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Chen B, Yu P, Chan WN, Xie F, Zhang Y, Liang L, Leung KT, Lo KW, Yu J, Tse GMK, Kang W, To KF. Cellular zinc metabolism and zinc signaling: from biological functions to diseases and therapeutic targets. Signal Transduct Target Ther 2024; 9:6. [PMID: 38169461 PMCID: PMC10761908 DOI: 10.1038/s41392-023-01679-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 01/05/2024] Open
Abstract
Zinc metabolism at the cellular level is critical for many biological processes in the body. A key observation is the disruption of cellular homeostasis, often coinciding with disease progression. As an essential factor in maintaining cellular equilibrium, cellular zinc has been increasingly spotlighted in the context of disease development. Extensive research suggests zinc's involvement in promoting malignancy and invasion in cancer cells, despite its low tissue concentration. This has led to a growing body of literature investigating zinc's cellular metabolism, particularly the functions of zinc transporters and storage mechanisms during cancer progression. Zinc transportation is under the control of two major transporter families: SLC30 (ZnT) for the excretion of zinc and SLC39 (ZIP) for the zinc intake. Additionally, the storage of this essential element is predominantly mediated by metallothioneins (MTs). This review consolidates knowledge on the critical functions of cellular zinc signaling and underscores potential molecular pathways linking zinc metabolism to disease progression, with a special focus on cancer. We also compile a summary of clinical trials involving zinc ions. Given the main localization of zinc transporters at the cell membrane, the potential for targeted therapies, including small molecules and monoclonal antibodies, offers promising avenues for future exploration.
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Affiliation(s)
- Bonan Chen
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- CUHK-Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Peiyao Yu
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangdong Province Key Laboratory of Molecular Tumor Pathology, Guangzhou, China
| | - Wai Nok Chan
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- CUHK-Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Fuda Xie
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- CUHK-Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Yigan Zhang
- Institute of Biomedical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Li Liang
- Department of Pathology, Nanfang Hospital and Basic Medical College, Southern Medical University, Guangdong Province Key Laboratory of Molecular Tumor Pathology, Guangzhou, China
| | - Kam Tong Leung
- Department of Pediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Kwok Wai Lo
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Jun Yu
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Gary M K Tse
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Kang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
- CUHK-Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
| | - Ka Fai To
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
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Liria-Domínguez R, Penny M, Kroon PA, Burgos G, Dainty J, Zeder C, Zimmermann MB, King J, Mithen R, Boy E, Al-Jaiballi O, Fairweather-Tait S. Biofortified Yellow-Fleshed Potatoes Provide More Absorbable Zinc than a Commonly Consumed Variety: A Randomized Trial Using Stable Isotopes in Women in the Peruvian Highlands. J Nutr 2023; 153:2893-2900. [PMID: 37648112 PMCID: PMC10613720 DOI: 10.1016/j.tjnut.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Zinc-biofortified potatoes have considerable potential to reduce zinc deficiency because of their low levels of phytate, an inhibitor of zinc absorption, and their high consumption, especially in the Andean region of Peru. OBJECTIVES The purpose of this study was to measure fractional and total zinc absorption from a test meal of biofortified compared with regular potatoes. METHODS We undertook a single-blinded randomized crossover study (using 67Zn and 70Zn stable isotopes) in which 37 women consumed 500-g biofortified or regular potatoes twice a day. Urine samples were collected to determine fractional and total zinc absorption. RESULTS The zinc content of the biofortified potato and regular potato was 0.48 (standard deviation [SD]: 0.02) and 0.32 (SD: 0.03) mg/100 g fresh weight, respectively. Mean fractional zinc absorption (FZA) from the biofortified potatoes was lower than from the regular potatoes, 20.8% (SD: 5.4%) and 25.5% (SD: 7.0%), respectively (P < 0.01). However, total zinc absorbed was significantly higher (0.49; SD: 0.13 and 0.40; SD: 0.11 mg/500 g, P < 0.01, respectively). CONCLUSIONS The results of this study demonstrate that biofortified potatoes provide more absorbable zinc than regular potatoes. Zinc-biofortified potatoes could contribute toward reducing zinc deficiency in populations where potatoes are a staple food. This trial was registered at clinicaltrials.gov as NCT05154500.
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Affiliation(s)
| | - Mary Penny
- Instituto de Investigación Nutricional, Lima, Peru
| | - Paul Antony Kroon
- Food, Microbiome and Health Program, Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Gabriela Burgos
- Genetics, Genomics, and Crop Improvement Division, International Potato Center, Lima, Peru
| | - Jack Dainty
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Christophe Zeder
- ETH Zürich, Laboratory of Human Nutrition, Department of Health Sciences and Technology, Institute of Food, Nutrition, and Health, Zurich, Switzerland
| | - Michael B Zimmermann
- ETH Zürich, Laboratory of Human Nutrition, Department of Health Sciences and Technology, Institute of Food, Nutrition, and Health, Zurich, Switzerland
| | - Janet King
- Department of Nutritional Sciences and Toxicology, University of California-Berkeley, Berkeley, CA, United States
| | - Richard Mithen
- Liggins Institute, Waipapa Taumata Rau - The University of Auckland, Auckland, New Zealand
| | - Erick Boy
- HarvestPlus Programme, Innovation, Policy and Scaling Unit, International Food Policy Research Institute, Washington, DC, USA
| | - Olla Al-Jaiballi
- Food, Microbiome and Health Program, Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
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Hall AG, King JC. The Molecular Basis for Zinc Bioavailability. Int J Mol Sci 2023; 24:ijms24076561. [PMID: 37047530 PMCID: PMC10095312 DOI: 10.3390/ijms24076561] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Zinc is an essential micronutrient, and its deficiency is perhaps the most prevalent and least understood worldwide. Recent advances have expanded the understanding of zinc’s unique chemistry and molecular roles in a vast array of critical functions. However, beyond the concept of zinc absorption, few studies have explored the molecular basis of zinc bioavailability that determines the proportion of dietary zinc utilized in zinc-dependent processes in the body. The purpose of this review is to merge the concepts of zinc molecular biology and bioavailability with a focus on the molecular determinants of zinc luminal availability, absorption, transport, and utilization.
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Katimba HA, Wang R, Cheng C, Zhang Y, Lu W, Ma Y. Zinc Absorption & Homeostasis in the Human Body: A General Overview. FOOD REVIEWS INTERNATIONAL 2023. [DOI: 10.1080/87559129.2023.2195188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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So M, Hatsuyama K, Tajima M, Ueki R, Tsuji Y, Suzuki T. Efficacy of Zinc Acetate in the Treatment of Zinc Deficiency in Elderly Inpatients and Effect of Total Dose on Its Replacement Therapy. Biol Pharm Bull 2022; 45:1306-1311. [DOI: 10.1248/bpb.b22-00273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Muramori So
- Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center
| | - Kanae Hatsuyama
- Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center
| | - Miyuki Tajima
- Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center
| | - Rie Ueki
- Department of Dermatology, Juntendo Tokyo Koto Geriatric Medical Center
| | - Yasuhiro Tsuji
- Center for Pharmacist Education, School of Pharmacy, Nihon University
| | - Toyofumi Suzuki
- Laboratory of Pharmaceutics, School of Pharmacy, Nihon University
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Net Conversion of Human-Edible Vitamins and Minerals in the U.S. Southern Great Plains Beef Production System. Animals (Basel) 2022; 12:ani12172170. [PMID: 36077891 PMCID: PMC9454978 DOI: 10.3390/ani12172170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 11/17/2022] Open
Abstract
Beef is a good source of several vitamins and minerals but data on the net contribution to the human diet is lacking. The objective was to quantify the net nutrient contribution of the beef supply chain to provide vitamins and minerals to the human diet. Beef cattle production parameters for the beef supply chain were as described by Baber et al., 2018 with the red and organ meat yield from each production segment estimated using literature values of serially-harvested beef cattle. Nutrient concentration of feeds was acquired from feed composition tables in nutrient requirement texts, and the nutrient concentration of beef and organ meats was based on 2018 USDA Food and Nutrient Database for Dietary Studies. The nutrient absorption coefficients of feeds, red meat, and organs were acquired from the literature. The human-edible conversion ratio was >1.0 for phosphorus when only red meat yield was considered indicating that the beef supply chain produced more human-edible phosphorus than it consumed. When organ meats were included, riboflavin, niacin, choline, and phosphorus had conversion ratios >1.0. After adjusting for the absorption of nutrients, the beef supply chain was a net contributor of niacin and phosphorus in the human diet when accounting for red meat yield only, but when including organ meats, iron, riboflavin, and choline also had conversion ratios >1.0. The maximum proportion of corn in the corn grain plus distillers’ grains component of the feedlot diets for the absorbable conversion ratio to be ≥1 ranged from 8.34 to 100.00% when only red meat yield was considered and from 32.02 to 100.00% when red and organ meats were considered. In conclusion, the current beef production system in the Southern Great Plains produces more human-absorbable iron, phosphorus, riboflavin, niacin, and choline to the human diet than is consumed in the beef supply chain.
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Protective role of zinc in the pathogenesis of respiratory diseases. Eur J Clin Nutr 2022; 77:427-435. [PMID: 35982216 PMCID: PMC9387421 DOI: 10.1038/s41430-022-01191-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022]
Abstract
Respiratory diseases remain a major cause of morbidity and mortality worldwide. An imbalance of zinc, an essential trace element, is associated with a variety of lung diseases. We reviewed and summarized recent research (human subjects, animal studies, in vitro studies) on zinc in respiratory diseases to explore the protective mechanism of zinc from the perspective of regulation of oxidative stress, inflammation, lipid metabolism, and apoptosis. In the lungs, zinc has anti-inflammatory, antioxidant, and antiviral effects; can inhibit cancer cell migration; can regulate lipid metabolism and immune cells; and exerts other protective effects. Our comprehensive evaluation highlights the clinical and experimental effects of zinc in the pathogenesis of respiratory diseases. Our analysis also provides insight into the clinical application of zinc-targeted therapy for respiratory diseases.
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Hussain S, Khan M, Sheikh TMM, Mumtaz MZ, Chohan TA, Shamim S, Liu Y. Zinc Essentiality, Toxicity, and Its Bacterial Bioremediation: A Comprehensive Insight. Front Microbiol 2022; 13:900740. [PMID: 35711754 PMCID: PMC9197589 DOI: 10.3389/fmicb.2022.900740] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
Zinc (Zn) is one of the most abundantly found heavy metals in the Earth's crust and is reported to be an essential trace metal required for the growth of living beings, with it being a cofactor of major proteins, and mediating the regulation of several immunomodulatory functions. However, its essentiality also runs parallel to its toxicity, which is induced through various anthropogenic sources, constant exposure to polluted sites, and other natural phenomena. The bioavailability of Zn is attributable to various vegetables, beef, and dairy products, which are a good source of Zn for safe consumption by humans. However, conditions of Zn toxicity can also occur through the overdosage of Zn supplements, which is increasing at an alarming rate attributing to lack of awareness. Though Zn toxicity in humans is a treatable and non-life-threatening condition, several symptoms cause distress to human activities and lifestyle, including fever, breathing difficulty, nausea, chest pain, and cough. In the environment, Zn is generally found in soil and water bodies, where it is introduced through the action of weathering, and release of industrial effluents, respectively. Excessive levels of Zn in these sources can alter soil and aquatic microbial diversity, and can thus affect the bioavailability and absorption of other metals as well. Several Gram-positive and -negative species, such as Bacillus sp., Staphylococcus sp., Streptococcus sp., and Escherichia coli, Pseudomonas sp., Klebsiella sp., and Enterobacter sp., respectively, have been reported to be promising agents of Zn bioremediation. This review intends to present an overview of Zn and its properties, uses, bioavailability, toxicity, as well as the major mechanisms involved in its bioremediation from polluted soil and wastewaters.
