J.S., Dhansay, M.A., Tolboom, J.J.M. & Hautvast, J.G.A.J., 2002, 'Disadvantaged black and coloured infants in two urban communities in the Western Cape, South Africa differ in micronutrient status', Public Health Nutrition 5(2), 290-294.         [ Links ]

Oldewage-Theron, W.H., Dicks, E.G., Napier, C.E. & Rutengwe, R., 2004, 'A community-based integrated nutrition research programme to alleviate poverty: Baseline survey', Public Health 119, 312-320.         [ Links ]

Oldewage-Theron, W.H., Dicks, E.G., Napier, C.E. & Rutengwe, R., 2005, 'Situation analysis of an informal settlement in the Vaal Triangle', Development Sothern Africa 22(1), 13-26.         [ Links ]

Oldewage-Theron, W.H., Dicks, E.G., & Napier, C.E., 2006, 'Poverty, household food insecurity and nutrition: Coping strategies in an informal settlement in the Vaal Triangle, South Africa', Public Health 120, 795-804.         [ Links ]

Pisa, P., 2006, Determination of phytate, iron, calcium, zinc and the phytate to mineral molar ratios in maize meal from six South African provinces, BSc (Hons) dissertation, North-West University, Potchefstroom.         [ Links ]

Prasad, A.S., 2007, 'Zinc: Mechanisms of host defense', Journal of Nutrition 137, 1345-1349.         [ Links ]

Sandstead, H.H., 2000, 'Causes of iron and zinc deficiencies and their effects on the brain', Journal of Nutrition 130, 347S-349S.         [ Links ]

Shankar, A.H., 2000, 'Nutritional modulation of malaria morbidity and mortality', Journal of Infectious Diseases 182(suppl.), S37-53.         [ Links ]

Smith, J.C., Butrimovitz, G.P. & Purdy, W.C., 1979, 'Direct measurement of zinc by atomic absorption spectroscopy', Clinical Chemistry 25, 1487-1491.         [ Links ]

The Survey System, 'Sample size calculator', viewed 22 July 2008, from        [ Links ]

Thurlow, B.A., Winichagoon, P., Pongcharoen, T., Gowachirapant, S., Boonpraderm, A., Manger, M.S. et al., 2006, 'Risk of zinc, iodine and other micronutrient deficiencies among school children in North-East Thailand', European Journal of Clinical Nutrition 60, 623-632.         [ Links ]

Wheeler, E.L. & Ferrel, R.E., 1971, 'A method for phytic acid determination in wheat and wheat fractions', Cereal Chemistry 48, 312-320.         [ Links ]

World Health Organization (WHO), 'Anthro plus version 1.0.2.', viewed 22 March 2009, from        [ Links ]



Wilna Oldewage-Theron
Institute of Sustainable Livelihoods, Vaal University of Technology
Private Bag X021
Vanderbijlpark 1900
South Africa

Received: 03 Apr. 2009
Accepted: 04 Nov. 2009
Published: 11 May 2010

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