Baby food pouches criticised

Our very young children are precious. The first 1000 days of a child’s life is a crucial period of early life development. The establishment of healthy eating habits early in life provides a path towards the prevention of future diet-related chronic diseases. Introducing complementary food after exclusive breast feeding for six months as recommended by the World Health Organisation is not an easy period for parents. And of course the food industry has attempted to be the saviour by inventing the baby squeeze pouch.

Squeeze pouches

Squeeze or spout pouches are a plastic retort baby food sachet or pouch containing pureed foods marketed as suitable for children aged between six months to five years. The pouches enable children to consume wet ready-to-use food directly from the packet through sucking on the spout. Food pouches for babies and toddlers were first launched in the USA around 2008 and has since taken off worldwide. The increased market share of squeeze pouch baby foods has been driven by changes in the labour market and ‘time-poor’ parents making life a little bit easier for them.

The global pouches market was valued at US$22 billion in 2021 and is expected to expand to around US$40 billion by 2030. Squeeze pouches are now the primary product sold in the Australian baby food market and have contributed to sales worth A$1.2 billion. The food industry calls it mobile food technology for the modern family. They are marketed as ‘convenient’ and ‘easy to feed’ to help parents on the run to select a product that they perceive as the healthiest food for their infant. But are they?

Nutritional composition

Nutritional composition analysis of squeeze pouch infant food undertaken in the US, Germany, Denmark, UK and New Zealand have a striking common finding. All pouch products were considered high in both total and added or free sugars when compared to other infant and toddler foods with most of the total energy provided from free sugars.

There was a predominance of apple, pear and sweet vegetable purees in squeeze pouches, and only small amounts of bitter vegetables and grains.

In the USA, the Baby Food Facts Report found that most infant squeeze pouches do not support recommendations for encouraging healthy eating habits, and the marketing of the pouches is misleading about the true nutritional content.

Similarly, in the UK, a report by First Steps Nutrition found that many product names did not reflect their actual content, with 30% of 188 products analysed failing to mention the main ingredient (e.g. fruit puree) in the product name.

In New Zealand it was found that squeeze pouches contained as little as 0.3 mg/100 g of iron, placing infants at risk of iron deficiency if complementary fed exclusively on commercial squeeze pouches

Recent Australian data

A team of Australian scientists from the Western Sydney University recently confirmed the findings of previous international studies when investigating product content and labelling of 276 ready-to-use infant food pouches available on the Australian market. Only two products were nutritionally adequate according to a nutrient profiling tool. Marketing messages included desirable ingredient emphasis, nutrient absence claims, claims about infant development and health, good parenting, and convenience. Claims of ‘no added sugar’ were made for 59% of pouches, despite the addition of free sugars through the use of fruit juice or syrup.

They concluded that squeeze pouch products available in Australia are nutritionally poor, high in sugars, not fortified with iron, and there is a clear risk of harm to the health of infants and young children if these products are fed regularly. The marketing messages and labelling on squeeze pouches are misleading and do not support official recommendations for the appropriate introduction of complementary foods and the labelling of products. There is an urgent need for improved regulation of product composition, serving sizes and labelling to protect infants and young children aged 0–36 months and better inform parents.

So what to do?

Feeding time can be a difficult mission and certainly requires patience and plenty of cleaning cloths and protecting the carpet is essential. None of these things are needed with pouches making them a great choice if you want to avoid spills and chaos that are often associated with feeding babies in a highchair.

Thus, infant pouches can make up over 70% of the baby food market and they dominate the baby food aisle in supermarkets in many countries. No doubt that’s because they are easy to carry, have a shelf life of at least 12 months and don’t produce a messy feeding situation. They clearly have their place for an occasional meal when out and about or taking to a special event where messy eating isn’t appropriate.

However, numerous studies have shown that the more variety of tastes, textures, colors, and mouth feels a baby is exposed to, the more likely those children are to accept new foods later on in life. Every time a baby or toddler sits down to eat presents a learning opportunity in more ways than one. And unfortunately, pouches detract from that learning more than they contribute to it. 