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Affiliation(s)
- Sarfraz Hussain
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes of Ministry of Education, College of Environment, Hohai University, Nanjing, China
| | - Maryam Khan
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
| | - Taha Majid Mahmood Sheikh
- Institute of Plant Protection, Jiangsu Academy of Agriculture Sciences, Nanjing, China,*Correspondence: Taha Majid Mahmood Sheikh,
| | - Muhammad Zahid Mumtaz
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
| | - Talha Ali Chohan
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan
| | - Saba Shamim
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore, Pakistan,Saba Shamim,
| | - Yuhong Liu
- Key Laboratory of Integrated Regulation and Resource Development on Shallow Lakes of Ministry of Education, College of Environment, Hohai University, Nanjing, China,Yuhong Liu,
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Wuehler S, Lopez de Romaña D, Haile D, McDonald CM, Brown KH. Reconsidering the Tolerable Upper Levels of Zinc Intake among Infants and Young Children: A Systematic Review of the Available Evidence. Nutrients 2022; 14:1938. [PMID: 35565906 PMCID: PMC9102402 DOI: 10.3390/nu14091938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/27/2023] Open
Abstract
Safe upper levels (UL) of zinc intake for children were established based on either (1) limited data from just one study among children or (2) extrapolations from studies in adults. Resulting ULs are less than amounts of zinc consumed by children in many studies that reported benefits of zinc interventions, and usual dietary zinc intakes often exceed the UL, with no apparent adverse effects. Therefore, existing ULs may be too low. We conducted a systematic bibliographic review of studies among preadolescent children, in which (1) additional zinc was provided vs. no additional zinc provided, and (2) the effect of zinc on serum or plasma copper, ceruloplasmin, ferritin, transferrin receptor, lipids, or hemoglobin or erythrocyte super-oxide dismutase were assessed. We extracted data from 44 relevant studies with 141 comparisons. Meta-analyses found no significant overall effect of providing additional zinc, except for a significant negative effect on ferritin (p = 0.001), albeit not consistent in relation to the zinc dose. Interpretation is complicated by the significant heterogeneity of results and uncertainties regarding the physiological and clinical significance of outcomes. Current zinc ULs should be reassessed and potentially revised using data now available for preadolescent children and considering challenges regarding interpretation of results.
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Affiliation(s)
- Sara Wuehler
- Nutrition International, Global Technical Services, Ottawa, ON K2P 2K3, Canada;
| | | | - Demewoz Haile
- Department of Nutrition, Institute for Global Nutrition, University of California, Davis, CA 95616, USA;
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA
| | - Christine M. McDonald
- Department of Pediatrics, University of California, San Francisco, CA 92161, USA;
- International Zinc Nutrition Consultative Group, Oakland, CA 94609, USA
| | - Kenneth H. Brown
- Department of Nutrition, Institute for Global Nutrition, University of California, Davis, CA 95616, USA;
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Cunha TA, Vermeulen-Serpa KM, Grilo EC, Leite-Lais L, Brandão-Neto J, Vale SHL. Association between zinc and body composition: An integrative review. J Trace Elem Med Biol 2022; 71:126940. [PMID: 35121408 DOI: 10.1016/j.jtemb.2022.126940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/23/2021] [Accepted: 01/24/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Zinc deficiency is related to lean body mass reduction, fat deposition, and obesity. Zinc acts in catalytic, structural, and regulatory functions, being an essential micronutrient to humans. It is crucial for maintaining lean body mass, synthesizing nucleic acids and proteins, and forming new tissues. Pre-existing zinc deficiency may contribute to obesity due to its relationship with fat deposition associated with short stature. This integrative review aims to analyze the association between zinc and body composition, hitherto very poorly established in previous studies. MATERIAL AND METHODS The electronic databases utilized in this review were PubMed and Web of Science. We identified titles and abstracts from 1178 articles relating to zinc and body composition that were published in the last ten years. After duplicates were removed, the reference lists of relevant reviews were checked, and 47 articles were obtained by manual search. MAIN FINDINGS AND CONCLUSIONS The articles were transversal or longitudinal studies, clinical trials, randomized controlled trials, reviews, systematic reviews, and meta-analysis. Although there was heterogeneity among the methodologies, the existence of an association between zinc and body composition was predominant among the studies. All articles concluded that zinc had positive effects on proteogenesis. Moreover, zinc metabolism is dysregulated in obese individuals, whose mechanisms remain controversial.
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Affiliation(s)
- Thais A Cunha
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
| | - Karina M Vermeulen-Serpa
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
| | - Evellyn C Grilo
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
| | - Lúcia Leite-Lais
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
| | - José Brandão-Neto
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil; Department of Internal Medicine, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
| | - Sancha H L Vale
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil; Department of Nutrition, Federal University of Rio Grande do Norte, Natal/RN, Brazil; Nutrition Postgraduate Program, Federal University of Rio Grande do Norte, Natal/RN, Brazil.
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Zyambo K, Hodges P, Chandwe K, Mweetwa M, Westcott J, Krebs NF, Amadi B, Kelly P. Reduced Fractional Absorption of Zinc in Children With Environmental Enteropathy in Zambia. J Pediatr Gastroenterol Nutr 2022; 74:277-283. [PMID: 34469927 DOI: 10.1097/mpg.0000000000003292] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES We measured fractional absorption of zinc (FAZ) in children with environmental enteropathy (EE) and carried out transcriptomic analysis of biopsies from these children in order to compare FAZ to histology of intestinal biopsies, expression of zinc transporter genes, and biomarkers of enteropathy. METHODS Fractional absorption of a standardized aqueous dose of zinc was measured by a dual isotope ratio technique in a cohort of children ages between 9 and 24 months in Lusaka, Zambia, who all had non-responsive stunting. Gene expression analysis was carried out on biopsies through RNA sequencing using an Illumina HiSeq2000 platform. RESULTS All 33 children had histological features of environmental enteropathy and plasma zinc concentrations below the lower limit of normal. Measured FAZ ranged from 0.18 to 0.93; all values >0.55 were observed in girls. FAZ was negatively correlated with faecal myeloperoxidase (MPO) (ρ = -0.51, n = 17; P = 0.04) and faecal calprotectin (ρ = -0.50, n = 16; P = 0.05), but not blood biomarkers. Of 41 genes with known roles in zinc metabolism, only three metallothionein genes were significantly correlated with FAZ. CONCLUSIONS Zinc homeostasis is impaired in children with environmental enteropathy, and was inversely correlated with mucosal inflammation. Reduced FAZ without specific changes in expression of most zinc transporter genes could be explained by reduced absorptive surface area due to villus/microvillus atrophy.
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Affiliation(s)
- Kanekwa Zyambo
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
| | - Phoebe Hodges
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
- Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, London, UK
| | - Kanta Chandwe
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
| | - Monica Mweetwa
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
| | - Jamie Westcott
- Section of Pediatric Nutrition, University of Colorado School of Medicine, Aurora, CO
| | - Nancy F Krebs
- Section of Pediatric Nutrition, University of Colorado School of Medicine, Aurora, CO
| | - Beatrice Amadi
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
| | - Paul Kelly
- Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia
- Blizard Institute, Barts & The London School of Medicine, Queen Mary University of London, London, UK
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Hennigar SR, Olson CI, Kelley AM, McClung JP. Slc39a4 in the small intestine predicts zinc absorption and utilization: a comprehensive analysis of zinc transporter expression in response to diets of varied zinc content in young mice. J Nutr Biochem 2021; 101:108927. [PMID: 34843931 DOI: 10.1016/j.jnutbio.2021.108927] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/28/2021] [Accepted: 11/18/2021] [Indexed: 12/20/2022]
Abstract
Zinc homeostasis is primarily maintained by zinc transporters that regulate zinc uptake and efflux in the small intestine; however, the relative contribution of the many zinc transporters identified (Slc39a1-14, Slc30a1-10) to dietary zinc absorption and utilization remains unknown. The objective of this study was to determine the expression of Slc39a1-14 and Slc30a1-10 in the small intestine and their relative contribution to dietary zinc absorption in mice. Five-week-old male C57BL/6J mice were fed modified AIN-93G diets containing <1, 30, or 100ppm zinc (n=15 mice/diet). Following 1 week of feeding, mice were given an oral gavage containing 67Zn and liver and plasma isotope appearance was determined 6-h later by ICP-MS. Expression of Slc39a1-14 and Slc30a1-10 was determined in mucosa from duodenum, jejunum, and ileum. Plasma and liver total zinc concentrations were not different after one week of feeding (P>.05). Liver and plasma appearance of 67Zn was greater in mice fed <1ppm compared to the 30ppm (P<.0001) and 100ppm (P<.0001) zinc diets. With the exception of Slc39a2, Slc39a12, Slc30a3, and Slc30a8, the remaining zinc transporters were expressed across all diets and intestinal segments. Expression of Slc39a4, Slc39a11, and Slc30a6 changed with diet (Pdiet<.05 for all); expression of Slc39a5, Slc39a7, Slc39a11, Slc39a14, Slc30a1, Slc30a2, Slc30a4, Slc30a5, Slc30a7, and Slc30a10 changed by intestinal segment (Psegment<.05 for all). Slc39a4 was the only transporter positively associated with liver (r2=0.316, P<.001) and plasma (r2=0.189, P<.01) 67Zn appearance. Although most zinc transporters are expressed in the small intestine, intestinal Slc39a4 predicts fractional zinc absorption and utilization in young mice.
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Affiliation(s)
- Stephen R Hennigar
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA; U.S. Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, Massachusetts, USA; Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA.
| | - Cassandra I Olson
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Alyssa M Kelley
- U.S. Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, Massachusetts, USA; Oak Ridge Institute for Science and Education, Belcamp, Maryland, USA
| | - James P McClung
- U.S. Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, Massachusetts, USA
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Tsang BL, Holsted E, McDonald CM, Brown KH, Black R, Mbuya MNN, Grant F, Rowe LA, Manger MS. Effects of Foods Fortified with Zinc, Alone or Cofortified with Multiple Micronutrients, on Health and Functional Outcomes: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:1821-1837. [PMID: 34167148 PMCID: PMC8483949 DOI: 10.1093/advances/nmab065] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/02/2021] [Accepted: 05/05/2021] [Indexed: 12/29/2022] Open
Abstract
Seventeen per cent of the world's population is estimated to be at risk of inadequate zinc intake, which could in part be addressed by zinc fortification of widely consumed foods. We conducted a review of efficacy and effectiveness studies to ascertain the effect of zinc fortification [postharvest fortification of an industrially produced food or beverage; alone or with multiple micronutrients (MMN)] on a range of health outcomes. Previous reviews have required that the effect of zinc be isolated; because zinc is always cofortified with MMN in existing fortification programs, we did not impose this condition. Outcomes assessed were zinc-related biomarkers (plasma or serum, hair or urine zinc concentrations, comet assay, plasma fatty acid concentrations, and the proportion of and total zinc absorbed in the intestine from the diet), child anthropometry, morbidity, mortality, cognition, plasma or serum iron and copper concentrations, and for observational studies, a change in consumption of the food vehicle. Fifty-nine studies were included in the review; 54 in meta-analyses, totaling 73 comparisons. Zinc fortification with and without MMN increased plasma zinc concentrations (efficacy, n = 27: 4.68 μg/dL; 95% CI: 2.62-6.75; effectiveness, n = 13: 6.28 μg/dL; 95% CI: 5.03-7.77 μg/dL) and reduced the prevalence of zinc deficiency (efficacy, n = 11: OR: 0.76, 95% CI: 0.60-0.96; effectiveness, n = 10: OR: 0.45, 95% CI: 0.31-0.64). There were statistically significant increases in child weight (efficacy, n = 11: 0.43 kg, 95% CI: 0.11-0.75 kg), improvements in short-term auditory memory (efficacy, n = 3: 0.32 point, 95% CI: 0.13-0.50 point), and decreased incidence of diarrhea (efficacy, n = 3: RR: 0.79, 95% CI: 0.68-0.92) and fever (efficacy, n = 2: RR: 0.85, 95% CI: 0.74-0.97). However, these effects cannot be solely attributed to zinc. Our review found that zinc fortification with or without MMN reduced the prevalence of zinc deficiency and may provide health and functional benefits, including a reduced incidence of diarrhea.
