Chapter 2: Assessment of the Risk of Zinc Deficiency in Populations

Brown K.H. , Peerson J.M. , Rivera J. , Allen L.H. Effect of supplemental zinc on the growth and serum zinc concentrations of prepubertal children: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2002; 75: 1062–71.

World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series, No. 854. Geneva: World Health Organization, 1995.

World Health Organization. WHO global database on child growth and malnutrition. Geneva: World Health Organization, 1997.

Brown K.H. , Wuehler S.E. , Peerson J.M. The importance of zinc in human nutrition and estimation of the global prevalence of zinc deficiency. Food Nutr Bull 2001; 22: 113–25.

World Health Organization (WHO), Food and Agriculture Organization (FAO), International Atomic Energy Association (IAEA). Trace elements in human health and nutrition. Geneva: World Health Organization, 1996.

Food and Nutrition Board, Institute of Medicine. Dietary reference intakes: applications in dietary assessment. Washington, DC: National Academy Press, 2001.

US International Trade Commission (USITC). (1998) Industry and trade summary. Milled grains, malts, and starches. USITC publication no. 3095. Washington, DC: USITC, 1998. (Accessed via ftp//ftp.usitc.gov/pub/reports/studies/PUB3095, September 1999).

Gregory J. , Lowe S. , Bates C.J. , Prentice A. , Jackson L.V. , Smithers G. , Wenlock R. , Farron M. National diet and nutrition survey: young people aged 4 to 18 years. Volume 1: report of the diet and nutrition survey. London: The Stationery Office, 2000.

De Maeyer E.M. Preventing and controlling iron-deficiency anaemia through primary health care: a guide for health administrators and programme managers. Geneva: World Health Organization, 1989.

Folin M. , Contiero E. , Vaselli G.M. Zinc content of normal human serum and its correlation with some hematic parameters. BioMetals 1994; 7: 75–9.

de Jong N. , Romano A.B. , Gibson R.S. Zinc and iron status during pregnancy of Filipino women. Asia Pac J Clin Nutr 2002; 11: 186–93.

Rivera Dommarco J. , Shamah Levy T. , Villalpando Hernández S. , González de Cossío T. , Hernández Prado B. , Sepúlveda J. Encuesta Nacional de Nutrición 1999. Estado nutricio de niños y mujeres en México. Cuernavaca, México: Instituto Nacional de Salud Pública, 2001.

Gibson R.S. , Huddle J.M. Suboptimal zinc status in pregnant Malawian women: its association with low intakes of poorly available zinc, frequent reproductive cycling, and malaria. Am J Clin Nutr 1998; 67: 702–9.

Thu B.D. , Schultink W. , Dillon D. , Gross R. , Leswara N.D. , Khoi H.H. Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children. Am J Clin Nutr 1999; 69: 80–6.

World Health Organization (WHO). Iron-deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva: World Health Organization, 2001.

National Research Council and Coordinating Committee on Evaluation of Food Consumption Surveys, Subcommittee on Criteria for Dietary Evaluation. Nutrient adequacy: assessment using food consumption surveys. Washington, DC: National Academy Press, 1986.

Beaton G.H. , Milner J. , Corey P. , McGuire V. , Cousins M. , Stewart E. , de Ramos M. , Hewitt D. , Grambsch P.V. , Kassim N. , Little J.A. Sources of variance in 24-hour dietary recall data: implications for nutrition study design and interpretation. Am J Clin Nutr 1979; 32: 2546–9.

Willett W. Nature of variation in diet. In: Willett W ed. Nutrition epidemiology. New York: Oxford University Press, 1990; 34–51.

Cameron M.E. , van Staveren W.A. Manual on methodology for food consumption studies. Oxford: Oxford University Press, 1988.

Gibson R.S. Principles of nutritional assessment. New York: Oxford University Press, 1990.

Ferguson E.L. , Gibson R.S. , Opare-Obisaw C. The relative validity of the repeated 24 h recall for estimating energy and selected nutrient intakes of rural Ghanaian children. Eur J Clin Nutr 1994; 48: 241–52.

Gibson R.S. Nutritional assessment: a laboratory manual. New York: Oxford University Press, 1993.

Rutishauser H.E. Food intake studies in pre-school children in developing countries: problems of measurement and evaluation. Hum Nutr 1973; 27: 253–61.

