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Ceballos-Rasgado M, Brazier AKM, Gupta S, Moran VH, Pierella E, Fekete K, Lowe NM. Methods of Assessment of Zinc Status in Humans: An Updated Review and Meta-analysis. Nutr Rev 2024:nuae072. [PMID: 38917458 DOI: 10.1093/nutrit/nuae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
CONTEXT The assessment of zinc status is difficult but essential for the identification of zinc deficiency and evaluation of interventions to improve zinc status. OBJECTIVE The purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: Which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake of at least 2 weeks? DATA SOURCES A structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria. DATA EXTRACTION Data were extracted and combined with data from the previous SR. DATA ANALYSIS A random-effects model was used to calculate pooled mean differences using STATA (StataCorp). The risk of bias and the certainty of evidence for all outcomes were assessed. Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that, in healthy participants, both plasma/serum zinc concentration and urinary zinc excretion responded to changes in zinc intake (plasma/serum: mean effect [95% CI], controlled studies: 2.17 µmol/L [1.73, 2.61]; P < .005, I2 = 97.8; before-and-after studies: 2.87 µmol/L [2.45, 3.30]; P < .005, I2 = 98.1%; urine zinc: 0.39 mmol/mol creatinine [0.17, 0.62]; P < .005, I2 = 81.2; 3.09 µmol/day [0.16, 6.02]; P = .039, I2 = 94.3). CONCLUSION The updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability. SYSTEMATIC REVIEW REGISTRATION PROSPERO no. CRD42020219843.
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Affiliation(s)
- Marena Ceballos-Rasgado
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Anna K M Brazier
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Swarnim Gupta
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Victoria H Moran
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Elisa Pierella
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Katalin Fekete
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Pécs 7624, Hungary
| | - Nicola M Lowe
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
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Cheng J, Kolba N, Tako E. The effect of dietary zinc and zinc physiological status on the composition of the gut microbiome in vivo. Crit Rev Food Sci Nutr 2024; 64:6432-6451. [PMID: 36688291 DOI: 10.1080/10408398.2023.2169857] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Zinc serves critical catalytic, regulatory, and structural roles. Hosts and their resident gut microbiota both require zinc, leading to competition, where a balance must be maintained. This systematic review examined evidence on dietary zinc and physiological status (zinc deficiency or high zinc/zinc overload) effects on gut microbiota. This review was conducted according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and registered in PROSPERO (CRD42021250566). PubMed, Web of Science, and Scopus databases were searched for in vivo (animal) studies, resulting in eight selected studies. Study quality limitations were evaluated using the SYRCLE risk of bias tool and according to ARRIVE guidelines. The results demonstrated that zinc deficiency led to inconsistent changes in α-diversity and short-chain fatty acid production but led to alterations in bacterial taxa with functions in carbohydrate metabolism, glycan metabolism, and intestinal mucin degradation. High dietary zinc/zinc overload generally resulted in either unchanged or decreased α-diversity, decreased short-chain fatty acid production, and increased bacterial metal resistance and antibiotic resistance genes. Additional studies in human and animal models are needed to further understand zinc physiological status effects on the intestinal microbiome and clarify the applicability of utilizing the gut microbiome as a potential zinc status biomarker.
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Affiliation(s)
- Jacquelyn Cheng
- Department of Food Science, Cornell University, Ithaca, New York, USA
| | - Nikolai Kolba
- Department of Food Science, Cornell University, Ithaca, New York, USA
| | - Elad Tako
- Department of Food Science, Cornell University, Ithaca, New York, USA
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Lowe NM, Hall AG, Broadley MR, Foley J, Boy E, Bhutta ZA. Preventing and Controlling Zinc Deficiency Across the Life Course: A Call to Action. Adv Nutr 2024; 15:100181. [PMID: 38280724 PMCID: PMC10882121 DOI: 10.1016/j.advnut.2024.100181] [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: 10/31/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024] Open
Abstract
Through diverse roles, zinc determines a greater number of critical life functions than any other single micronutrient. Beyond the well-recognized importance of zinc for child growth and resistance to infections, zinc has numerous specific roles covering the regulation of glucose metabolism, and growing evidence links zinc deficiency with increased risk of diabetes and cardiometabolic disorders. Zinc nutriture is, thus, vitally important to health across the life course. Zinc deficiency is also one of the most common forms of micronutrient malnutrition globally. A clearer estimate of the burden of health disparity attributable to zinc deficiency in adulthood and later life emerges when accounting for its contribution to global elevated fasting blood glucose and related noncommunicable diseases (NCDs). Yet progress attenuating its prevalence has been limited due, in part, to the lack of sensitive and specific methods to assess human zinc status. This narrative review covers recent developments in our understanding of zinc's role in health, the impact of the changing climate and global context on zinc intake, novel functional biomarkers showing promise for monitoring population-level interventions, and solutions for improving population zinc intake. It aims to spur on implementation of evidence-based interventions for preventing and controlling zinc deficiency across the life course. Increasing zinc intake and combating global zinc deficiency requires context-specific strategies and a combination of complementary, evidence-based interventions, including supplementation, food fortification, and food and agricultural solutions such as biofortification, alongside efforts to improve zinc bioavailability. Enhancing dietary zinc content and bioavailability through zinc biofortification is an inclusive nutrition solution that can benefit the most vulnerable individuals and populations affected by inadequate diets to the greatest extent.