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Affiliation(s)
- Becky L Tsang
- IZiNCG Fortification Task Force
- Food Fortification Initiative, Atlanta, GA, USA
| | - Erin Holsted
- IZiNCG Fortification Task Force
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christine M McDonald
- IZiNCG Fortification Task Force
- International Zinc Nutrition Consultative Group, Oakland, CA, USA
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Kenneth H Brown
- IZiNCG Fortification Task Force
- Department of Nutrition and Institute for Global Nutrition, University of California, Davis, CA, USA
| | - Robert Black
- IZiNCG Fortification Task Force
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mduduzi N N Mbuya
- IZiNCG Fortification Task Force
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | - Frederick Grant
- IZiNCG Fortification Task Force
- Helen Keller International, Phnom Penh, Cambodia
| | - Laura A Rowe
- IZiNCG Fortification Task Force
- Food Fortification Initiative, Atlanta, GA, USA
| | - Mari S Manger
- IZiNCG Fortification Task Force
- International Zinc Nutrition Consultative Group, Oakland, CA, USA
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Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Basfi-Fer K, Csendes A, Papapietro K, Pizarro F, Olivares M, Westcott JL, Hambidge KM, Krebs NF. Zinc absorption and zinc status are reduced after either sleeve gastrectomy or Roux-en-Y gastric bypass in premenopausal women with severe obesity studied prospectively over 24 postoperative months. Am J Clin Nutr 2021; 114:322-329. [PMID: 33829230 DOI: 10.1093/ajcn/nqab039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/02/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGBP) is known to reduce zinc absorption; the effects of vertical sleeve gastrectomy (SG) and its long-term implications on zinc absorption have not yet been studied. OBJECTIVE The aim was to evaluate the effects of SG and RYGBP on zinc absorption and zinc status in premenopausal women with severe obesity up to 24 mo after surgery. METHODS Twenty-six premenopausal women undergoing SG [BMI (in kg/m2): 37.3 ± 3.2] and 32 undergoing RYGBP (BMI: 42.0 ± 4.2) were studied. A series of anthropometric, dietary, and zinc status parameters (plasma and hair zinc), and the size of the exchangeable zinc pool (EZP), as well as percentage zinc absorption from a standardized dose using a stable isotope methodology were evaluated in the patients before the surgical procedure and at 12 and 24 mo after SG or RYGBP. SG patients received 15 mg and RYGBP received 25 mg of supplemental Zn/d. RESULTS In premenopausal women, zinc absorption was decreased by 71.9% and 52.0% in SG and RYGBP, respectively, 24 mo postsurgery, compared with initial values. According to 2-factor repeated-measures ANOVA, time effect was significant (P = <0.0001), but not time × group interaction (P = 0.470). Plasma zinc below the cutoff point of 70 µg/dL increased from 0 to 15.4% and 38.1% in SG and RYGBP, respectively. Mean EZP was significantly reduced 24 mo after surgery, although no time × group interactions were observed. Hair zinc did not change across time or between groups. CONCLUSIONS Both SG and RYGBP have profound effects on zinc absorption capacity, which are not compensated for after 24 mo. Although zinc absorption reduction was similar in both types of surgeries, plasma zinc was more affected in RYGBP than SG, despite greater zinc supplementation in RYGBP.This trial was registered at http://www.isrctn.com as ISRCTN31937503.
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Affiliation(s)
- Manuel Ruz
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Pamela Rojas
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Juana Codoceo
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jorge Inostroza
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Karen Basfi-Fer
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Attila Csendes
- Department of Surgery, University of Chile Clinical Hospital, Santiago, Chile
| | - Karin Papapietro
- Department of Surgery, University of Chile Clinical Hospital, Santiago, Chile
| | - Fernando Pizarro
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Manuel Olivares
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Jamie L Westcott
- Section of Nutrition, Department of Pediatrics, School of Medicine University of Colorado, Aurora, CO, USA
| | - K Michael Hambidge
- Section of Nutrition, Department of Pediatrics, School of Medicine University of Colorado, Aurora, CO, USA
| | - Nancy F Krebs
- Section of Nutrition, Department of Pediatrics, School of Medicine University of Colorado, Aurora, CO, USA
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Quilliot D, Coupaye M, Ciangura C, Czernichow S, Sallé A, Gaborit B, Alligier M, Nguyen-Thi PL, Dargent J, Msika S, Brunaud L. Recommendations for nutritional care after bariatric surgery: Recommendations for best practice and SOFFCO-MM/AFERO/SFNCM/expert consensus. J Visc Surg 2021; 158:51-61. [PMID: 33436155 DOI: 10.1016/j.jviscsurg.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nutritional care after bariatric surgery is an issue of major importance, especially insofar as risk of deficiency has been extensively described in the literature. Subsequent to the deliberations carried out by a multidisciplinary working group, we are proposing a series of recommendations elaborated using the Delphi-HAS (official French health authority) method, which facilitates the drawing up of best practice and consensus recommendations based on the data of the literature and on expert opinion. The recommendations in this paper pertain to dietary management and physical activity, multivitamin and trace element supplementation and the prevention and treatment of specific deficiencies in vitamins B1, B9, B12, D and calcium, iron, zinc, vitamins A, E and K, dumping syndrome and reactive hypoglycemia.
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Affiliation(s)
- D Quilliot
- French Speaking Society of Clinical Nutrition and Metabolism (SFNCM), France.
| | - M Coupaye
- French Association for the Study and Research on Obesity (AFERO), France
| | - C Ciangura
- French Association for the Study and Research on Obesity (AFERO), France
| | - S Czernichow
- French Speaking Society of Clinical Nutrition and Metabolism (SFNCM), France
| | - A Sallé
- French Association for the Study and Research on Obesity (AFERO), France
| | - B Gaborit
- French Association for the Study and Research on Obesity (AFERO), France
| | - M Alligier
- French Obesity Research Center of Excellence (FORCE), France
| | - P-L Nguyen-Thi
- Medical Evaluation Department, Department of Clinical Research Support PARC, University of Lorraine, CHRU Nancy, Nancy, France
| | - J Dargent
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
| | - S Msika
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
| | - L Brunaud
- French and Francophone Society of Obesity Surgery and Metabolic Disorders (SO.FF.CO.MM), France
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16
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Grüngreiff K, Gottstein T, Reinhold D. Zinc Deficiency-An Independent Risk Factor in the Pathogenesis of Haemorrhagic Stroke? Nutrients 2020; 12:E3548. [PMID: 33228216 PMCID: PMC7699494 DOI: 10.3390/nu12113548] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/03/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022] Open
Abstract
Zinc is an essential trace element for human health and plays a fundamental role in metabolic, immunological and many other biological processes. The effects of zinc are based on the intra- and extracellular regulatory function of the zinc ion (Zn2+) and its interactions with proteins. The regulation of cellular zinc homeostasis takes place via a complex network of metal transporters and buffering systems that react to changes in the availability of zinc in nutrition, chronic diseases, infections and many other processes. Zinc deficiency is associated with impairment of numerous metabolic processes, reduced resistance to infections due to impaired immune functions, changes in skin and its appendages and disorders of wound healing and haemostasis. While ischemic heart attacks (myocardial infarction) occur more frequently with meat-based normal diets, haemorrhagic strokes are more frequently observed with vegetarian/vegan diets. The causes are discussed as deficiencies of various micronutrients, such as vitamin B12, vitamin D, various amino acids and also zinc. In the present review, after a description of the functions of zinc and its resorption, a discussion of daily food intake will follow, with a special focus on the importance of food composition and preparation for the zinc balance. The close interrelationships between proteins, especially albumin and zinc will be discussed. Finally, the possible causes and consequences of a zinc deficiency on the blood vessels and blood coagulation are considered.
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Affiliation(s)
- Kurt Grüngreiff
- Clinic of Gastroenterology, City Hospital Magdeburg GmbH, 39130 Magdeburg, Germany;
| | - Thomas Gottstein
- Clinic of Gastroenterology, City Hospital Magdeburg GmbH, 39130 Magdeburg, Germany;
| | - Dirk Reinhold
- Institute of Molecular and Clinical Immunology, Otto-von-Guericke University, 39120 Magdeburg, Germany;
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Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in low- and middle-income countries: prevalence and approaches for mitigation. J Hum Nutr Diet 2020; 33:624-643. [PMID: 32627912 DOI: 10.1111/jhn.12791] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/14/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022]
Abstract
This review addresses the prevalence of zinc deficiency in Low- and Middle-income Countries (LMICs) and assesses the available strategies for its alleviation. The paucity of national-level data on the zinc deficiency in LMICs is partially a result of the lack of a reliable biomarker. Zinc deficiency appears to be a public health problem in almost all the LMICs, irrespective of the recommended indicators (plasma zinc concentration, dietary zinc adequacy and stunting prevalence) used. Based on plasma/serum zinc concentration (PZC), which is the most appropriate indicator at present, the prevalence of zinc deficiency in LMICs is of concern. Among the 25 countries for which national PZC data were available, 23 had a zinc deficiency prevalence of >20% for at least one physiological group. Zinc supplementation is largely restricted as an adjunct therapy for diarrhoea management in children, and the best platform and the most effective way of preventive zinc supplementation delivery remains to be established. Impact assessment for current zinc fortification programmes in LMICs and the effectiveness of zinc supplementation as part of a multi-micronutrient powder is to be determined. Dietary diversification, though promising for LMICs, is in the nascent stages of development at present. Inclusion of meat and animal products can be an important way of improving zinc status. Programmatic experience with the promotion of home processing techniques to increase absorbable zinc in the diet is lacking. Conventional biofortification techniques are gaining recognition in LMICs; however, transgenic biofortification as a strategy remains controversial.