Ferguson E.L. , Gadowsky S.L. , Huddle J.M. , Cullinan T.R. , Lehrfeld J. , Gibson R.S. An interactive 24-h recall technique for assessing the adequacy of trace mineral intakes of rural Malawian women: its advantages and limitations. Eur J Clin Nutr 1995; 49: 565–78.

Gibson R.S. Sources of error and variability in dietary assessment methods: a review. J Can Diet Assoc 1987; 48: 150–5.

Gibson R.S. , Ferguson E.L. An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries. Washington, DC: ILSI Press, 1999.

Sillanpaa M. Micronutrients and the nutrient status of soils: a global study. FAO Soils Bulletin 48. Rome: Food and Agriculture Organization of the United Nations, 1982.

Horwitz W. Official methods of analysis of the AOAC, 17th edition, 1st revision. Arlington, VA: Association of Official Analytical Chemists, 2002.

Aurand L.W. , Woods A.E. , Wells M.R. Food composition and anlaysis. New York: Van Nostrand Reinhold, 1987.

Gibson R.S. , Ferguson E.L. Assessment of dietary zinc in a population. Am J Clin Nutr 1998; 68: 430S–4S.

Lehrfeld J. High-performance liquid chromatography analysis of phytic acid of a pH-stable, macroporous polymer column. Cereal Chemists 1989; 66: 510–5.

Lönnerdal B. , Sandberg A.S. , Sandstrom B. , Kunz C. Inhibitory effects of phytic acid and other inositol phosphates on zinc and calcium absorption in suckling rats. J Nutr 1989; 119: 211–4.

Cheryan M. Phytic acid interactions in food systems. Urbana, IL: Department of Food Science, University of Illinois, 1980.

Dodd K.W. A technical guide to C-SIDE, software for intake distributions estimation. Technical report 96-TR32. Dietary assessment research series report 9. Ames, IA: Center for Agricultural and Rural Development, Iowa State University, 1996.

Nusser S.M. , Carriquiry A.L. , Dodd K.W. , Fuller W.A. A semiparametric transformation approach to estimating usual daily intake distributions. J Am Stat Assoc 1996; 91: 1440–9.

Beaton G.H. Criteria of an adequate diet. In: Shils M.E. , Olson J.A. , Shike M eds. Modern nutrition in health and disease, 8th ed. Philadelphia: Lea & Febiger, 1994; 1491–505.

World Health Organization (WHO), Food and Agriculture Organization (FAO), International Atomic Energy Association (IAEA). Trace elements in human health and nutrition, 2nd ed. Geneva: World Health Organization, 2002.

Brown K.H. Effect of infections on plasma zinc concentration and implications for zinc status assessment in low-income countries. Am J Clin Nutr 1998; 68: 425S–9S.

King J.C. Assessment of zinc status. J Nutr 1990; 120: 1474–9.

Gibson R.S. , Heath A.L.M. , Limbaga M.L.S. , Prosser N. , Skeaff C.M. Are changes in food consumption patterns associated with lower biochemical zinc status among women from Dunedin, New Zealand? Br J Nutr 2001; 86: 71–80.

Donovan U.M. , Gibson R.S. Iron and zinc status of young women aged 14 to 19 years consuming vegetarian and omnivorous diets. J Am Coll Nutr 1995; 14: 463–72.

Hunt J.R. , Matthys L.A. , Johnson L.K. Zinc absorption, mineral balance, and blood lipids in women consuming controlled lactoovovegetarian and omnivorous diets for 8 wk. Am J Clin Nutr 1998; 67: 421–30.

Srikumar T.S. , Johansson G.K. , Ockerman P.A. , Gustafsson J.A. , Akesson B. Trace element status in healthy subjects switching from a mixed to a lactovegetarian diet for 12 mo. Am J Clin Nutr 1992; 55: 885–90.

Brown K.H. , Peerson J.M. , Allen L.H. Effect of zinc supplementation on children's growth: a meta-analysis of intervention trials. Bibl Nutr Dieta 1998; (54): 76–83.

Bahl R. , Bhandari N. , Hambidge K.M. , Bahn M.K. Plasma zinc as a predictor of diarrheal and respiratory morbidity in children in an urban slum setting. Am J Clin Nutr 1998; 68: 414S–7S.