But don’t feel guilty when sneaking in a pouch or two now and then. Caring for an infant is a difficult task and occasionally some relief is necessary. Hopefully, food manufacturers can improve the nutritional composition of the food they put in their pouches to better justify their use.

Feeling energetic?

Are you counting your calories and limiting your energy intake from food and drink for a slimmer you? Or maybe just talking about calories in general terms as many of us do. Then you might like to know what you are talking about or counting so I thought a brief explanation would be useful. It is actually a little bit complicated as it has evolved over time.

Let’s start from scratch

It is self evident that food and drink provide the energy we need to stay alive and active. However, the standard measure of energy in the International System of Units or SI system is joules (although a derived unit from the seven defined SI base units) and not calories. The joule is named after James Prescott Joule. It is clearly defined as a unit of work or energy equal to the work done by a force of one newton acting through a distance of one meter.

So why do many of us still think in calories (or Calories as you will see below)?

It might be historical as the term calorie has been in use since the early 19th century when Nicholas Clément-Desormes in 1825 defined it as the amount of heat required to raise the temperature of a kilogram of water from 0°C to 1°C. However, scientists were not happy with this definition so changed it to the amount of heat required to raise the temperature of a gram (not kilogram) of water from 0°C to 1°C. So the initial calorie (now often expressed as the capitalised Calorie) is now equal to 1,000 new calories or 1 kilocalorie (abbreviated kcal). The concept entered the food world when W.O. Atwater used it in 1887 to describe food energy.

After that the Calorie became the preferred unit of potential energy in nutrition science and dietetics for a while.

But it didn’t stop there as in the early 20th century the calorie started to be defined in terms of joules. Thus the Committee on Nomenclature of the International Union of Nutritional Sciences changed the definition of the “small calorie” to the amount of heat required to raise the temperature of 1 g of water from 14.5 to 15.5°C, a 1% change from the previous definition. And the Calorie followed. This way a Calorie could be defined as equal to 4.184 kJ.

Slightly confusing?

To avoid further confusion most countries have officially adopted the joule as a measure of food energy, expressed as kilojoule (kJ) for convenience on food labels. However, a few countries (and maybe you and me) stick to Calories and the final say goes to the current US Dietary Reference Intakes that define 1 kcal (or Calorie) as 4.186 kJ, again slightly different to previous definitions.

So after all that feel free to think in Calories as long as you know that you can multiply your Calories by 4.2 to get to kJ or divide your kJ by 4.2 to get to Calories. Or for the lazy you can even use a simple 4 for the calculations to get to a close enough approximation.

Energy intake in practice

With that out of the way let’s get back to practical considerations in looking at energy intake. It is assumed that an average adult needs about 8,700 kJ (2,100 kcal) a day to maintain a healthy weight. But it varies quite a bit – some people need more and others less. It depends on age, gender, height and weight as well as how active we are. If consuming more energy than we use, the extra energy is stored as fat. To lose excess fat means you need to take in less energy (fewer kJ) or use more through exercise, or preferably both.

The energy is provided by the protein, carbohydrate and fat in the foods we eat and in drinks. These nutrients deliver energy in varying amounts. Fat is the most concentrated source of energy (37.7kJ/g), followed by protein and carbohydrate (both at 16.7kJ/g). Alcohol also provides energy (29.3kJ/g) while also increasing the amount of vitamins and minerals that the body requires. 

Although every person’s daily energy intake is highly variable, based on their personal goals and needs, the typical daily energy intake of 8,700kJ is often split with 1,800kJ for breakfast, 450kJ for a morning snack, 2,500kJ for lunch, 450kJ for an afternoon snack and 3,500kJ for dinner.

Spending the daily energy intake

Preferably we should balance our energy intake with our energy expenditure. Metabolism is the process by which the body changes food and drink into energy. During this process, nutrients in food and drinks mix with oxygen to liberate the energy the body needs. Digesting, absorbing, moving and storing food burn energy. About 10% of daily energy consumed are used for digesting food and taking in nutrients. This can’t be changed much.