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Affiliation(s)
- S Gupta
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
| | - A K M Brazier
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
| | - N M Lowe
- Lancashire Research Centre for Global Development, University of Central Lancashire, Preston, UK
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Purwandari A, Suparyatmo JB, Sugiarto S. Pengaruh Konsumsi Buah jeruk (Citrus reticulata) dan Suplementasi Zinc terhadap Kadar Glukosa Darah Puasa pada Wanita Diabetes Melitus Tipe 2. AMERTA NUTRITION 2019. [DOI: 10.20473/amnt.v3i4.2019.225-231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Patients with Diabetes Mellitus (DM) Type 2 are at risk of micronutrient loss related to metabolic diseases, one of them is zinc. It plays an important role since it affects the function of pancreatic cell β, insulin activities, glucose homeostasis and pathogenesis of DM. Low zinc levels are associated with higher complications of DM. One of the nutrients that helps absorbing zinc is organic acids such as citric acid and ascorbic acid contained in citrus fruits.Objective: to analyze the effect of citrus fruits (Citrus reticulata) and zinc supplements consumption on fasting blood glucose in women with DM Type 2.Method: This study was an experimental study using pretest and posttest method with control group. The subjects were 30 people with DM Type 2 in Prolanis club in three Puskesmas in Surabaya who had been selected using consecutive sampling, and divided into 2 groups, namely the treatment group that consumed 200 g of orange and 20 mg of zinc supplement per day and the control group that consumed only 20 mg zinc per day. Citrus fruits and zinc supplements were consumed daily for four weeks. Fasting blood glucose was analyzed using automatic chemistry analyzer. Data analysis included univariate analysis with Shapiro-Wilk and bivariate analysis with Independent t-test, Mann-Whitney and Paired t-testResults: Fasting blood glucose in the subjects consuming citrus fruits and zinc supplements was decreased by 16.67 mg/dl (from 155.87 mg/dl to 139.20 mg/dl) (p = 0.121), while the group with zinc consumption was decreased by 9.85 mg/dl (from 140.93 mg/dl to 131.13 mg/dl) (p = 0.095). The decrease in fasting blood glucose in both groups was not statistically significant.Conclusion: Consumption of citrus fruits and zinc supplements did not significantly reduce fasting blood glucose in women with DM Type 2. Further research is needed with a longer period of intervention to better reflect the changes in zinc metabolism related to blood glucose control.ABSTRAKLatar Belakang : Pasien Diabetes Mellitus (DM) Tipe 2 beresiko kehilangan zat gizi mikro terkait metabolik penyakitnya, salah satunya adalah zinc. Zinc berperan penting karena mempengaruhi fungsi sel β pankreas, aktifitas insulin, homeostasis glukosa dan patogenesis DM. Kadar zinc yang rendah terkait dengan komplikasi DM yang lebih tinggi. Salah satu zat gizi yang membantu penyerapan zinc adalah asam organik seperti asam sitrat dan asam askorbat yang terkandung dalam buah jeruk.Tujuan : Menganalisa pengaruh konsumsi buah jeruk (Citrus reticulata) dan suplementasi zinc terhadap kadar gula darah puasa wanita DM tipe 2.Metode : Rancangan berupa quasi eksperimental dengan metode pretest and posttest with control group. Jumlah subjek 30 orang wanita DM tipe 2 anggota klub Prolanis di 3 Puskesmas di Kota Surabaya yang dipilih secara consecutive sampling, terbagi dalam 2 kelompok yaitu kelompok perlakuan yang mengkonsumsi 200 gram jeruk dan suplementasi zinc 20 mg/hari serta kelompok kontrol hanya mengkonsumsi zinc 20 mg/hari. Intervensi dilakukan 4 minggu. Gula darah puasa dianalisa menggunakan automatic chemistry analizer. Analisis data meliputi univariat dengan Shapiro-Wilk, analisa bivariat meliputi Independent t-test dan Mann-Whitney.Hasil : Meskipun rata-rata penurunan gula darah puasa sebesar 16,67 mg/dl pada subjek yang mengkonsumsi jeruk dan suplementasi zinc (p=0,121), namun tidak signifikan secara statistik.Kesimpulan : Konsumsi buah jeruk dan suplementasi zinc tidak signifikan menurunkan gula darah puasa wanita DM Tipe 2. Diperlukan penelitian lanjutan dengan jangka waktu intervensi yang lebih lama.
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Zyba SJ, Wegmüller R, Woodhouse LR, Ceesay K, Prentice AM, Brown KH, Wessells KR. Effect of exogenous phytase added to small-quantity lipid-based nutrient supplements (SQ-LNS) on the fractional and total absorption of zinc from a millet-based porridge consumed with SQ-LNS in young Gambian children: a randomized controlled trial. Am J Clin Nutr 2019; 110:1465-1475. [PMID: 31504101 DOI: 10.1093/ajcn/nqz205] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/26/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Dietary phytate inhibits zinc absorption from composite meals in adults. OBJECTIVE The objective of this study was to investigate the effect of adding exogenous phytase to a small-quantity lipid-based nutrient supplement (SQ-LNS) on zinc absorption among young children. METHODS In a double-blind randomized controlled trial, intraindividual differences in fractional and total absorption of zinc (FAZ and TAZ, respectively) from a millet-based porridge containing SQ-LNS with and without phytase were measured in 30 asymptomatic children 18-23 mo of age in the Kiang West district of The Gambia. Using a crossover design, children received for 1 d each porridge test meals with 20 g SQ-LNS containing 8 mg zinc and either 1) exogenous phytase or 2) no exogenous phytase. The test meals were provided on consecutive days in randomized order. FAZ was measured using a triple stable isotope tracer ratio technique with Zn-67 and Zn-70 as oral tracers and Zn-68 as the intravenous tracer. RESULTS Twenty-six participants completed the study. The prevalence of stunting and wasting were 20% and 13%, respectively; no children had low plasma zinc concentrations (<65 μg/dL). Total mean ± SD dietary zinc intake from the test meals was 7.3 ± 2.2 mg (phytate:zinc molar ratio = 3.1 ± 0.3, not accounting for phytase activity). Mean FAZ increased from 8.6% ± 1.3% to 16.0% ± 1.3% when exogenous phytase was added to the SQ-LNS product (P < 0.001). Mean TAZ from test meals containing SQ-LNS with phytase was more than double that from test meals containing SQ-LNS without phytase (1.1 ± 0.1 mg and 0.5 ± 0.1 mg, respectively; P < 0.001). CONCLUSIONS The addition of exogenous phytase to SQ-LNS increased both FAZ and TAZ. These results suggest that phytate reduction may be an important strategy to increase zinc absorption among young children. This trial was registered at clinicaltrials.gov as NCT02668133.
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Affiliation(s)
- Sarah J Zyba
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Rita Wegmüller
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.,Department of Health Sciences and Technology, Human Nutrition Laboratory, Institute of Food, Nutrition and Health, ETH Zurich, Zurich, Switzerland
| | - Leslie R Woodhouse
- Agricultural Research Service, Western Human Nutrition Research Center, US Department of Agriculture, Davis, CA, USA
| | - Kabiru Ceesay
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Andrew M Prentice
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Kenneth H Brown
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - K Ryan Wessells
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA, USA
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Mondal P, Long JM, Westcott JE, Islam MM, Ahmed M, Mahfuz M, Ahmed T, Miller LV, Krebs NF. Zinc Absorption and Endogenous Fecal Zinc Losses in Bangladeshi Toddlers at Risk for Environmental Enteric Dysfunction. J Pediatr Gastroenterol Nutr 2019; 68:874-879. [PMID: 31033623 PMCID: PMC6553983 DOI: 10.1097/mpg.0000000000002361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/21/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Environmental enteric dysfunction (EED) impairs zinc absorption from food, and zinc deficiency may contribute to the poor growth associated with EED. We examined zinc absorption from a standardized aqueous zinc dose, and habitual daily endogenous fecal zinc excretion (EFZ) and compared these outcomes between children grouped by the lactulose to mannitol ratio (L:M). METHODS Bangladeshi toddlers (18-24 months) with low (<0.09) and high (≥0.09) L:M were administered isotope-labeled 3 mg aqueous zinc in the fasted state. Fractional absorption of zinc (FAZ) and EFZ were measured by dual stable isotope tracer method and an isotope dilution method, respectively. Secondary aims included examining relationships of biomarkers of systemic and intestinal inflammation and gut function with FAZ and EFZ. RESULTS Forty children completed the study; nearly all had evidence of EED. No differences in zinc homeostasis measurements (mean ± SD) were observed between high and low L:M groups: FAZ was 0.38 ± 0.19 and 0.31 ± 0.19, respectively; both figures were within estimated reference range. Means of EFZ were 0.73 ± 0.27 and 0.76 ± 0.20 mg/day for high and low L:M, respectively, and were 10% to 15% above estimated reference range. Regression analyses indicated that biomarkers of systemic inflammation were directly associated with increasing FAZ, consistent with increased gut permeability. Biomarkers of intestinal inflammation were negatively associated with EFZ, consistent with low-zinc intake and chronic deficiency. CONCLUSIONS In these children at risk of EED, endogenous zinc losses were not markedly increased. Results suggest that efforts to improve zinc status in EED should focus on substantially improving zinc intakes.
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Affiliation(s)
- Prasenjit Mondal
- Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Julie M. Long
- University of Colorado School of Medicine, Department of Pediatrics, Section of Nutrition, Aurora, CO
| | - Jamie E. Westcott
- University of Colorado School of Medicine, Department of Pediatrics, Section of Nutrition, Aurora, CO
| | - M. Munirul Islam
- Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mondar Ahmed
- Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mustafa Mahfuz
- Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Leland V. Miller
- University of Colorado School of Medicine, Department of Pediatrics, Section of Nutrition, Aurora, CO
| | - Nancy F. Krebs
- University of Colorado School of Medicine, Department of Pediatrics, Section of Nutrition, Aurora, CO
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Richardson CER, Nolan EM, Shoulders MD, Lippard SJ. A Sensitive, Nonradioactive Assay for Zn(II) Uptake into Metazoan Cells. Biochemistry 2018; 57:6807-6815. [PMID: 30381945 PMCID: PMC6437758 DOI: 10.1021/acs.biochem.8b01043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sensitive measurements of cellular Zn(II) uptake currently rely on quantitating radioactive emissions from cells treated with 65Zn(II). Here, we describe a straightforward and reliable method employing a stable isotope to sensitively measure Zn(II) uptake by metazoan cells. First, biological medium selectively depleted of natural abundance Zn(II) using A12-resin [Richardson, C. E. R., et al. (2018) J. Am. Chem. Soc. 140, 2413] is restored to physiological levels of Zn(II) by addition of a non-natural Zn(II) isotope distribution comprising 70% 70Zn(II). The resulting 70Zn(II)-enriched medium facilitates quantitation of Zn(II) uptake using inductively coupled plasma-mass spectrometry (ICP-MS). This sensitive and reliable assay assesses Zn(II)-uptake kinetics at early time points and can be used to delineate how chemical and genetic perturbations influence Zn(II) uptake. Further, the use of ICP-MS in a Zn(II)-uptake assay permits simultaneous measurement of multiple metal ion concentrations. We used this capability to show that, across three cell lines, Zn(II) deficiency enhances selectivity for Zn(II) over Cd(II) uptake.