Hambidge K.M. , Goodall M.J. , Stall C. , Pritts J. Postprandial and daily changes in plasma zinc. J Trace Elem Electrolytes Health Dis 1989; 3: 55–7.

Couturier E. , van Onderbergen A. , Bosson D. , Neve J. Circadian variations in plasma zinc and cortisol in man. J Trace Elem Electrolytes Health Dis 1988; 2: 245–9.

Goode H.F. , Robertson D.A. , Kelleher J. , Walker B.E. Effect of fasting, self-selected and isocaloric glucose and fat meals and intravenous feeding on plasma zinc concentrations. Ann Clin Biochem 1991; 28: 442–5.

Guillard O. , Piriou A. , Gombert J. , Reiss D. Diurnal variations of zinc, copper and magnesium in the serum of normal fasting adults. Biomedicine 1979; 31: 193–4.

Singh A. , Smoak B.L. , Patterson K.Y. , LeMay L.G. , Veillon C. , Deuster P.A. Biochemical indices of selected trace minerals in men: effect of stress. Am J Clin Nutr 1991; 53: 126–31.

Schroeder J.J. , Cousins R.J. Interleukin 6 regulates metallothionein gene experession and zinc metabolism in hepatocyte monolayer cultures. Proc Natl Acad Sci U S A 1990; 87: 3137–41.

Rofe A.M. , Philcox J.C. , Coyle P. Trace metal, acute phase and metabolic response to endotoxin in metallothionein-null mice. Biochem J 1996; 314: 793–7.

Prasad A.S. Laboratory diagnosis of zinc deficiency. J Am Coll Nutr 1985; 4: 591–8.

Solomons N.W. On the assessment of zinc and copper nutriture in man. Am J Clin Nutr 1979; 32: 856–71.

Halsted J.A. , Hackley B.M. , Smith J.C. Jr. . Plasma-zinc and copper in pregnancy and after oral contraceptives. Lancet 1968; 2: 278–9.

Hobisch-Hagen P. , Mortl M. , Schobersberger W. Hemostatic disorders in pregnancy and the peripartum period. Acta Anaesthesiol Scand Suppl 1997; 111: 216–7.

Gunter E.W. , Turner W.E. , Neese J.W. , Bayse D.D. Laboratory procedures used by the Clinical Chemistry Division, Centers for Disease Control, for the Second Health and Nutrition Examination Survey (HANES II) 1976–1980. Revised edition. Atlanta, GA: US Department of Health and Human Services, 1985.

Pilch S.M. , Senti F.R. Assessment of the zinc nutritional status of the US population based on data collected in the second National Health and Nutrition Examination Survey, 1976–1980. Bethesda, MD: Life Sciences Research Office, Federation of American Societies for Experimental Biology, 1984.

Grandjean P. , Nielsen G.D. , Jorgensen P.J. , Horder M. Reference intervals for trace elements in blood: significance of risk factors. Scand J Clin Lab Invest 1992; 52: 321–37.

Lockitch G. , Halstead A.C. , Wadsworth O.L. , Quigley G. , Reston L. , Jacobson B. Age- and sex-specific pediatric reference intervals and correlations for zinc, copper, selenium, iron, vitamins A and E, and related proteins. Clin Chem 1988; 34: 1625–8.

Briefel R.R. , Bialostosky K. , Kennedy-Stephenson J. , McDowell M.A. , Ervin R.B. , Wright J.D. Zinc intake of the U.S. population: findings from the third National Health and Nutrition Examination Survey, 1988–1994. J Nutr 2000; 130: 1367S–73S.

Karr M. , Mira M. , Causer J. , Earl J. , Alperstein G. , Wood F. , Fett M.J. , Coakley J. Age-specific reference intervals for plasma vitamins A, E and beta-carotene and for serum zinc, retinol-binding protein and prealbumin for Sydney children aged 9–62 months. Int J Vitam Nutr Res 1997; 67: 432–6.

Butrimovitz G.P. , Purdy W.C. The determination of zinc in blood plasma by atomic absorption spectrometry. Anal Chim Acta 1977; 94: 63–73.

Iyengar G.V. Reevaluation of the trace element content in reference man. Radiat Phys Chem 1998; 51: 545–60.

