Correlation of zinc intake with hair zinc levels and appetite in children aged 2-3 years in Jakarta

Main Article Content

Anin Ika Rosa
Diana Sunardi
Novi Silvia Hardiany


Background: Children under five years experience rapid growth and development, so that adequate nutritional intake is very important. Zinc is essential for child development and growth. Children’s zinc requirements are fulfilled from daily food intake that might be affected by Covid-19 pandemic. The aim of this study is to determine the correlation between zinc intake with hair zinc level and appetite in children aged 2-3 years in Jakarta.
Methods: This cross-sectional study was carried out from September to October 2020 in Kampung Melayu, Jakarta. Seventy children aged 2-3 years were taken using total population sampling method. Interviews were conducted to obtain characteristic data and zinc intake using semi quantitative-food frequency questionnaire (SQ-FFQ). Appetite were assessed using VAS appetite questionnaire. Hair samples were collected to check level of hair zinc. Spearman correlation was performed using SPSS.
Results: Median of zinc intake was 6 (1,2-22,5) mg/day, with 20% of the subjects had insufficient zinc intake. The median hair zinc value was 132 (30-451) µg/g, with 17,1% subjects zinc insufficient. The median of VAS appetite score was 54,5 mm. There were no significant correlation between zinc intake and hair zinc level (r = -0.077, p = 0.528). A weak positive correlation was found between appetite and hair zinc levels (r = 0,247, p = 0,039).
Conclusion: Zinc intake in children aged 2-3 years had no significant correlation with hair zinc level, and appetite had a weak positive correlation with hair zinc level.


Download data is not yet available.

Article Details

Author Biographies

Anin Ika Rosa, Universitas Indonesia

Faculty of Medicine

Diana Sunardi, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Departement of Nutrition

Novi Silvia Hardiany, Faculty of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Departement of Biochemistry