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Affiliation(s)
- Christopher E. R. Richardson
- Department of Chemistry, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
| | - Elizabeth M. Nolan
- Department of Chemistry, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
| | - Matthew D. Shoulders
- Department of Chemistry, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
| | - Stephen J. Lippard
- Department of Chemistry, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, United States
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23
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Catapano MC, Tvrdý V, Karlíčková J, Mercolini L, Mladěnka P. A simple, cheap but reliable method for evaluation of zinc chelating properties. Bioorg Chem 2018; 77:287-292. [DOI: 10.1016/j.bioorg.2018.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/05/2018] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
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Pneumococcal vaccination for splenectomized patients with thalassemia major in Indonesia. Vaccine 2017; 35:4583-4586. [PMID: 28712490 DOI: 10.1016/j.vaccine.2017.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/25/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Streptococcus pneumoniae is a capsulated bacterium that can cause severe infection in patients with thalassemia major, particularly those who have undergone splenectomy. The absence of the spleen as well as zinc deficiency in splenectomized patients with thalassemia major increases the possibility of developing invasive pneumococcal infection. The aims of this study are to evaluate pneumococcal IgG levels following PCV and PPV immunizations and the effect of zinc supplementation on qualitative specific immune responses in splenectomized patients with thalassemia. METHODS Splenectomized patients with thalassemia major were administered a PCV pneumococcal vaccine (Prevenar 13®) at the start of the trial, after which they were randomly assigned to 2 groups (zinc and placebo group). After 8weeks, the patients received a PPV pneumococcal vaccine (Pneumovax®). Zinc syrup was provided to the zinc group at a dose of 1.5mg/kg/day (maximum of 50mg/day). Pneumococcal IgG examinations were conducted at the start of the trial and after 12weeks. RESULTS In the group without PPV, the median initial pneumococcal IgG value was 315 (ranging from 65 to 1419) mU/mL for the zinc group and 338.5 (ranging from 82 to 1648) mU/mL for the placebo group. The median final pneumococcal IgG value was 1812.5 (ranging from 834 to 2444) mU/mL for the zinc group and 2857.5 (ranging from 834 to 2624) for the placebo group. The increase in the pneumococcal IgG value between the two groups was comparable (p=0.642). In the group with previous PPV, the median initial pneumococcal IgG value was 1333 (ranging from 793 to 2031) mU/mL for the zinc group and 880 (ranging from 74 to 1686) mU/mL for the placebo group. The median final pneumococcal IgG value was 1487 (ranging from 635 to 1757) mU/mL for the zinc group and 1012 (ranging from 292 to 1732) mU/mL for the placebo group. The increase in the pneumococcal IgG value between the two groups was comparable (p=0.528). CONCLUSION There is no difference in the increase in pneumococcal IgG level in splenectomized patients with thalassemia major prior to and after receiving PPV. There were no differences observed in the development of pneumococcal IgG following zinc supplementation.
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Wang C, Lin X, Guo D, Ding L, Guo H, Xu G, Cui X, Wang X. Zinc Fractional Absorption from a Representative Diet in Young Chinese Men and Women of the Shandong Rural Region. Biol Trace Elem Res 2017; 177:16-24. [PMID: 27744602 DOI: 10.1007/s12011-016-0865-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
The objective of this study was to investigate the zinc fractional absorption of young Chinese men and women from the Shandong rural region under the routine dietary pattern by stable isotope technique. Ten men and 10 women, aged 20 to 35 years, and with a representative diet during the experiment were recruited from the Shandong rural region. Stable 67Zn was used as a tracer to label ZnCl2, and Yb was used to monitor the excretion of 67Zn in urine and feces. All volunteers were given rice containing 4.0 mg 67Zn and 1.0 mg Yb on the fourth day. Then the food and fecal samples of all subjects were collected for 12 consecutive days. The total zinc and the stable zinc isotope ratio of all samples were determined by atomic absorption spectrophotometer and thermal ionization mass spectrometer, respectively. The determination of the other nutrients was performed based on the Chinese National Standard Methods. Among volunteers, the daily intake of zinc was 15.50 mg, 103.33 % of recommended nutrient intake (RNI, set by the Chinese Nutrition Society) in men and 15.43 mg, 134.17 % in women. The fractional absorption of Zn was 23.42 ± 2.23 % in men, and 22.49 ± 2.19 % in women. The protein candidates got from the typical diets was 93.96 % of RNI in women. Calcium and ascorbic acid intakes were 76.23 % of RNI and 27.91 % of RNI in men, respectively and 51.17 % of RNI and 34.23 % of RNI in women, respectively. Our results showed that a typical meal for someone in the Shandong rural region presented an adequate intake of zinc and a moderate Zn bioavailability. The shortage of protein and the inappropriate protein pattern may play important roles in reducing zinc bioavailability.
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Affiliation(s)
- Cuiping Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xinying Lin
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
| | - Dongmei Guo
- Department of Chemistry and Bacteria Detection, School of Public Health, Shandong University, Jinan, China
| | - Lili Ding
- Nutrition Department, Beijing Hospital, Beijing, China
| | - Haifeng Guo
- China Nutrition and Health Food Association, Beijing, China
| | - Guifa Xu
- Department of Nutrition and Food Hygiene, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China
| | - Xi Cui
- Department of Chemistry and Bacteria Detection, School of Public Health, Shandong University, Jinan, China
| | - Xia Wang
- Department of Maternal and Child Health Care, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.
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Hess SY, Peerson JM, King JC, Brown KH. Use of Serum Zinc Concentration as an Indicator of Population Zinc Status. Food Nutr Bull 2016; 28:S403-29. [DOI: 10.1177/15648265070283s303] [Citation(s) in RCA: 189] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assessing the prevalence and severity of zinc deficiency in populations is critical to determine the need for and appropriate targeting of zinc intervention programs and to assess their effectiveness for improving the health and well-being of high-risk populations. However, there is very little information on the zinc status of populations worldwide due to the lack of consensus on appropriate biochemical indicators of zinc status. The objective of this review was to evaluate the use of serum zinc concentration as an indicator of population zinc status. We have reviewed the response of serum zinc concentration to dietary zinc restriction and zinc supplementation. In addition, we completed pooled analyses of nine zinc intervention trials in young children to assess the relations between serum zinc concentration of individuals before treatment and their responses to zinc supplementation. Also, in updated combined analyses of previously published data, we investigated the relation between the mean initial serum zinc concentration of a study population and their mean growth responses to zinc supplementation in randomized intervention trials among children. The results from depletion/repletion studies indicate that serum zinc concentrations respond appreciably to severe dietary zinc restriction, although there is considerable interindividual variation in these responses. There is also clear evidence that both individual and population mean serum zinc concentrations increase consistently during zinc supplementation, regardless of the initial level of serum zinc concentration. By contrast, an individual's serum zinc concentration does not reliably predict that person's response to zinc supplementation. Serum zinc concentration can be considered a useful biomarker of a population's risk of zinc deficiency and response to zinc interventions, although it may not be a reliable indicator of individual zinc status.
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Chu A, Foster M, Ward S, Zaman K, Hancock D, Petocz P, Samman S. Zinc-induced upregulation of metallothionein (MT)-2A is predicted by gene expression of zinc transporters in healthy adults. GENES AND NUTRITION 2015; 10:44. [PMID: 26446034 DOI: 10.1007/s12263-015-0494-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 09/25/2015] [Indexed: 01/09/2023]
Abstract
The usefulness of zinc transporter and metallothionein (MT) gene expressions to detect changes in zinc intake remains unclear. This pilot study aimed to determine the effects of zinc supplementation on zinc transporter and MT gene expressions in humans. Healthy adults (n = 39) were randomised to zinc treatment (ZT), receiving 22 mg Zn/day (n = 19), or no treatment (NT) (n = 20). Blood samples were collected on Days 0, 2, 7, 14, and 21. Plasma zinc and serum C-reactive protein concentrations were analysed. Gene expression of zinc transporters and MT in peripheral blood mononuclear cells was analysed using real-time PCR. Using repeated-measures ANOVA, MT-2A gene expression and fold change were found to be higher in the ZT group (P = 0.025 and P = 0.016, respectively) compared to the NT group, specifically at Day 2 (40 ± 18 % increase from baseline, P = 0.011), despite no significant increase in plasma zinc concentration. In a multiple regression model exploring the changes in gene expressions between Days 0 and 21, the change in MT-2A gene expression was correlated with changes in all zinc transporter expressions (r (2) = 0.54, P = 0.029); the change in ZIP1 expression emerged as a univariate predictor (P = 0.003). Dietary zinc intake was predictive of zinc transporter and MT expressions (P = 0.030). Physical activity level was positively correlated with baseline ZIP7 expression (r = 0.36, P = 0.029). The present study shows that MT-2A expression is related to changing expression of zinc transporter genes, specifically ZIP1, in response to zinc supplementation. The current report adds to our understanding of MT in the coordinated nature of cellular zinc homeostasis.
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Affiliation(s)
- Anna Chu
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia
| | - Meika Foster
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Sarah Ward
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia
| | - Kamrul Zaman
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia
| | - Dale Hancock
- Discipline of Molecular Biology, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia
| | - Peter Petocz
- Department of Statistics, Macquarie University, Sydney, NSW, 2109, Australia
| | - Samir Samman
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, NSW, 2006, Australia.
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Tran CD, Gopalsamy GL, Mortimer EK, Young GP. The potential for zinc stable isotope techniques and modelling to determine optimal zinc supplementation. Nutrients 2015; 7:4271-95. [PMID: 26035248 PMCID: PMC4488783 DOI: 10.3390/nu7064271] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/18/2015] [Indexed: 01/17/2023] Open
Abstract
It is well recognised that zinc deficiency is a major global public health issue, particularly in young children in low-income countries with diarrhoea and environmental enteropathy. Zinc supplementation is regarded as a powerful tool to correct zinc deficiency as well as to treat a variety of physiologic and pathologic conditions. However, the dose and frequency of its use as well as the choice of zinc salt are not clearly defined regardless of whether it is used to treat a disease or correct a nutritional deficiency. We discuss the application of zinc stable isotope tracer techniques to assess zinc physiology, metabolism and homeostasis and how these can address knowledge gaps in zinc supplementation pharmacokinetics. This may help to resolve optimal dose, frequency, length of administration, timing of delivery to food intake and choice of zinc compound. It appears that long-term preventive supplementation can be administered much less frequently than daily but more research needs to be undertaken to better understand how best to intervene with zinc in children at risk of zinc deficiency. Stable isotope techniques, linked with saturation response and compartmental modelling, also have the potential to assist in the continued search for simple markers of zinc status in health, malnutrition and disease.
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Affiliation(s)
- Cuong D Tran
- CSIRO Food and Nutrition Flagship, Gate 13, Kintore Ave, Adelaide SA 5000, Australia.
- School of Medical Sciences, Faculty of Health Sciences, The University of Adelaide, Adelaide SA 5005, Australia.
| | - Geetha L Gopalsamy
- CSIRO Food and Nutrition Flagship, Gate 13, Kintore Ave, Adelaide SA 5000, Australia.
- Flinders University of South Australia, Bedford Park, GPO Box 2100, Adelaide SA 5001, Australia.
| | - Elissa K Mortimer
- Flinders University of South Australia, Bedford Park, GPO Box 2100, Adelaide SA 5001, Australia.
| | - Graeme P Young
- Flinders University of South Australia, Bedford Park, GPO Box 2100, Adelaide SA 5001, Australia.