Danford D.E. , Chandler D.W. Zinc estimation in clinical practice: effect of anticoagulant choice on analyzed values [abstract]. Fed Proc 1983; 42: 3102.

Helman E.Z. , Wallick D.K. , Reingold I.M. Vacutainer contamination in trace-elements studies. Clin Chem 1971; 17: 61–2.

Parrish R.F. , Fair W.R. Selective binding of zinc ions to heparin rather than to other glycosaminoglycans. Biochem J 1981; 193: 407–10.

Moody J.R. NBS clean laboratories for trace element analysis. Anal Chem 1982; 54: 1358–76A.

Kelson J.R. , Shamberger R.J. Methods compared for determining zinc in serum by flame atomic absorption spectroscopy. Clin Chem 1978; 24: 240–4.

English J.L. , Hambidge K.M. Plasma and serum zinc concentrations: effect of time between collection and separation. Clin Chim Acta 1988; 175: 211–5.

Kasperek K. , Kiem J. , Iyengar G.V. , Feinendegen L.E. Concentration differences between serum and plasma of the elements cobalt, iron, mercury, rubidium, selenium and zinc determined by neutron activation analysis. Sci Total Environ 1981; 17: 133–43.

Tamura T. , Johnston K.E. , Freeberg L.E. , Perkins L.L. , Goldenberg R.L. Refrigeration of blood samples prior to separation is essential for the accurate determination of plasma or serum zinc concentrations. Biol Trace Elem Res 1994; 41: 165–73.

Pineau A. , Guillard O. , Chappuis P. , Arnaud J. , Zawislak R. Sampling conditions for biological fluids for trace elements monitoring in hospital patients: a critical approach. Crit Rev Clin Lab Sci 1993; 30: 203–22.

Foley B. , Johnson S.A. , Hackley B. , Smith J.C. Jr. , Halsted J.A. Zinc content of human platelets. Proc Soc Exp Biol Med 1968; 128: 265–9.

Vellion C. , Valee B.L. Atomic spectroscopy in metal analysis of enzymes and other biological material. In: Fleischer S. , Pavker L eds. Methods in enzymology. New York: Academic Press, 1979.

Herber R.F.M. , Stoeppler M. Trace element analysis in biological specimens: techniques and instrumentation in analytical chemistry, volume 15. Amsterdam: Elsevier, 1994.

Hackley B.M. , Smith J.C. , Halsted J.A. A simplified method for plasma zinc determination by atomic absorption spectrophotometry. Clin Chem 1968; 14: 1–5.

Peaston R.T. Determination of copper and zinc in plasma and urine. Med Lab Technol 1973; 30: 249.

Smith J.C. Jr. , Butrimovitz G.P. , Purdy W.C. Direct measurement of zinc in plasma by atomic absorption spectroscopy. Clin Chem 1979; 25: 1487–91.

Sazawal S. , Black R.E. , Jalla S. , Mazumdar S. , Sinha A. , Bhan M.K. Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children: a double-blind, controlled trial. Pediatrics 1998; 102: 1–5.

Cavan K.R. , Gibson R.S. , Grazioso C.F. , Isalgue A.M. , Ruz M. , Solomons N.W. Growth and body composition of periurban Guatemalan children in relation to zinc status: a cross-sectional study. Am J Clin Nutr 1993; 57: 334–43.

Cavan K.R. , Gibson R.S. , Grazioso C.F. , Isalgue A.M. , Ruz M. , Solomons N.W. Growth and body composition of periurban Guatemalan children in relation to zinc status: a longitudinal zinc intervention trial. Am J Clin Nutr 1993; 57: 344–52.

Gibson R.S. , DeWolfe M.S. The zinc, copper, manganese, vanadium, and iodine content of hair from 38 Canadian neonates. Pediatr Res 1979; 13: 959–62.

Hambidge K.M. , Hambidge C. , Jacobs M. , Baum J.D. Low levels of zinc in hair, anorexia, poor growth, and hypogeusia in children. Pediatr Res 1972; 6: 868–74.

Paschal D.C. , DiPietro E.S. , Phillips D.L. , Gunter E.W. Age dependence of metals in hair in a selected U.S. population. Environ Res 1989; 48: 17–28.