1. Nasar SS, Pulungan BA. Masalah makan pada anak. Makalah lengkap konggres nutririon growth-development, continuing professional development IDAI, Jakarta; 2006, hal. 53-68
2. Dewi A. Gambaran asupan zat gizi mikro pada balita di Kota Semarang. Journal of Nutrition and Health. 2015; 3(2)
3. Chao HC, Chang YJ, Huang WL. Cut-off Serum Zinc Concentration Affecting the Appetite, Growth, and Nutrition Status of Undernourished Children Supplemented With Zinc. Nutrition in Clinical Practice published, American Society for Parenteral and Enteral Nutrition. Wiley Periodicals Inc. 2018;33(5):701-9
4. Caulfield LE, Black RE. Zinc deficiency. Diakses tanggal 6 Maret 2020 chapters/volume1/0257-0280pdf.
5. Gibson RS. Principle of Nutritional Assessment.Second edition.Oxford University Press. 2005: p.380.
6. Kemenkes. Peraturan Menteri Kesehatan Republik Indonesia nomor 28 tahun 2019 tentang angka kecukupan gizi yang dianjurkan untuk masyarakat Indonesia, 2019.
7. Deshpande JD, Joshi MM, Giri PA. Zinc: The Trace Element Of Major Importance In Human Nutrition And Health. International Journal of Medical Science and Public Health. Vol 2 Issue 1. 2013;1-4.
8. Stubbs RJ, Hughes DA, A, Johnstone M, Rowley E, Reid C, Elia M, Stratton R, Delargy H, King N, Blundell JE. The use of visual analogue scales to assess motivation to eat in human subjects: a review of their reliability and validity with an evaluation of new hand-held computerized systems for temporal tracking of appetite ratings. British Journal of Nutrition. 2000, 84, p405
9. Allison DB, Baskin ML. Handbook of assessment methods for eating behaviours and weight-related problems. Second edition. SAGE publication. 2009, p454-6, 296-9
10. Alarcon PA, Lin LH, Noche M, Hernandez VC, Cimafranca L, Lam W, Comer GM. Effect of oral supplemental on catch-up growth in picky eaters. Clin Pediatr 2003;42:209–17.
11. Huynh DT, Estorninos E, Capeding RZ, Oliver JS, Low YL, Rosales FJ. Longitudinal growth and health outcomes in nutritionally at-risk children who received long-term nutritional intervention. J Hum Nutr Diet 2015;28:623–35.
12. Sundari E, Nuryanto. Hubungan Asupan Protein, Seng, Zat Besi, dan Riwayat Penyakit Infeksi dengan Z-Score TB/U pada Balita, Journal of Nutrition College Volume 5, Nomor 4, 2016 : 520-529
13. Tee ES, Florentino R. Recommended Dietary Allowances (RDA) Harmonization in Southeast Asia. Monograph Series. Singapore: International Life Sciences Institute, Southeast Asia Region, 2005
14. Galetti V. Zinc Deficiency and Stunting. Pada: Preedy V., Patel V. (eds) Handbook of Famine, Starvation, and Nutrient Deprivation. Springer, Cham. 2018.
15. Beinner MA, Menezes MADBC, da Silva JBB, de Amorim FR, Jansen AK, Lamounier JA. Plasma Zinc and Hair Zinc Levels, Anthropometric Status and Food Intake of Children in a Rural Area of Brazil, Revista de Nutricao, 2010
16. Siahaan DK. Hubungan Asupan Seng (Zn) dan Protein terhadap Kadar Seng (Zn) Rambut pada Anak Autis di Kota Medan, 2019.
17. Cousins RJ. Systemic transport of zinc. In: Mills CF, editor. Zinc in human biology. New York: Springer-Verlag; 1989. pp. 79–93. [Google Scholar] [Ref list]
18. Han TH, Lee J, Kim YJ. Hair Zinc Level Analysis and Correlative Micronutrients in Children Presenting with Malnutrition and Poor Growth. Pediatr Gastroenterol Hepatol Nutr. 2016;19(4):259-268. doi:10.5223/pghn.2016.19.4.259
19. Daniels L, Williams SM, Gibson RS, Taylor RW, Samman S, Heath AM. Modifiable "Predictors" of Zinc Status in Toddlers. Nutrients. 2018 Mar 5;10(3):306. doi: 10.3390/nu10030306. PMID: 29510562; PMCID: PMC5872724.
20. Jackson, M. J., Jones, D. A. Edwards, R.H.T. Tissue zinc levels as an index of body zinc status. Clin. Physiol.1982, 2:333–343.
21. El Sayed Ahmad Y, Nehme J, Moukarzel N. Comparison of Postoperative Pain and Appetite in Pediatric Patients Undergoing Monopolar Tonsillotomy and Cold Steel Tonsillectomy. Int J Otolaryngol. 2020;2020:8060971. Published 2020 May 18. doi:10.1155/2020/8060971
22. 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, 334–343.
23. Buzina, R.; Jusi´c, M.; Sapunar, J.; Milanovi´c, N. Zinc nutrition and taste acuity in school children with impaired growth. Am. J. Clin. Nutr. 1980, 33, 2262–2267.
24. Gibson, R.S.; Vanderkooy, P.; 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, 1266–1273.
25. 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, 868–874.
26. Kusumastuti AC, Ardiaria M, Hendrianingtyas M, Effect of Zinc and Iron Supplementation on Appetite, Nutritional Status and Intelligence Quotient in Young Children, The Indonesian Biomedical Journal, Vol.10, No.2, August 2018, p.133-9
27. Arsenault JE, Romaña DL, Penny ME, Loan MDV, Brown KH. Additional zinc delivered in a liquid supplement, but not in a fortified porridge, increased fat-free mass accrual among young peruvian children with mild-to-moderate stunting. J Nutr. 2008; 138: 108-14
28. Khademian M, Farhangpajouh N, Shahsanaee A, Bahreynian M, Mirshamsi M Kelishadi R. Effects of zinc supplementation on subscales of anorexia in children: A randomized controlled trial. Pak J Med Sci. 2014; 30: 1213-7.
29. Suzuki H, Asakawa A, Li JB, Tsai M, Amitani H, Ohinata K, et al. Zinc as an appetite stimulator - the possible role of zinc in the progression of diseases such as cachexia and sarcopenia. Recent Patents on Food, Nutrition & Agriculture (2011) 3: 226-31. Bentham Science Publisher
30. Yagi T, Asakawa A, Ueda H, Ikeda S, Inui SMA. The role of zinc in the treatment of taste disorders. Recent Pat Food Nutr Agric. 2013; 5: 44-51.