2022 brought new publications from the Zinc in Powders Trial, the initiation of the Multiply-Fortified Salt study in India, and the inclusion of zinc fortification in the new WHO Wheat Flour Fortification Guideline. We have summarized achievements and publications in 2022 below.

Nutrients special issue: Zinc Supplementation and Fortification: The Unfinished Agenda

This special issue of Nutrients, edited by IZiNCG’s Dr Christine McDonald and Dr Robert Black, highlights the results of recent research that has aimed to fill gaps in the current evidence base around zinc supplementation, fortification and biofortification as strategies to reduce the global burden of zinc deficiency. The special issue is now complete with 10 articles.

Publications from the Zinc in Powders Trial

Different Doses, Forms, and Frequencies of Zinc Supplementation for the Prevention of Diarrhea and Promotion of Linear Growth among Young Bangladeshi Children: A Six-Arm, Randomized, Community-Based Efficacy Trial

Effects of Different Doses, Forms, and Frequencies of Zinc Supplementation on Biomarkers of Iron and Zinc Status among Young Children in Dhaka, Bangladesh

Exchangeable Zinc Pool Size Reflects Form of Zinc Supplementation in Young Children and Is Not Associated with Markers of Inflammation

Zinc Supplementation with or without Additional Micronutrients Does Not Affect Peripheral Blood Gene Expression or Serum Cytokine Level in Bangladeshi Children

The Multiply-Fortified Salt study

Trial of Multiply-Fortified Salt is now underway in Punjab, India!

Participant enrollment was initiated in October 2022, and enrolled women of reproductive age and a subgroup of preschool children are being randomized to receive one of the following three interventions:1) salt fortified with iodine, zinc, folic acid, vitamin B12 and iron in the form of encapsulated ferrous fumarate; 2) salt fortified with iodine, zinc, folic acid, vitamin B12 and iron in the form of ferric pyrophosphate plus EDTA; and 3) iodized salt.

The study is funded by the Bill & Melinda Gates Foundation and the Thrasher Research Fund.

Study protocol

Quintuply-fortified salt for the improvement of micronutrient status among women of reproductive age and preschool-aged children in Punjab, India: protocol for a randomized, controlled, community-based trial

Abstracts

Comparison of Methods for Estimating Discretionary Salt Intake in Field Settings Our post-doctoral fellow Dr Yvonne Goh received an award for this abstract as part of Emerging Leaders in Nutrition Science Abstract Recognition Program.

Women in Punjab have low dietary intakes of iron, zinc, folate, and vitamin B12 and a high prevalence of micronutrient deficiencies: Implications for the design of a trial of multiply-fortified salt

A mixed-methods study to explore salt preferences, procurement, and utilization practices among local households to inform a trial of multiply-fortified salt in Punjab, India

Zinc Fortification Task Force

Removal of policy barrier for zinc fortification

IZiNCG’s Zinc Fortification Task Force’s systematic review of zinc fortification contributed to the new WHO Guideline on Fortification of Wheat Flour with Vitamins and Minerals as a Public Health Strategy. The new guideline now includes a conditional recommendation for the fortification of wheat flour with zinc for improving plasma/serum zinc status of populations.

There are two publications in the pipeline from this year’s task force activities funded by the International Zinc Association:

1. Estimating the cost and cost-effectiveness of adding zinc to, and improving the performance of, Burkina Faso’s mandatory wheat flour fortification program.

2. An updated analysis of the country-specific prevalence of inadequate zinc intake globally, and the potential impact of scaling up zinc fortification programs on the risk of inadequate zinc intake in countries where zinc deficiency is a public health problem.

Systematic Review on Zinc Tolerable Upper Levels

Reconsidering the Tolerable Upper Levels of Zinc Intake among Infants and Young Children: A Systematic Review of the Available Evidence

IZiNCG blogs

The Zinc in Powders Trial: More than a “null finding”

Is there a new biomarker on the block when it comes to measuring zinc status? …Yes & no!

New estimate of the global prevalence of hidden hunger - what does it say about zinc?

Best wishes from Christine, Mari and Shar

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