DeAntonio S.M. , Katz S.A. , Scheiner D.M. , Wood J.D. Anatomically-related variations in trace-metal concentrations in hair. Clin Chem 1982; 28: 2411–3.

Smit Vanderkooy P.D. , Gibson R.S. Food consumption patterns of Canadian preschool children in relation to zinc and growth status. Am J Clin Nutr 1987; 45: 609–16.

Taylor A. Usefulness of measurements of trace elements in hair. Ann Clin Biochem 1986; 23: 364–78.

Nishi Y. Zinc and growth. J Am Coll Nutr 1996; 15: 340–4.

Gibson R.S. , Ferguson E.F. , Vanderkooy P.D. , MacDonald A.C. Seasonal variations in hair zinc concentrations in Canadian and African children. Sci Total Environ 1989; 84: 291–8.

Buzina R. , Jusic M. , Sapunar J. , Milanovic N. Zinc nutrition and taste acuity in school children with impaired growth. Am J Clin Nutr 1980; 33: 2262–7.

Chen X.C. , Yin T.A. , He J.S. , Ma Q.Y. , Han Zm , Li L.X. Low levels of zinc in hair and blood, pica, anorexia, and poor growth in Chinese preschool children. Am J Clin Nutr 1985; 43: 694–700.

Castillo-Duran C. , Heresi G. , Fisberg M. , Uauy R. Controlled trial of zinc supplementation during recovery from malnutrition: effects on growth and immune function. Am J Clin Nutr 1987; 45: 602–8.

Gibson R.S. , Vanderkooy P.D. , MacDonald A.C. , Goldman A. , Ryan B.A. , Berry M. A growth-limiting, mild zinc-deficiency syndrome in some southern Ontario boys with low height percentiles. Am J Clin Nutr 1989; 49: 1266–73.

Ferguson E.L. , Gibson R.S. , Opare-Obisaw C. , Ounpuu S. , Thompson L.U. , Lehrfeld J. The zinc nutriture of preschool children living in two African countries. J Nutr 1993; 123: 1487–96.

Ruz M. , Castillo-Duran C. , Lara X. , Codoceo J. , Rebolledo A. , Atalah E. A 14-mo zinc-supplementation trial in apparently healthy Chilean preschool children. Am J Clin Nutr 1997; 66: 1406–13.

Gibson R.S. , Heath A.L. , Prosser N. , Parnell W. , Donovan U.M. , Green T. , McLaughlin K.E. , O'Connor D.L. , Bettger W. , Skeaff C.M. Are young women with low iron stores at risk of zinc as well as iron deficiency? In: Roussel A.M. , Anderson R.A. , Favier A eds. Trace elements in man and animals 10. New York: Kluwer Academic/Plenum Press, 2000; 323–8.

Gibson R.S. , Smit Vanderkooy P.D. , Thompson L. Dietary phytate x calcium/zinc millimolar ratios and zinc nutriture in some Ontario preschool children. Biol Trace Elem Res 1991; 30: 87–94.

Ferguson E.L. , Gibson R.S. , Thompson L.U. , Ounpuu S. Dietary calcium, phytate, and zinc intakes and the calcium, phytate, and zinc molar ratios of the diets of a selected group of East African children. Am J Clin Nutr 1989; 50: 1450–6.

Erten J. , Arcasoy A. , Cavdar A.O. , Cin S. Hair zinc levels in healthy and malnourished children. Am J Clin Nutr 1978; 31: 1172–4.

Bradfield R.B. , Hambidge K.M. Problems with hair zinc as an indicator of body zinc status. Lancet 1980; 1: 363.

McKenzie J.M. Alteration of the zinc and copper concentration of hair. Am J Clin Nutr 1979; 31: 470–6.

Harrison W.W. , Yurachek J.P. , Benson C.A. The determination of trace elements in human hair by atomic absorption spectroscopy. Clin Chim Acta 1969; 23: 83–91.

Cao J. , Cousins R.J. Metallothionein mRNA in monocytes and peripheral blood mononuclear cells and in cells from dried blood spots increases after zinc supplementation of men. J Nutr 2000; 130: 2180–7.

Sullivan V.K. , Burnett F.R. , Cousins R.J. Metallothionein expression is increased in monocytes and erythrocytes of young men during zinc supplementation. J Nutr 1998; 128: 707–13.

