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Articles

Dietary Phytate Reduction Improves Zinc Absorption in Malawian Children Recovering from Tuberculosis but Not in Well Children¹

Mark J. Manary^*,2, Christine Hotz^**, Nancy F. Krebs, Rosalind S. Gibson^**, Jamie E. Westcott, Thomas Arnold, Robin L. Broadhead and K. Michael Hambidge

^* Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, 63110; Department of Paediatrics, College of Medicine, University of Malawi, Blantyre, Malawi; ^** Department of Human Nutrition, University of Otago, Dunedin, New Zealand and Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Denver, Colorado 80262

²To whom correspondence should be addressed.

High dietary phytate content that compromises zinc nutriture is thought to be a major problem among children of the developing world. Zinc stable isotope techniques permit the quantitative assessment of the effect of phytate reduction on zinc homeostasis. We tested the hypothesis that zinc absorption would be increased in Malawian children fed a reduced-phytate corn-plus-soy diet compared with a standard high phytate diet. Twenty-three children hospitalized in Blantyre, Malawi, were enrolled. Children were selected from those recovering from tuberculosis and from well children (those with minor injuries, those awaiting elective surgery or healthy siblings). Children received a diet of corn-plus-soy porridge (either low phytate or high phytate) for a period of 3–7 d and then participated in a zinc stable isotope study. The study included the administration of oral and intravenous zinc stable isotopes and 7-d collections of urine and stool. The diet was maintained throughout the duration of specimen collection. Zinc isotopic enrichments in urine and stool were measured, and zinc fractional absorption, total zinc absorption, endogenous fecal zinc, net zinc retention and size of the exchangeable zinc pool were calculated. Among the 14 children recovering from tuberculosis, dietary phytate reduction resulted in higher fractional absorption (0.41 ± 0.14 versus 0.24 ± 0.09, mean ± SD, P < 0.05) and total zinc absorption (169 ± 55 versus 100 ± 46 µg/(kg · d), P < 0.05). No effect of phytate reduction was seen in the well children (n = 9). Phytate reduction did not decrease the absolute endogenous fecal zinc, but it did decrease it relative to total absorbed zinc. These preliminary results indicate that phytate reduction may be beneficial in improving zinc nutriture in groups with increased zinc requirements who consume a cereal-based diet.

KEY WORDS: • zinc • stable isotopes • phytate • zinc homeostasis • Africa • children

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