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The relationship between zinc intake and growth in children aged 1-8 years: a systematic review and meta-analysis. Eur J Clin Nutr 2014; 69:147-53. [PMID: 25335444 DOI: 10.1038/ejcn.2014.204] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 08/21/2014] [Accepted: 08/26/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES It is estimated that zinc deficiency affects 17% of the world's population, and because of periods of rapid growth children are at an increased risk of deficiency, which may lead to stunting. This paper presents a systematic review and meta-analysis of the randomised controlled trials (RCTs) that assess zinc intake and growth in children aged 1-8 years. This review is part of a larger systematic review by the European Micronutrient Recommendations Aligned Network of Excellence that aims to harmonise the approach to setting micronutrient requirements for optimal health in European populations (www.eurreca.org). SUBJECT/METHODS Searches were performed of literature published up to and including December 2013 using MEDLINE, Embase and the Cochrane Library databases. Included studies were RCTs in apparently healthy child populations aged from 1 to 8 years that supplied zinc supplements either as capsules or as part of a fortified meal. Pooled meta-analyses were performed when appropriate. RESULTS Nine studies met the inclusion criteria. We found no significant effect of zinc supplementation of between 2 weeks and 12 months duration on weight gain, height for age, weight for age, length for age, weight for height (WHZ) or WHZ scores in children aged 1-8 years. CONCLUSIONS Many of the children in the included studies were already stunted and may have been suffering from multiple micronutrient deficiencies, and therefore zinc supplementation alone may have only a limited effect on growth.
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Fink G, Heitner J. Evaluating the cost-effectiveness of preventive zinc supplementation. BMC Public Health 2014; 14:852. [PMID: 25128210 PMCID: PMC4143582 DOI: 10.1186/1471-2458-14-852] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 08/06/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Even though the WHO currently recommends zinc for diarrhea management, no consensus has been reached with respect to routine distribution of zinc for preventive reasons. We reviewed the health impact of preventive zinc interventions, and evaluated the relative cost effectiveness of currently feasible interventions. METHODS Using the latest relative risk estimates reported in the literature, we parameterized a health impact model, and calculated the expected benefits of zinc supplementation in a representative low-income country. We then computed the cost and cost-effectiveness for three delivery mechanisms: the direct distribution of zinc supplements, the distribution of micronutrient biscuits including zinc, and the distribution of zinc through water filtration systems. RESULTS Combining all health outcomes and impact estimates, we find that systematic zinc supplementation among children of ages one to five would avert 1.423 DALYs per 100 households and year in least developed countries. The estimated cost per DALY is US$ 606 for pill supplementation, US$ 1211 for micronutrient biscuits, and US$ 879 per DALY saved for water filtration systems. CONCLUSIONS Preventive zinc supplementation to children of ages 1-5 appears to be a highly cost-effective intervention in typical developing country settings. More research will be needed to determine the most effective mechanism to deliver zinc to this target population.
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Affiliation(s)
- Günther Fink
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA USA
| | - Jesse Heitner
- Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA USA
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Wegmüller R, Tay F, Zeder C, Brnić M, Hurrell RF. Zinc absorption by young adults from supplemental zinc citrate is comparable with that from zinc gluconate and higher than from zinc oxide. J Nutr 2014; 144:132-6. [PMID: 24259556 PMCID: PMC3901420 DOI: 10.3945/jn.113.181487] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The water-soluble zinc salts gluconate, sulfate, and acetate are commonly used as supplements in tablet or syrup form to prevent zinc deficiency and to treat diarrhea in children in combination with oral rehydration. Zinc citrate is an alternative compound with high zinc content, slightly soluble in water, which has better sensory properties in syrups but no absorption data in humans. We used the double-isotope tracer method with (67)Zn and (70)Zn to measure zinc absorption from zinc citrate given as supplements containing 10 mg of zinc to 15 healthy adults without food and compared absorption with that from zinc gluconate and zinc oxide (insoluble in water) using a randomized, double-masked, 3-way crossover design. Median (IQR) fractional absorption of zinc from zinc citrate was 61.3% (56.6-71.0) and was not different from that from zinc gluconate with 60.9% (50.6-71.7). Absorption from zinc oxide at 49.9% (40.9-57.7) was significantly lower than from both other supplements (P < 0.01). Three participants had little or no absorption from zinc oxide. We conclude that zinc citrate, given as a supplement without food, is as well absorbed by healthy adults as zinc gluconate and may thus be a useful alternative for preventing zinc deficiency and treating diarrhea. The more insoluble zinc oxide is less well absorbed when given as a supplement without food and may be minimally absorbed by some individuals. This trial was registered at clinicaltrials.gov as NCT01576627.
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Affiliation(s)
- Rita Wegmüller
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland; and,To whom correspondence should be addressed. E-mail:
| | - Fabian Tay
- Clinical Trials Center, Center for Clinical Research, University Hospital Zurich, Zurich, Switzerland
| | - Christophe Zeder
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland; and
| | - Marica Brnić
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland; and
| | - Richard F. Hurrell
- Human Nutrition Laboratory, Institute of Food, Nutrition and Health, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland; and
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Brown KH, Hess SY, Vosti SA, Baker SK. Comparison of the estimated cost-effectiveness of preventive and therapeutic zinc supplementation strategies for reducing child morbidity and mortality in sub-Saharan Africa. Food Nutr Bull 2013; 34:199-214. [PMID: 23964393 DOI: 10.1177/156482651303400209] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Zinc supplementation of young children in lower-income countries reduces morbidity from diarrhea and pneumonia and all-cause mortality, but the most cost-effective approach for distributing zinc supplements is unknown. OBJECTIVE To examine the potential impact of four possible strategies for delivering zinc supplements on disease prevention and deaths averted among children 6 to 59 months of age in sub-Saharan Africa. METHODS We analyzed different zinc supplementation strategies to assess their likely impact on morbidity and mortality of preschool children in sub-Saharan Africa and to estimate their possible costs. RESULTS Preventive zinc supplementation reduces diarrhea incidence by 27% among children 12 to 59 months of age, pneumonia incidence by 21% among children 6 to 59 months of age, and all-cause mortality by 18% among children 12 to 59 months of age. The likely average total program costs of zinc supplementation programs were estimated from the outlays of existing service delivery platforms, such as child health days, community-based nutrition programs, and clinic-based treatment of diarrhea, assuming different levels of coverage and target age ranges of children. CONCLUSIONS We found that the average total costs per life saved ranged from approximately US$462 to US$3,111, and the most cost-effective interventions were weekly or intermittent preventive zinc supplementation, because of the possibility of high coverage and fewer supplements required. Empirical data from zinc supplementation programs will be needed to confirm these estimates.
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Affiliation(s)
- Kenneth H Brown
- Department of Nutrition, Program in International and Community Nutrition, University of California, One Shields Avenue, Davis, CA 95616, USA.
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Foster M, Petocz P, Samman S. Inflammation markers predict zinc transporter gene expression in women with type 2 diabetes mellitus. J Nutr Biochem 2013; 24:1655-61. [DOI: 10.1016/j.jnutbio.2013.02.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 01/30/2013] [Accepted: 02/10/2013] [Indexed: 11/30/2022]
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Bzik VA, Medani M, Baird AW, Winter DC, Brayden DJ. Mechanisms of action of zinc on rat intestinal epithelial electrogenic ion secretion: insights into its antidiarrhoeal actions. ACTA ACUST UNITED AC 2012; 64:644-53. [PMID: 22471360 DOI: 10.1111/j.2042-7158.2011.01441.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Zinc is a useful addition to oral rehydration therapy for acute diarrhoea. We have assessed the mechanism of its epithelial antisecretory action when intestinal epithelial tight junctions were pharmacologically opened. METHODS Rat isolated ileal and colonic mucosae were mounted in Ussing chambers and exposed to ZnSO(4) (Zn(2+) ) in the presence of secretagogues and inhibition of short circuit current (I(sc) ) was measured. KEY FINDINGS Pre-incubation with basolateral but not apical Zn(2+) reduced I(sc) stimulated by forskolin, carbachol and A23187. In the presence of the tight junction-opener, cytochalasin D, antisecretory effects of apically-applied Zn(2+) were enabled in colon and ileum. The apparent permeability coefficient (P(app) ) of Zn(2+) was increased 1.4- and 2.4-fold across rat ileum and colon, respectively, by cytochalasin D. Basolateral addition of Zn(2+) also reduced the I(sc) stimulated by nystatin in rat colon, confirming K channel inhibition. In comparison with other inhibitors, Zn(2+) was a relatively weak blocker of basolateral K(ATP) and K (Ca2+) channels. Exposure of ileum and colon to Zn(2+) for 60 min had minimal effects on epithelial histology. CONCLUSIONS Antisecretory effects of Zn(2+) on intestinal epithelia arose in part through nonselective blockade of basolateral K channels, which was enabled when tight junctions were open.
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Affiliation(s)
- Victoria A Bzik
- Conway Institute and School of Veterinary Medicine, University College Dublin, Belfield, Ireland
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Tran CD, Katsikeros R, Manton N, Krebs NF, Hambidge KM, Butler RN, Davidson GP. Zinc homeostasis and gut function in children with celiac disease. Am J Clin Nutr 2011; 94:1026-32. [PMID: 21865333 DOI: 10.3945/ajcn.111.018093] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Celiac disease (CD) is an immunologic enteropathy triggered by the intake of gluten. It is thought that the enteropathy impairs gut function and absorption. OBJECTIVE We assessed the zinc-absorption capacity and small-bowel integrity in children with CD. DESIGN Children in whom a diagnosis of CD was considered clinically and either confirmed (n = 16; Marsh score ≥3) or not (n = 22; Marsh score of 0) with a small-bowel biopsy (SBB) were recruited. The fractional absorption of zinc (FAZ) was determined by the administration of an oral (67)Zn dose (2.5 mg) and an intravenous (70)Zn dose (0.2 mg) 2 h before and during the SBB, respectively. Spot urine samples were collected, and zinc isotopic ratios were determined by ion-coupled plasma mass spectrometry. Gut health was assessed by the ingestion of (13)C-sucrose (20 g) after an overnight fast, and breath samples were collected and analyzed by isotope ratio mass spectrometry. RESULTS There was no difference in FAZ between children with a Marsh score ≥3 (mean ± SEM: 0.68 ± 0.05) and children with a Marsh score of 0 (0.74 ± 0.05). The exchangeable zinc pool (EZP) was significantly (P < 0.05) lower in children with a Marsh score ≥3 (2.6 ± 0.8 mg/kg) than in children with a Marsh score of 0 (3.8 ± 1.4 mg/kg). Gut function in children with a Marsh score ≥3 (4.5 ± 0.7% cumulative dose recovered at 90 min) was lower than the lower cutoff of a normal gut-function breath test (5.06% cumulative dose recovered at 90 min) but not significantly different from that in children with a Marsh score of 0 (4.9 ± 0.4%). There was a significant (P < 0.01) correlation between zinc absorption and gut function in children with CD. CONCLUSIONS Zinc absorption did not appear below usual amounts in subjects with CD. Children with CD have impaired gut function that may affect their zinc nutritional status as shown by a smaller EZP. However, the EZP decrease in children with CD was not compared with that in healthy control subjects, and its biological meaning is uncertain.
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Affiliation(s)
- Cuong D Tran
- Gastroenterology Unit, Children, Youth and Women's Health Service, Adelaide, Australia.