King J.C. , Shames D.M. , Lowe N.M. , Woodhouse L.R. , Sutherland B. , Abrams S.A. , Turnlund J.R. , Jackson M.J. Effect of acute zinc depletion on zinc homeostasis and plasma zinc kinetics in men. Am J Clin Nutr 2001; 74: 116–24.

Lowe N.M. , Shames D.M. , Woodhouse L.R. , Matel J.S. , Roehl R. , Saccomani M.P. , Toffolo G. , Cobelli C. , King J.C. A compartmental model of zinc metabolism in healthy women using oral and intravenous stable isotope tracers. Am J Clin Nutr 1997; 65: 1810–9.

Miller L.V. , Hambidge K.M. , Naake V.L. , Hong Z. , Westcott J.L. , Fennessey P.V. Size of the zinc pools that exchange rapidly with plasma zinc in humans: alternative techniques for measuring and relation to dietary zinc intake. J Nutr 1994; 124: 268–76.

Wastney M.E. , Aamodt R.L. , Rumble W.F. , Henkin R.I. Kinetic analysis of zinc metabolism and its regulation in normal humans. Am J Physiol 1986; 251: R398–408.

Golden M.H.N. The diagnosis of zinc deficiency. In: Mills C.F. , ed. Zinc in human biology. London: Springer-Verlag, 1989.

Pinna K. , Woodhouse L.R. , Sutherland B. , Shames D.M. , King J.C. Exchangeable zinc pool masses and turnover are maintained in healthy men with low zinc intakes. J Nutr 2001; 131: 2288–94.

Sian L. , Mingyan X. , Miller L.V. , Tong L. , Krebs N.F. , Hambidge K.M. Zinc absorption and intestinal losses of endogenous zinc in young Chinese women with marginal zinc intakes. Am J Clin Nutr 1996; 63: 348–53.

Yokoi K. , Alcock N.W. , Sandstead H.H. Iron and zinc nutriture of premenopausal women: associations of diet with serum ferritin and plasma zinc disappearance and of serum ferritin with plasma zinc and plasma zinc disappearance. J Lab Clin Med 1994; 124: 852–61.

Prasad A.S. Metabolism of zinc and its deficiency in human subjects. In: Prasad A.S. , ed. Zinc metabolism. Springfield, IL: Charles C Thomas, 1966.

World Health Organization (WHO). Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programs. WHO/NUT/96.10 Micronutrient Series. Geneva: World Health Organization, 1996.

Caldwell J.C. , McDonald P. Influence of maternal education on infant and child mortality: levels and causes. Health Policy Educ 1982; 2: 251–67.

Cleland J.G. , Van Ginneken J.K. Maternal education and child survival in developing countries: the search for pathways of influence. Soc Sci Med 1988; 27: 1357–68.

Underlying and proximate determinants of child health: the Cebu Longitudinal Health and Nutrition Study. Am J Epidemiol 1991; 133: 185–201.

Engle P.L. , Menon P. , Haddad L. Care and nutrition: concepts and measurement (occasional paper). Washington, DC: International Food Policy Research Institute, 1997.

Armar-Klemesu M. , Ruel M.T. , Maxwell D.G. , Levin C.E. , Morris S.S. Poor maternal schooling is the main constraint to good child care practices in Accra. J Nutr 2000; 130: 1597–607.

Food and Nutrition Board, Institute of Medicine. Dietary reference intakes of vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: National Academy Press, 2002.

Bhandari N. , Bahl R. , Taneja S. , Strand T. , Molbak K. , Ulvik R.J. , Sommerfelt H. , Bhan M.K. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children. Pediatrics 2002; 109: e86.

Yadrick M.K. , Kenney M.A. , Winterfeldt E.A. Iron, copper, and zinc status: response to supplementation with zinc or zinc and iron in adult females. Am J Clin Nutr 1989; 49: 145–50.

Freeland-Graves J. , Friedman B. , Han W. , Shorey R. , Young R. Effect of zinc supplementation on plasma high-density lipoprotein cholesterol and zinc. Am J Clin Nutr 1982; 35: 988–92.

Black M. , Medeiros D. , Brunett E. , Welke R. Zinc supplements and serum lipids in young adult white males. Am J Clin Nutr 1988; 47: 970–5.