Then we have the basal metabolism. Even at rest, a body needs energy for all it does. This includes breathing, sending blood through the body, maintaining body temperature, keeping hormone levels even, and growing and repairing cells. The amount of energy a body at rest uses to do these things is known as basal metabolic rate. Our basal metabolism makes up about 60-70% of the energy we burn and again can’t be changed much although it is partly related to muscle mass. That is:

• people who are larger or have more muscle burn more energy, even at rest;
• men usually have less body fat and more muscle than do women of the same age and weight and thus burn more energy;
• with aging, people tend to lose muscle and more of the body’s weight consists of fat slowing energy burning.

Adding all this up we have already spent 6,000 to 7,000kJ and we haven’t accounted for all of our incidental activities that can be changed a lot. These include things such as housework, walking around the house, gardening, walking to a shop, hanging out the washing or even fidgeting. These activities are collectively called non-exercise activity thermogenesis and accounts for about 500 to 3,000 kJ used daily.

We are now hopefully in energy balance.

Surplus energy

But how well do we stick to the average energy intake of 8,700kJ? Not so sure about that!

We have the morning break and go for a coffee and order a large flat white (this is Australia) and an apple danish without considering the energy content. The apple danish will actually contribute 1,100kJ and the coffee 670kJ, well above our indicated average of 450kJ for the morning snack.

We might feel a bit tired in the afternoon and go for another coffee. This time we pick a cappuccino (only Italians limit a cappuccino to before 11am) and a blueberry muffin. Now we have added another 1,600kJ to our energy intake. On second thought we could replace the large blueberry muffin with a mini muffin to limit the energy intake to 850kJ for the afternoon snack, still above the suggested 450kJ.

After a long day we sit down for dinner. As we had a really successful day we share a bottle of red wine with our partner. If you share it equally you’ve had 1,260kJ even before you start to consider the energy content of the first bite of food. That’s the equivalent of a cup of chunky vegetable soup, a slice of wholemeal bread with a teaspoon of butter, and two slices of prosciutto. You skip the wine and instead go for a 375mL bottle of 4.5% strength beer. That way you limit the extra energy intake to 400kJ as long as you stick to only one beer.

We could go on with many other examples. Adding a chocolate croissant to our normal breakfast would contribute about 1,000kJ. A gin and tonic to relax in the evening provide 715kJ. A medium sized glass of a cola soft drink would add a further 750kJ. If you want to get more bad news you can search for the energy content of many other food and drinks on the excellent fatsecret Australia website.

Spending the extra energy

But even with the extra energy intake all is not lost as we can become more physically active. This is the form of energy expenditure that we have real control over. This is the energy used by physical movement and it varies the most depending on how much energy you use each day. Physical activity includes planned exercise like walking the dog, going for a run or playing sport.

Just standing for an hour working at your desk and your muscles have spent 600kJ to keep you upright. A walk with the dog for an hour would consume 1,000kJ or if you are power walking it could be close to 2,000kJ per hour. During strenuous or vigorous physical activity, our muscles may burn through as much as 3,000kJ per hour. If you are the one mowing the lawn (if you have one) you would spend 1,500kJ for an hour’s work. Fast step dancing, shovelling snow (not needed here in Sydney), using an exercise machine, or playing basketball all four half an hour and you have spent close to 1,000kJ.

As you can see there are many ways to spend excess energy intake so a little indulgence now and then wouldn’t go astray while still keeping your energy intake and expenditure in balance. Keep your brain working by reading a captivating book for an hour and you have spent 600kJ.

A matter of balance

Of course there is much more to consider when consuming food and drink. Empty calories (see there I can’t get myself to stick to kJ) are the worst, that is food and drink which mainly provide energy and few nutrients. Candy, pastries, chips, bacon, and sugar-sweetened beverages are less nutrient dense. These foods contain added sugar, solid fats, and refined starch, and they provide few essential nutrients.