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Affiliation(s)
- Nicola M Lowe
- Center for Global Development, University of Central Lancashire, Preston, United Kingdom.
| | - Andrew G Hall
- Department of Nutrition, University of California, Davis, CA, United States; Department of Nutritional Sciences & Toxicology, University of California, Berkeley, CA, United States
| | - Martin R Broadley
- Rothamsted Research, West Common, Harpenden, United Kingdom; School of Biosciences, University of Nottingham, Loughborough, United Kingdom
| | - Jennifer Foley
- HarvestPlus, International Food Policy Research Institute, Washington, DC, United States
| | - Erick Boy
- HarvestPlus, International Food Policy Research Institute, Washington, DC, United States
| | - Zulfiqar A Bhutta
- Center for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada; Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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Knez M, Boy E. Existing knowledge on Zn status biomarkers (1963-2021) with a particular focus on FADS1 and FADS2 diagnostic performance and recommendations for further research. Front Nutr 2023; 9:1057156. [PMID: 36712514 PMCID: PMC9878572 DOI: 10.3389/fnut.2022.1057156] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Abstract
The role of Zn in human health was discovered 60 years ago, and despite remarkable research efforts, a sufficiently sensitive and specific biomarker of Zn status is still lacking. Plasma/serum Zn, currently the best available and most accepted population Zn status indicator, responds well to severe Zn deficiency, yet, mild to moderate Zn deficiency states usually remain unrecognized. Identifying early-stage Zn deficiency requires additional robust markers of Zn status. This paper discusses the sensitivity, specificity, and responsiveness of plasma Zn concentrations to Zn interventions. It describes the biochemical and dietary basis for the causal association between Zn and fatty acid desaturases activity, FADS1 and FADS2, based on data collected through studies performed in animals and/or humans. The influence of potential confounders and covariates on the observed relationships is considered. Additional potential Zn biomarkers are discussed and suggestions for further research in this area are provided.
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Affiliation(s)
- Marija Knez
- Center of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia,*Correspondence: Marija Knez,
| | - Erick Boy
- HarvestPlus, International Food Policy Research Institute, Washington, DC, United States
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Davis EW, Wong CP, Arnold HK, Kasschau K, Gaulke CA, Sharpton TJ, Ho E. Age and micronutrient effects on the microbiome in a mouse model of zinc depletion and supplementation. PLoS One 2022; 17:e0275352. [PMID: 36534653 PMCID: PMC9762596 DOI: 10.1371/journal.pone.0275352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Older adult populations are at risk for zinc deficiency, which may predispose them to immune dysfunction and age-related chronic inflammation that drives myriad diseases and disorders. Recent work also implicates the gut microbiome in the onset and severity of age-related inflammation, indicating that dietary zinc status and the gut microbiome may interact to impact age-related host immunity. We hypothesize that age-related alterations in the gut microbiome contribute to the demonstrated zinc deficits in host zinc levels and increased inflammation. We tested this hypothesis with a multifactor two-part study design in a C57BL/6 mouse model. The two studies included young (2 month old) and aged (24 month old) mice fed either (1) a zinc adequate or zinc supplemented diet, or (2) a zinc adequate or marginal zinc deficient diet, respectively. Overall microbiome composition did not significantly change with zinc status; beta diversity was driven almost exclusively by age effects. Microbiome differences due to age are evident at all taxonomic levels, with more than half of all taxonomic units significantly different. Furthermore, we found 150 out of 186 genera were significantly different between the two age groups, with Bacteriodes and Parabacteroides being the primary taxa of young and old mice, respectively. These data suggest that modulating individual micronutrient concentrations does not lead to comprehensive microbiome shifts, but rather affects specific components of the gut microbiome. However, a phylogenetic agglomeration technique (ClaaTU) revealed phylogenetic clades that respond to modulation of dietary zinc status and inflammation state in an age-dependent manner. Collectively, these results suggest that a complex interplay exists between host age, gut microbiome composition, and dietary zinc status.