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Sadowska-Woda I, Rachel M, Pazdan J, Bieszczad-Bedrejczuk E, Pawliszak K. Nutritional supplement attenuates selected oxidative stress markers in pediatric patients with cystic fibrosis. Nutr Res 2011; 31:509-18. [DOI: 10.1016/j.nutres.2011.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 06/30/2011] [Accepted: 07/01/2011] [Indexed: 10/17/2022]
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Aaron GJ, Ba Lo N, Hess SY, Guiro AT, Wade S, Brown KH. Plasma zinc concentration increases within 2 weeks in healthy Senegalese men given liquid supplemental zinc, but not zinc-fortified wheat bread. J Nutr 2011; 141:1369-74. [PMID: 21562238 DOI: 10.3945/jn.110.136952] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The responsiveness of plasma zinc concentration to zinc fortification is uncertain. Our objective in this study was to determine whether plasma zinc concentration changes in response to consuming zinc-fortified foods or liquid zinc supplements. We conducted a 4-wk double-blind, randomized trial among 132 healthy Senegalese men ≥ 18 y. Participants received 1 of 4 interventions: 1) (control) 200 g/d of wheat bread fortified with iron and folic acid, but not zinc, and a liquid multivitamin supplement without zinc between meals; 2) (zinc supplement) the same bread and the same multivitamin supplement with 15 mg zinc as ZnSO(4) added; 3) (moderate zinc fortification) the same bread cofortified with 7.5 mg zinc as ZnO and the same multivitamin supplement without zinc; or 4) (high zinc fortification) the same bread cofortified with 15 mg zinc as ZnO and the same multivitamin supplement without zinc. Fasting blood samples were collected twice at baseline and at d 15 and 29 of the intervention. There was no significant interaction between group and study day (P = 0.11). However, at d 15, the mean change in plasma zinc concentration in the zinc-supplemented group was greater than in the placebo and fortification groups ( 0.72 μmol/L vs. -0.09 to 0.03 μmol/L; P = 0.05). At d 29 there were no significant group-wise differences. Across all time points, the zinc-supplemented group was the only group where plasma zinc concentration increased from baseline (P = 0.006). These results suggest that plasma zinc concentration may not be a sufficiently sensitive indicator to evaluate short-term responses to zinc fortification.
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Affiliation(s)
- Grant J Aaron
- Program in International and Community Nutrition, and Department of Nutrition, University of California, Davis, CA 95616, USA
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Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg 2011; 20:1660-70. [PMID: 20706804 DOI: 10.1007/s11695-010-0237-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although zinc deficiency is common after bariatric surgery, its incidence is underestimated. The objective was to monitor zinc and nutritional status before and 6, 12 and 24 months (M6, M12 and M24) after gastric bypass (Roux-en-Y gastric bypass), sleeve gastrectomy and biliopancreatic diversion with duodenal switch (DS) in patients receiving systematised nutritional care. METHODS Data for 324 morbidly obese patients (mean body mass index 46.2 ± 7.3 kg/m(2)) were reviewed retrospectively. The follow-up period was 6 months for 272 patients, 12 months for 175, and 24 months for 70. Anthropometric, dietary and serum albumin, prealbumin, zinc, iron and transferrin saturation measures were determined at each timepoint. RESULTS Nine percent of patients had zinc deficiency pre-operatively. Zinc deficiency was present in 42.5% of the population at M12 and then remained stable. Zinc deficiency was significantly more frequent after DS, with a prevalence of 91.7% at M12. Between M0 and M6, variation in plasma prealbumin, surgery type and zinc supplementation explained 27.2% of the variance in plasma zinc concentration. Surgery type explained 22.1% of this variance between M0 and M24. Mean supplemental zinc intake was low (22 mg/day). The percentage of patients taking zinc supplementation at M6, M12 and M24 was 8.9%, 20.6% and 29%, respectively. CONCLUSIONS Reduced protein intake, impaired zinc absorption and worsening compensatory mechanisms contribute to zinc deficiency. The mechanisms involved differ according to the type of surgery and time since surgery. Zinc supplementation is necessary early after bariatric surgery, but this requirement is often underestimated or is inadequate.
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Wessells KR, Jorgensen JM, Hess SY, Woodhouse LR, Peerson JM, Brown KH. Plasma zinc concentration responds rapidly to the initiation and discontinuation of short-term zinc supplementation in healthy men. J Nutr 2010; 140:2128-33. [PMID: 20943956 DOI: 10.3945/jn.110.122812] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To assist with the evaluation of zinc (Zn) intervention programs, information is needed on the magnitude and velocity of response of plasma Zn concentration following changes in Zn intake. Our objective in this study was to measure plasma Zn concentration of healthy adult men before and after initiation and discontinuation of 1 of 2 dosages of Zn supplements or placebo. We conducted a randomized, double-blind, placebo-controlled trial in 58 apparently healthy males aged 19-54 y. Participants received 1 of 3 liquid supplements daily for 21 d: 10 or 20 mg Zn/d, as Zn sulfate, or placebo. Fasting plasma Zn concentrations were measured on 14 occasions before, during, and after supplementation. Data were analyzed using mixed-model ANCOVA. The plasma Zn concentration was related to day of study (P < 0.0001) and study group (P < 0.0001). Controlling for baseline concentrations, plasma Zn concentrations were consistently elevated above baseline by d 5 among individuals in both of the Zn-supplemented groups compared with those receiving placebo supplements, regardless of their initial plasma Zn concentration. There were no significant group-wise differences between those who received either 10 or 20 mg/d Zn. Plasma Zn concentrations of supplemented individuals declined following withdrawal of supplementation and within 2 wk no longer differed from those of the placebo group. Change in the plasma Zn concentration is a useful indicator to monitor compliance with, and possibly effectiveness of, Zn supplementation programs. To ensure accurate interpretation of the results, samples should be collected while the intervention is still in progress.
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Affiliation(s)
- K Ryan Wessells
- Department of Nutrition, University of California, Davis, CA 95616, USA
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Bioavailability of zinc from NutriSet zinc tablets compared with aqueous zinc sulfate. Eur J Clin Nutr 2010; 65:125-31. [DOI: 10.1038/ejcn.2010.198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Brown KH, Hambidge KM, Ranum P. Zinc fortification of cereal flours: current recommendations and research needs. Food Nutr Bull 2010; 31:S62-74. [PMID: 20629353 DOI: 10.1177/15648265100311s106] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Zinc fortification is recommended as an appropriate strategy to enhance population zinc status, but guidelines are needed on the appropriate types and levels of zinc fortification of cereal flours for mass fortification programs. OBJECTIVE To review available information on the scientific rationale, efficacy, and effectiveness of zinc fortification programs, and to develop guidelines on appropriate levels of fortification of cereal flours, based on simulations of the amount of zinc absorbed under different dietary conditions and information on possible adverse effects. METHODS Systematic review of scientific literature and application of an existing prediction equation to estimate zinc absorption. RESULTS Previously completed research demonstrates that zinc intake and absorption are increased when zinc-fortified foods are consumed, but little information is, as yet, available on the biologic impact of large-scale fortification programs. Studies suggest that there are no disadvantages of the recommended ranges of zinc fortification with regard to the sensory properties of zinc-fortified foods, and most research indicates that there are no adverse effects of zinc fortification on the utilization of other minerals. CONCLUSIONS Zinc fortification of cereal flour is a safe and appropriate strategy for enhancing the zinc status of population subgroups who consume adequate amounts of fortified cereal flour, although additional information is needed to confirm the efficacy and effectiveness of large-scale zinc fortification programs to control zinc deficiency. The appropriate level of fortification depends on the population subgroup, their usual amount of flour intake, the degree of milling and fermentation that is practiced, and the usual intakes of zinc and phytate from other food sources. Fortification recommendations are presented for different dietary scenarios.
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Affiliation(s)
- Kenneth H Brown
- Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, One Shields Ave., Davis, CA 95616, USA.
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Effects of zinc exposure on zinc transporter expression in human intestinal cells of varying maturity. J Pediatr Gastroenterol Nutr 2010; 50:587-95. [PMID: 20479680 DOI: 10.1097/mpg.0b013e3181d98e85] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Zinc (Zn) homeostasis in adults is achieved principally through a balance between intestinal absorption and excretion involving adaptive mechanisms programmed by levels of dietary Zn. Zn absorption in infants is not as tightly regulated as that in adults, which may induce potential toxicity in infants due to the relatively high capacity of Zn absorption. We hypothesized that intestinal Zn homeostasis is developmentally regulated and depends on intestinal maturation, which in turn affects Zn transporter regulation. MATERIALS AND METHODS Cultured human fetal (FHs 74 Int, F) and adult (Caco-2: undifferentiated, U; differentiated, D) intestinal cells were used to determine developmental differences in Zn uptake and effects of Zn exposure on Zn transporters. RESULTS Zn uptake rates in F and U cells were higher compared with D cells (F, 9-fold; U, 3-fold). F cells were more intolerant to Zn exposure than were U or D cells (LD50 = 67.9 +/- 5.3; 117.0 +/- 5.2; 224.4 +/- 3.7 micromol/L, respectively). Two mechanisms were involved in developmental regulation of Zn homeostasis: differential Zn transporter expression and differential response to Zn exposure. In F cells, zinc-regulated transporter (ZRT)/iron-regulated transporter (IRT)-like protein (Zip)4 expression was undetectable; Zn (50 micromol/L) increased levels of Zn transporter (ZnT)1, ZnT2, and metallothionein-1 mRNA and ZnT1 protein. U and D cells had higher mRNA expression of ZnT1 (U: 5-fold; D: 7-fold, respectively) and ZnT2 (U: 2-fold; D: 9-fold, respectively) than F cells, and D cells also had higher Zip4 expression (3-fold) than U cells. In U cells, Zn exposure increased Zip4 protein level, but not membrane-associated abundance. However, in D cells, Zn exposure decreased both the Zip4 protein level and membrane-associated abundance. CONCLUSIONS Zn absorption is developmentally regulated through intestinal Zn efflux and sequestration and import mechanisms, which may be responsible for differences in Zn absorption observed between infants and adults.
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Mazariegos M, Hambidge KM, Westcott JE, Solomons NW, Raboy V, Das A, Goco N, Kindem M, Wright LL, Krebs NF. Neither a zinc supplement nor phytate-reduced maize nor their combination enhance growth of 6- to 12-month-old Guatemalan infants. J Nutr 2010; 140:1041-8. [PMID: 20335626 PMCID: PMC2855267 DOI: 10.3945/jn.109.115154] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 10/04/2009] [Accepted: 02/28/2010] [Indexed: 11/14/2022] Open
Abstract
After age 6 mo, the combination of breast-feeding and unfortified plant-based complementary feeding provides inadequate zinc (Zn). Additionally, high phytate intakes compromise the bioavailability of zinc. Our principal objective in this randomized controlled, doubly masked trial was to determine the effect of substituting low-phytate maize, a daily 5-mg zinc supplement, or both, in infants between ages 6-12 mo on impaired linear growth velocity, a common feature of zinc deficiency. In the Western Highlands of Guatemala, 412 infants were randomized to receive low-phytate or control maize. Within each maize group, infants were further randomized to receive a zinc supplement or placebo. Length, weight, and head circumference were measured at 6, 9, and 12 mo of age. There were no significant differences between the 2 maize groups or between the Zn supplement and placebo groups and no treatment interaction was observed for length-for-age (LAZ), weight-for-length (WLZ) or head circumference Z-scores. Overall mean (+/- SD) Z-scores at 6 mo for combined treatment groups were: LAZ, -2.1 +/- 1.1; WLZ, 0.7 +/- 1.0; and head circumference Z-score, -0.7.0 +/- 1.0. At 12 mo, these had declined further to: LAZ, -2.5 +/- 1.1; WLZ, -0.0 +/- 0.9; and head circumference Z-score, -0.9 +/- 1.1; 83.3% were stunted and 2% were wasted. Low linear growth in older Guatemalan infants was not improved with either low-phytate maize or a daily 5-mg zinc supplement. Low contribution of maize to the complementary food of the infants negated any potential advantage of feeding low-phytate maize.