On the other hand there should also be pleasure in eating. Food can nourish our body in a lot of different ways. In fact, experts often indicate that eating for pleasure not only fuels the body but the mind as well. When people feel satiated, they are less likely to feel deprived or restricted.

So we are back to the balanced diet concept with the last word going to the Verywell Fit website. The best you can do is to find a balance between enjoying food and life, feeling good, and enjoying the best health we can.

What more can we ask for?

Satisfying saffron!

Mmm … saffron, such a flavoursome and useful spice, but there is more to it than that so read on.

Initially it is worth noting that saffron is the most expensive spice in the world. Nevertheless, it has a long history of use as a flavouring agent essential to a broad range of dishes from Swedish saffron buns to Spanish paella, Persian rice dishes and Indian curries.

Actually, saffron use dates back 3000–4000 years with records found in Persian, Greco–Roman and Egyptian cultures. From here it spread first to India and China and much later to other parts of North Africa and Europe. While saffron’s origin is still debated, it most likely originated in old Persia. There, as in other countries, it was revered not only for its flavour but also for its perceived medicinal properties. People would eat saffron to enhance libido, boost mood, and improve memory. Cleopatra used it to infuse her bathwater. Alexander the Great bathed his battle wounds with it and drank saffron tea.

So what is saffron?

Saffron is derived from the saffron crocus plant (Crocus sativus) related to the lily. It is a domesticated autumn-flowering perennial plant unknown in the wild. Being sterile, its purple flowers fail to produce viable seeds. Instead reproduction depends on humans digging up and replanting bulb-like organs called corms. A corm survives for one season, producing via vegetative division up to ten cormlets that can grow into new plants in the next season.

The dried thread-like parts of the flower called stigmas are used to make saffron spice, food colouring and medicine.

The high retail value of saffron is maintained on world markets because of labour-intensive harvesting methods, which makes its production costly. One freshly picked crocus flower yields on average 30 mg of fresh or 7 mg of dried saffron threads. Some forty hours of labour are needed to harvest 150,000 flowers and hand-pick 440,000 red stigmas from the flowers that after heating and curing yield a kilogram of dried saffron.

Iran produces some 90% of the world total of saffron. At $10,000 per kg or even higher, saffron has long been the world’s costliest spice by weight.

Health impact of saffron

Saffron has long been used in traditional medicine to treat menstrual problems, depression, asthma and sexual dysfunction. It contains an impressive variety of plant compounds acting as antioxidants – molecules that protect cells against free radicals and oxidative stress. These compounds include crocin and crocetin that are carotenoid pigments responsible for saffron’s red colour, safranal that gives saffron its distinct aroma and picrocrocin producing the bitter taste, among several other compounds. Together they are believed to be responsible for the observed beneficial effects identified in initial scientific trials covering conditions from memory loss to cancer.

Although early evidence has been inconclusive, this is starting to change with reports of results from new scientific studies.

A review of ten randomised controlled trials involving unhealthy subjects showed that saffron supplementation clearly improved oxidative stress through its antioxidant activity, a general indicator of beneficial health effects.

Summarising nineteen studies, more specific results indicated that saffron significantly reduced fasting blood glucose, waist circumference, diastolic blood pressure, concentrations of total cholesterol and low-density lipoprotein cholesterol, and improved symptoms of depression, cognitive function and sexual dysfunction compared with controls (mainly placebos).

Scientists studying the effects of saffron on sleep quality in healthy adults with self-reported poor sleep completed a randomised, double-blind, placebo-controlled trial. Saffron intake was associated with larger improvements in sleep quality in adults than the placebo.

A further overview of the scientific literature pointed to a consistent and significant improvement of depression, anxiety, and cognitive impairment associated with the daily intake of moderate quantities of saffron extracts. The effects seemed to be comparable to those of specific pharmacological treatments and appeared to be generally well tolerated with no major adverse effects associated with its daily consumption.

