Deficiency

Iron and especially zinc deficiency are difficult to diagnose and differing diagnostic criteria contribute to the confusion surrounding deficiency and immune dysfunction. Plasma levels of either micronutrient are not adequate to define status, however they commonly have been used for such. Deficiency of iron can be quantified at individual and community levels using a combination of indices, e.g., hemoglobin/ mean cell volume combined with an index of storage iron, ferritin plus an index of iron supply to tissues, or serum transferrin receptor concentration. Plasma zinc level decreases with inflammation and currently the best method of assessment for deficiency is response to supplementation. Alternatively, plasma zinc levels can be interpreted with caution in conjunction with a marker of the acute phase response. In developing countries iron and zinc deficiency are widespread and often occur together. Meat is the most important dietary source for both micronutrients; however, in many countries with predominately vegetarian diets phytate-containing cereals inhibit absorption of both.

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