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Affiliation(s)
- Manolo Mazariegos
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - K. Michael Hambidge
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Jamie E. Westcott
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Noel W. Solomons
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Victor Raboy
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Abhik Das
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Norman Goco
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Mark Kindem
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Linda L. Wright
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
| | - Nancy F. Krebs
- Center for Studies of Sensory Impairments, Aging and Metabolism, Guatemala City, Guatemala 01011; Section of Nutrition, Department of Pediatrics, University of Colorado Denver, Aurora, CO 80045; USDA, Agricultural Research Service, Aberdeen, ID 83210; Research Triangle Institute, Research Triangle Park, NC 27709; National Institute of Child Health and Human Development, Rockville, MD 20852
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Hambidge KM, Miller LV, Westcott JE, Sheng X, Krebs NF. Zinc bioavailability and homeostasis. Am J Clin Nutr 2010; 91:1478S-1483S. [PMID: 20200254 PMCID: PMC2854914 DOI: 10.3945/ajcn.2010.28674i] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Zinc has earned recognition recently as a micronutrient of outstanding and diverse biological, clinical, and global public health importance. Regulation of absorption by zinc transporters in the enterocyte, together with saturation kinetics of the absorption process into and across the enterocyte, are the principal means by which whole-body zinc homeostasis is maintained. Several physiologic factors, most notably the quantity of zinc ingested, determine the quantity of zinc absorbed and the efficiency of absorption. Other factors are age and the time over which zinc is ingested. Zinc from supplements has not been shown to be absorbed differently from that taken with meals that lack inhibitors of zinc absorption. The principal dietary factor known to impair zinc bioavailability is inositol hexa- (and penta-) phosphate or phytate. Modeling of zinc absorption as a function of dietary zinc and phytate accounts for >80% of the variability in the quantity of zinc absorbed. Fitting the model to new data has resulted in continual improvement in parameter estimates, which currently indicate a maximal absorption in adults of approximately 6 mg Zn/d and that the average estimated dietary requirement doubles with 1000 mg dietary phytate/d. Intestinal excretion of endogenous zinc is regulated in response to recent absorption and to zinc status. The quantitative relation of intestinal excretion of endogenous zinc to zinc absorption is currently considered to be of major importance in the determination of zinc requirements. The effects of phytate on intestinal losses of endogenous zinc merit further investigation but are probably not of the same magnitude as its inhibitory effects on absorption of exogenous zinc.
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Affiliation(s)
- K Michael Hambidge
- Department of Pediatrics, Section of Nutrition, University of Colorado Denver, Denver, CO, USA.
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Abstract
Food fortification is increasingly recognized as an effective approach to improve a population's micronutrient status. The present report provides a critical review of the scientific evidence currently available on the impact of zinc fortification on zinc nutrition. The available studies clearly show that zinc fortification can increase dietary zinc intake and total daily zinc absorption. Most absorption studies also indicate that adding zinc to food does not adversely affect the absorption of other minerals, such as iron. Despite the positive effect of zinc fortification on total zinc absorption, only a few studies have found positive impacts of zinc fortification on serum zinc concentrations or functional indicators of zinc status. The reasons for these inconsistent results are uncertain but may relate to the choice of food vehicles, the age group and zinc status of the study populations, or particular aspects of the study design. Thus, additional research is needed to determine the impact of zinc fortification, with or without other micronutrients, in populations at risk for zinc deficiency. Because of the benefits of increasing intake in populations at high risk for zinc deficiency, the documented increase in total zinc absorption that occurs following zinc fortification, the absence of any adverse effects, and the relatively low cost of adding zinc, public health planners should consider including zinc in mass and targeted fortification programs in such populations. Because of the limited available information on program impact, it will be important to evaluate the outcomes of such programs.
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Sreenivasulu K, Raghu P, Ravinder P, Nair KM. Effect of dietary ligands and food matrices on zinc uptake in Caco-2 cells: implications in assessing zinc bioavailability. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2008; 56:10967-72. [PMID: 18947232 DOI: 10.1021/jf802060q] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The kinetics, depletion/repletion of zinc, and effects of dietary ligands/food matrices on (65)Zn uptake was studied in Caco-2 cells. The uptake of zinc showed a saturable and nonsaturable component, depending upon the media zinc concentrations. Intracellular depletion increased zinc uptake, whereas zinc loading did not. Phytic acid and histidine inhibited zinc uptake, while tannic acid, tartaric acid, arginine, and methionine increased zinc uptake. Tannic acid at a 1:50 molar ratio promoted zinc uptake from wheat- and rice-based food matrices. Further, Caco-2 cells responded similarly with zinc and iron uptake when fed Indian bread prepared from low- and high-extraction wheat flour, representing low and high phytate content. However, inclusion of tea extract or red grape juice as a source of polyphenols enhanced the uptake of zinc while decreasing that of iron. These results suggest that the Caco-2 cells predict the correct direction of response to dietary ligands even from complex foods.
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Affiliation(s)
- Kilari Sreenivasulu
- Biophysics Division, National Institute of Nutrition (ICMR), Jamai Osmania, Hyderabad, India
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Abstract
The role of zinc deficiency as an important cause of morbidity and impaired linear growth has prompted the need to identify indicators of population zinc status. Three indicators have been recommended - prevalence of zinc intakes below the estimated average requirement (EAR), percentage with low serum zinc concentrations, and percentage of children aged < 5 years who are stunted. This review outlines steps to estimate the prevalence of inadequate intakes, and confirm their validity based on the EARs set by International Zinc Nutrition Collaborative Group. Next, the appropriateness of serum zinc as a biochemical marker for population zinc status is confirmed by a summary of: (a) the response of serum zinc concentrations to zinc intakes; (b) usefulness of serum zinc concentrations to predict functional responses to zinc interventions; (c) relationship between initial serum zinc and change in serum zinc in response to interventions. Height- or length-for-age was chosen as the best functional outcome after considering the responses of growth, infectious diseases (diarrhoea, pneumonia), and developmental outcomes in zinc supplementation trials and correlation studies. The potential of other zinc biomarkers such as zinc concentrations in hair, cells, zinc-metalloenzymes, and zinc-binding proteins, such as metallothionein, is also discussed. Molecular techniques employing reverse transcriptase (RT)-polymerase chain reaction to measure mRNA in metallothionein and ZIP1 transporter hold promise, as do kinetic markers such as exchangeable zinc pools (EZP) and plasma zinc turnover rates. More research is needed to establish the validity, specificity, sensitivity, and feasibility of these new biomarkers, especially in community-settings.
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Wuehler SE, Sempértegui F, Brown KH. Dose-response trial of prophylactic zinc supplements, with or without copper, in young Ecuadorian children at risk of zinc deficiency. Am J Clin Nutr 2008; 87:723-33. [PMID: 18326612 DOI: 10.1093/ajcn/87.3.723] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Multiple studies have shown the benefits of zinc supplementation among young children in high-risk populations. However, the optimal dose and safe upper level of zinc have not been determined. OBJECTIVES The objectives of this study were to measure the effects of different doses of supplemental zinc on the plasma zinc concentration, morbidity, and growth of young children; to detect any adverse effects of 10 mg supplemental Zn on markers of copper or iron status; and to determine whether any adverse effects are alleviated by providing copper with zinc. DESIGN This randomized, double-masked, community-based intervention trial was conducted in 631 Ecuadorian children who were 12-30 mo old at baseline and who had initial length-for-age z scores <-1.3. Children received 1 of 5 daily supplements for 6 mo: 3, 7, or 10 mg Zn as zinc sulfate, 10 mg Zn + 0.5 mg Cu as copper sulfate, or placebo. RESULTS The change in plasma zinc concentration from baseline was positively related to the zinc dose (P < 0.001). Zinc supplementation, including doses as low as 3 mg/d, reduced the incidence of diarrhea by 21-42% (P < 0.01). There were no other significant group-wise differences. CONCLUSIONS Zinc supplementation with a dose as low as 3 mg/d increased plasma zinc concentrations and reduced diarrhea incidence in the study population. There were no observed adverse effects of 10 mg Zn/d on indicators of copper or iron status. The current tolerable upper level of zinc recommended by the Institute of Medicine should be reassessed for young children.
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Affiliation(s)
- Sara E Wuehler
- Department of Nutrition, Program in International and Community Nutrition, University of California, Davis, Davis, CA 95616, USA
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Miller LV, Krebs NF, Hambidge KM. A mathematical model of zinc absorption in humans as a function of dietary zinc and phytate. J Nutr 2007; 137:135-41. [PMID: 17182814 PMCID: PMC1995555 DOI: 10.1093/jn/137.1.135] [Citation(s) in RCA: 152] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The quantities of zinc and phytate in the diet are the primary factors determining zinc absorption. A mathematical model of zinc absorption as a function of dietary zinc and phytate can be used to predict dietary zinc requirements and, potentially, enhance our understanding of zinc absorption. Our goal was to develop a model of practical and informative value based on fundamental knowledge of the zinc absorption process and then fit the model to selected published data to assess its validity and estimate parameter values. A model of moderate mathematical complexity relating total zinc absorption to total dietary zinc and total dietary phytate was derived and fit to 21 mean data from whole day absorption studies using nonlinear regression analysis. Model validity, goodness of fit, satisfaction of regression assumptions, and quality of the parameter estimates were evaluated using standard statistical criteria. The fit had an R(2) of 0.82. The residuals were found to exhibit a normal distribution, constant variance, and independence. The parameters of the model, A(MAX), K(R), and K(P), were estimated to have values of 0.13, 0.10, and 1.2 mmol/d, respectively. Several of these estimates had wide CI attributable in part to the small number and the scatter of the data. The model was judged to be valid and of immediate value for studying and predicting absorption. A version of the model incorporating a passive absorption mechanism was not supported by the available data.
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Affiliation(s)
- Leland V Miller
- Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
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Sheng XY, Hambidge KM, Zhu XX, Ni JX, Bailey KB, Gibson RS, Krebs NF. Major variables of zinc homeostasis in Chinese toddlers. Am J Clin Nutr 2006. [DOI: 10.1093/ajcn/84.2.389] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Xiao-Yang Sheng
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - K Michael Hambidge
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - Xi-Xiang Zhu
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - Jun-Xue Ni
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - Karl B Bailey
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - Rosalind S Gibson
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
| | - Nancy F Krebs
- From the Department of Child and Adolescent Health, Xin-Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X-YS); the Section of Nutrition, Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO (KMH and NFK); the Yun-Nan Maternal and Children’s Hospital, Yun-Nan, China (X-XZ); the Yun-Nan No. 1 People’s Hospital, Yun-Nan, China (J-XN); a
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