Indeed, it is now beyond doubt that saffron and especially its main constituent molecules (crocins, crocetin, picrocrocin and safranal) exert beneficial effects on frequent neuropsychiatric (depression, anxiety, schizophrenia, etc.) and age-related diseases (cardiovascular, ocular, neurodegenerative diseases and sarcopenia).

So all fine then?

Well yes, it seems to be fine from a scientific point of view. Saffron provides clear health benefits in reasonable doses of 20, 30 or 50 mg per day in the trials. But there is one remaining problem apart from the price and it is saffron adulteration.

Despite attempts at quality control and standardisation, an extensive history of saffron adulteration continues into modern times. Adulteration was first documented in Europe’s Middle Ages, when those found selling adulterated saffron were executed under the Safranschou code.

Typical methods include mixing in extraneous substances like beetroot, pomegranate fibres, red-dyed silk fibres, or the saffron crocus’s tasteless and odourless yellow stamens. Other methods included dousing saffron fibres with viscid substances like honey or vegetable oil to increase their weight. Powdered saffron is more prone to adulteration, with turmeric, paprika, and other powders used as diluting fillers. Safflower is a common substitute sometimes sold as saffron.

In recent years, saffron adulterated with the colouring extract of gardenia fruits has been detected in the European market. This form of fraud is difficult to detect due to the presence of flavonoids and crocines in the gardenia-extracts similar to those naturally occurring in saffron. Detection methods have been developed by using HPLC and mass spectrometry to determine the presence of geniposide, a compound present in the fruits of gardenia, but not in saffron.

Counter methods you can take!

All is not lost if you’re a little clever about it.

First, don’t buy bargain saffron as there is a reason for the high price of high quality saffron. The adage ‘you get what you pay for’ is most relevant in this case.

Second, check that the saffron strands are frayed at one end and look for a deep red hue that colours water orangey-yellow when submerged.

Finally, smell it and put it on your tongue – fake saffron has very little aroma or flavour while real saffron will smell slightly fruity and floral and taste sweet and bitter at the same time.

And after all that you can enjoy the wonderful taste of your saffron dishes and potential health benefits at the same time.

The Coffee Consumption Genes

Are you desperate for a cup of coffee just now? The urge might be determined by your genes. I almost didn’t believe it when the newspaper reported that scientists had explored the genes of pregnant women to predict the amount of coffee they consume and its potential impact on their pregnancy.

I have been heavily involved in developing elaborate protocols to explore population food consumption in detail. And now all you have to do is look at the genes. So I did some research and it seems to be true that coffee drinking behaviour is at least partly due to genetics, with a specific set of genetic variants affecting how much coffee we drink.

What the researchers found

In the reported findings, researchers at the University of Queensland used a method called Mendelian randomisation which used eight genetic variants that predicted pregnant women’s coffee drinking behaviour and examined whether these variants were also associated with birth outcomes. Current World Health Organization guidelines say pregnant women should drink less than 300mg of caffeine, or two to three cups of coffee per day. However, the researchers through their genetic analyses found that coffee consumption during pregnancy might not itself contribute to adverse outcomes such as stillbirth, sporadic miscarriages and pre-term birth or lower gestational age or birthweight of the offspring.

As a caveat just to be on the safe side, the researchers emphasised that the study only looked at certain adverse pregnancy outcomes, and it might be possible that coffee consumption could affect other important aspects of foetal development. 

This has been known for some time

The important outcome is that genetics can be used to estimate the amount of coffee consumed. This has actually been known for some time. Heritability refers to degree of genetic influence and can vary from 0 (not heritable) to 1 (completely inherited).

A review published in 2010, reported that twin studies had estimated heritability of coffee consumption by comparing monozygotic twins, who share the common familial environment and the same genes, to dizygotic twins, who also share common familial environment but only half of the genetic material. These studies found that heritability of coffee consumption varied from 0.30 to 0.60 in different populations. Heavy consumption, defined as more than 6 cups of coffee daily, had a heritability of 0.77. A few conclusions can be drawn. First, heavy consumers seem to differ from moderate and light coffee users on several accounts. Secondly, heavier coffee users appear to be more influenced by genetics than lighter caffeine users. 