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Affiliation(s)
- Edward W. Davis
- Center for Quantitative Life Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Carmen P. Wong
- Linus Pauling Institute, Oregon State University, Corvallis, Oregon, United States of America
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Holly K. Arnold
- Department of Microbiology, Oregon State University, Corvallis, Oregon, United States of America
| | - Kristin Kasschau
- Department of Microbiology, Oregon State University, Corvallis, Oregon, United States of America
| | - Christopher A. Gaulke
- Department of Microbiology, Oregon State University, Corvallis, Oregon, United States of America
| | - Thomas J. Sharpton
- Department of Microbiology, Oregon State University, Corvallis, Oregon, United States of America
- Department of Statistics, Oregon State University, Corvallis, Oregon, United States of America
| | - Emily Ho
- Linus Pauling Institute, Oregon State University, Corvallis, Oregon, United States of America
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, United States of America
- * E-mail:
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Maares M, Hackler J, Haupt A, Heller RA, Bachmann M, Diegmann J, Moghaddam A, Schomburg L, Haase H. Free Zinc as a Predictive Marker for COVID-19 Mortality Risk. Nutrients 2022; 14:nu14071407. [PMID: 35406020 PMCID: PMC9002649 DOI: 10.3390/nu14071407] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 12/12/2022] Open
Abstract
Free zinc is considered to be the exchangeable and biological active form of zinc in serum, and is discussed to be a suitable biomarker for alterations in body zinc homeostasis and related diseases. Given that coronavirus disease 2019 (COVID-19) is characterized by a marked decrease in total serum zinc, and clinical data indicate that zinc status impacts the susceptibility and severity of the infection, we hypothesized that free zinc in serum might be altered in response to SARS-CoV-2 infection and may reflect disease severity. To test this hypothesis, free zinc concentrations in serum samples of survivors and nonsurvivors of COVID-19 were analyzed by fluorometric microassay. Similar to the reported total serum zinc deficit measured by total reflection X-ray fluorescence, free serum zinc in COVID-19 patients was considerably lower than that in control subjects, and surviving patients displayed significantly higher levels of free zinc than those of nonsurvivors (mean ± SD; 0.4 ± 0.2 nM vs. 0.2 ± 0.1 nM; p = 0.0004). In contrast to recovering total zinc concentrations (r = 0.706, p < 0.001) or the declining copper−zinc ratio (r = −0.646; p < 0.001), free zinc concentrations remained unaltered with time in COVID-19 nonsurvivors. Free serum zinc concentrations were particularly low in male as compared to female patients (mean ± SD; 0.4 ± 0.2 nM vs. 0.2 ± 0.1 nM; p = 0.0003). This is of particular interest, as the male sex is described as a risk factor for severe COVID-19. Overall, results indicate that depressed free serum zinc levels are associated with increased risk of death in COVID-19, suggesting that free zinc may serve as a novel prognostic marker for the severity and course of COVID-19.
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Affiliation(s)
- Maria Maares
- Department of Food Chemistry and Toxicology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany; (M.M.); (A.H.)
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena, Germany;
| | - Julian Hackler
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena, Germany;
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany;
| | - Alessia Haupt
- Department of Food Chemistry and Toxicology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany; (M.M.); (A.H.)
| | - Raban Arved Heller
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany;
- Bundeswehr Hospital Berlin, Department of Traumatology and Orthopaedics, Septic and Reconstructive Surgery, 10115 Berlin, Germany
- Department of General Practice and Health Services Research, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Manuel Bachmann
- ATORG, Aschaffenburg Trauma and Orthopedic Research Group, Center for Orthopedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau, 63739 Aschaffenburg, Germany; (M.B.); (J.D.)
| | - Joachim Diegmann
- ATORG, Aschaffenburg Trauma and Orthopedic Research Group, Center for Orthopedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau, 63739 Aschaffenburg, Germany; (M.B.); (J.D.)
| | - Arash Moghaddam
- Orthopedic and Trauma Surgery, Frohsinnstraße 12, 63739 Aschaffenburg, Germany;
| | - Lutz Schomburg
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena, Germany;
- Institute for Experimental Endocrinology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10115 Berlin, Germany;
- Correspondence: (L.S.); (H.H.); Tel.: +49-30-450524289 (L.S.); +49-(0)-30-31472701 (H.H.); Fax: +49-30-4507524289 (L.S.); +49-(0)-30-31472823 (H.H.)
| | - Hajo Haase
- Department of Food Chemistry and Toxicology, Technische Universität Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany; (M.M.); (A.H.)
- TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena, Germany;
- Correspondence: (L.S.); (H.H.); Tel.: +49-30-450524289 (L.S.); +49-(0)-30-31472701 (H.H.); Fax: +49-30-4507524289 (L.S.); +49-(0)-30-31472823 (H.H.)
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Vázquez-Lorente H, Molina-López J, Herrera-Quintana L, Gamarra-Morales Y, Quintero-Osso B, López-González B, Planells E. Good antioxidant response of erythrocyte Zn levels after supplementation with Zn in a postmenopausal population. A double-blind randomized trial. Exp Gerontol 2022; 162:111766. [DOI: 10.1016/j.exger.2022.111766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/09/2022] [Accepted: 03/07/2022] [Indexed: 11/04/2022]
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