So far the studies confirmed the possibilities of coffee consumption inheritance without identifying the individual genes responsible for such differential inheritance pattern. 

And the complicated stuff

So genetics have long been suspected of contributing to individual differences in coffee consumption. However, pinpointing the specific genetic variants has been challenging. Thus, researchers as part of the Coffee and Caffeine Genetics Consortium conducted a genome-wide meta-analysis of more than 120,000 regular coffee drinkers of European and African American ancestry. They identified two variants that mapped to genes involved in caffeine metabolism, POR and ABCG2 (two others, AHR and CYP1A2 had been identified previously). Two variants were identified near genes BDNF and SLC6A4 that potentially influence the rewarding effects of caffeine. Two others – near the GCKR and MLXIPL genes involved in glucose and lipid metabolism – had not previously been linked to the metabolism or neurological effects of coffee.

The findings suggest that genes drive people to naturally modulate their coffee intake to experience the optimal effects exerted by the caffeine in coffee and that the strongest genetic factors linked to increased coffee intake likely work by directly increasing caffeine metabolism.

But there is more

People who like to drink their coffee black also prefer dark chocolate, a new Northwestern Medicine study found. The reason is also in their genes.

The scientists found that coffee drinkers who have a genetic variant that reflects a faster metabolism of caffeine prefer bitter, black coffee. And the same genetic variant is found in people who prefer the more bitter dark chocolate over the more mellow milk chocolate.

The reason is not because they love the taste, but rather because they associate the bitter flavour with the boost in mental alertness they expect from coffee.

It is interesting because these gene variants are related to faster metabolism of caffeine and not related to taste. These individuals metabolise caffeine faster, so the stimulating effects wear off faster as well. So, they need to drink more. They learn to associate bitterness with caffeine and the boost they feel. When they think of coffee, they think of a bitter taste, so they enjoy dark coffee and, likewise, dark chocolate.

A new era

In the past, when scientists studied the health benefits of coffee and dark chocolate, they had to rely on epidemiological studies, which only confer an association with health benefits rather than a stronger causal link. The new research shows these genetic variants can be used more precisely to study the relationship between coffee and health benefits.

And who knows, in the future there might be other genetic markers found that drive our food consumption behaviour.

A Word About Zinc

I assume you’re not too worried about zinc intake. This might be correct for most people in the developed world, with some important exceptions, as zinc is naturally found in a wide variety of both animal and plant foods. Still you should be aware that we all need a constant supply of zinc as it is considered an essential nutrient for the human body involved in numerous different processes.

However, worldwide zinc deficiency can be a serious problem as it affects about two billion people in the developing world and is associated with many diseases. Zinc deficiency causes growth retardation in children, delayed sexual maturation, infection susceptibility, and diarrhea.

Consumption of excess zinc may in turn cause ataxia, lethargy, and copper deficiency. So a balance is important.

The magic of zinc

Zinc is the second most abundant trace mineral in our bodies after iron and is present in every cell. It is necessary for the activity of over 300 enzymes that aid in metabolism, digestion, nerve function and many other processes. It is critical for the development and function of immune cells and is also fundamental to skin health, DNA synthesis and protein production. Zinc deficiency can lead to a weakened immune response, particularly important in covid times. Zinc supplements can significantly reduce the risk of infections and promote immune response in older adults

Body growth and development relies on zinc because of its role in cell growth and division. Zinc is commonly used in hospitals as a treatment for burns, certain ulcers and other skin injuries. Because it plays critical roles in collagen synthesis, immune function and inflammatory response, it is necessary for proper healing.

Oddly, zinc deficiency will reduce our ability to taste or smell our food and surroundings because one of the enzymes crucial for proper taste and smell is dependent on this nutrient.

A pretty impressive list.

Too little or too much zinc intake

Although severe zinc deficiency is rare, milder forms of zinc deficiency are more common, especially in children in developing countries where diets are often lacking in important nutrients. Symptoms of mild zinc deficiency include diarrhea, decreased immunity, thinning hair, decreased appetite, mood disturbances, dry skin, fertility issues and impaired wound healing.

Just as a deficiency in zinc can cause health complications, excessive intake can also lead to negative side effects. This is mainly related to going overboard with consumption of too much zinc through food supplements. Symptoms of toxicity include nausea, vomiting and loss of appetite. It can cause diarrhea, abdominal cramps and headaches. Ingesting too much zinc can also interfere with the absorption of copper and iron.

Zinc’s immune-boosting properties

The importance of zinc for a properly functioning immune system is intriguing. Although well known in principle, new details have recently come to light.

Results published in 2022 by scientists at the Fred Hutchinson Cancer Center in Seattle looked at the importance of adequate zinc intake to boost immune function. They revealed two ways that the mineral supports immunity and suggested how it could be used to improve health. The team discovered that zinc is needed for the development of disease-fighting immune cells called T cells and prompts regeneration of the thymus, the immune organ that produces T cells.

The scientists found that the thymus of mice deprived of dietary zinc shrink and produce notably fewer mature T cells, even after as little as three weeks of a no-zinc diet. They also showed that without zinc, T cells cannot fully mature. Conversely, with extra zinc T cells recover faster than normal.

They are now looking into how zinc may fit in with how the immune system repairs itself after stressors like chemotherapy, blood stem cell transplant and radiation exposure or how zinc can assist people with chronic immune decline that accompanies ageing.

Vulnerable population groups

Although zinc deficiency is uncommon, vegetarians, some pregnant women, 7-12 months old infants, alcoholics and people with some digestive disorders need to consider their zinc intake.

The bioavailability of zinc from vegetarian diets is lower than from non-vegetarian diets. In addition, vegetarians typically eat high levels of legumes and whole grains, which contain phytates that bind zinc and inhibit its absorption.

Pregnant women, particularly those starting their pregnancy with marginal zinc status, are at increased risk of becoming zinc insufficient due, in part, to high fetal requirements for zinc. Lactation can also deplete maternal zinc stores.

Breast milk provides sufficient zinc for the first 6 months of life but does not provide recommended amounts of zinc for infants aged 7–12 months. In addition to breast milk, infants aged 7–12 months should consume age-appropriate foods containing zinc.

Up to 50% of alcoholics have low zinc status because ethanol consumption decreases intestinal absorption of zinc and increases urinary zinc excretion. In addition, the variety and amount of food consumed by many alcoholics is limited, leading to inadequate zinc intake.

Digestive disorders such as ulcerative colitis, Crohn’s disease, and short bowel syndrome can decrease zinc absorption and increase endogenous zinc losses. Other diseases associated with zinc deficiency include malabsorption syndrome, chronic liver disease, chronic renal disease, sickle cell disease, diabetes, malignancy, and other chronic illnesses. Chronic diarrhea also leads to excessive loss of zinc.

So where to find zinc?

Many animal and plant foods are naturally rich in zinc, making it easy for most people to consume adequate amounts.

Foods highest in zinc include fish and shellfish, meat and poultry, legumes, nuts and seeds, dairy products, eggs, whole grains and vegetables like mushrooms, kale, asparagus and beet greens.

There is a caveat.

As is often common for minerals, animal products contain zinc in a form that is easily absorbed by the body. On the other hand zinc in plant-based sources is absorbed less efficiently as phytates—which are present in whole-grain breads, cereals, legumes, and other foods—bind zinc and inhibit its absorption. Thus, the bioavailability of zinc from grains and plant foods is lower than that from animal foods, although many grain- and plant-based foods are still good sources of zinc.

Clearly most people meet the recommended daily zinc intake of 11 mg for men and 8 mg for women through diet. Although I am normally not a fan of food supplements, there might be a case for using supplements containing zinc as the main ingredient for older adults and people with diseases that inhibit zinc absorption. I might even consider using a zinc supplement myself.

However, remember that high-dose zinc supplements can lead to dangerous side effects, so it’s important to stick to recommendations and only take supplements when necessary.