Ethanol metabolism in postmenopausal women fed a diet marginal in zinc

Applying Zinc Nutrient Reference Values as Proposed by Different Authorities Results in Large Differences in the Estimated Prevalence of Inadequate Zinc Intake by Young Children and Women and in Cameroon

Nutrient reference values (NRVs) for zinc set by several expert groups differ widely and may affect the predicted prevalence of inadequate zinc intake. We examined this possibility using NRVs published by four different authorities and nationally representative dietary intake data collected among children aged 12–59 months and women in Cameroon. Usual zinc intake was estimated from 24 h recall data using the National Cancer Institute method. Prevalences of total zinc intake below the dietary requirement and of “absorbable zinc intake” below the physiological requirement were estimated using NRVs published by the World Health Organization (WHO), US Institute of Medicine (IOM), International Zinc Nutrition Consultative Group (IZiNCG), and European Food Safety Authority (EFSA). The prevalence of inadequate zinc intake ranged from 10% (IZiNCG—physiological requirement, 95% CI 7–13%) to 81% (EFSA—physiological requirement, 95% CI 78–84%) among children and 9% (WHO—physiological requirement, 95% CI 8–11.0%) to 94% (IOM—physiological requirement, 95% CI 92–95%) among women These differences in the prevalence of inadequate intake translated into sizeable differences in the predicted benefit and cost-effectiveness of zinc fortification programs. Depending on the NRVs applied, assessments differ regarding the need for and design of zinc fortification programs. Efforts are needed to harmonize NRVs for zinc.

Dietary patterns related to zinc and polyunsaturated fatty acids intake are associated with serum linoleic/dihomo-γ-linolenic ratio in NHANES males and females

Identifying dietary patterns that contribute to zinc (Zn) and fatty acids intake and their biomarkers that may have an impact on health of males and females. The present study was designed to (a) extract dietary patterns with foods that explain the variation of Zn and PUFAs intake in adult men and women; and (b) evaluate the association between the extracted dietary patterns with circulating levels of serum dihomo-γ-linolenic fatty acid (DGLA) or serum linoleic/dihomo-γ-linolenic (LA/DGLA) ratio in males and females. We used reduced rank regression (RRR) to extract the dietary patterns separated by sex in the NHANES 2011-2012 data. A dietary pattern with foods rich in Zn (1st quintile = 8.67 mg/day; 5th quintile = 11.11 mg/day) and poor in PUFAs (5th quintile = 15.28 g/day; 1st quintile = 18.03 g/day) was found in females (S-FDP2) and the same pattern, with foods poor in PUFAs (5th quintile = 17.6 g/day; 1st quintile = 20.7 g/day) and rich in Zn (1st quintile = 10.4 mg/day; 5th quintile = 12.9 mg/day) (S-MDP2), was found in males. The dietary patterns with foods rich in Zn and poor in PUFAs were negatively associated with serum LA/DGLA ratio. This is the first study to associate the LA/DGLA ratio with Zn and PUFAs related dietary patterns in males and females.

A Review of Dietary Zinc Recommendations

BACKGROUND

Large discrepancies exist among the dietary zinc recommendations set by expert groups.

OBJECTIVE

To describe the basis for the differences in the dietary zinc recommendations set by the World Health Organization, the US Institute of Medicine, the International Zinc Nutrition Consultative Group, and the European Food Safety Agency.

METHODS

We compared the sources of the data, the concepts, and methods used by the 4 expert groups to set the physiological requirements for absorbed zinc, the dietary zinc requirements (termed estimated and/or average requirements), recommended dietary allowances (or recommended nutrient intakes or population reference intakes), and tolerable upper intake levels for selected age, sex, and life-stage groups.

RESULTS

All 4 expert groups used the factorial approach to estimate the physiological requirements for zinc. These are based on the estimates of absorbed zinc required to offset all obligatory zinc losses plus any additional requirements for absorbed zinc for growth, pregnancy, or lactation. However, discrepancies exist in the reference body weights used, studies selected, approaches to estimate endogenous fecal zinc (EFZ) losses, the adjustments applied to derive dietary zinc requirements that take into account zinc bioavailability in the habitual diets, number of dietary zinc recommendations set, and the nomenclature used to describe them.

CONCLUSIONS

Estimates for the physiological and dietary requirements varied across the 4 expert groups. The European Food Safety Agency was the only expert group that set dietary zinc recommendations at 4 different levels of dietary phytate for adults (but not for children) and as of yet no tolerable upper intake level for any life-stage group.

Zinc insufficiency mediates ethanol-induced alveolar macrophage dysfunction in the pregnant female mouse

AIMS

(a) Establish the minimum number of weeks of chronic ethanol ingestion needed to perturb zinc homeostasis, (b) Examine intracellular zinc status in the alveolar macrophages (AMs) when ethanol ingestion is combined with pregnancy, (c) Investigate whether in vitro zinc treatment reverses the effects of ethanol ingestion on the AM.

METHODS

C57BL/6 female mice were fed a liquid diet (±25% ethanol-derived calories) during preconception and pregnancy. The control group was pair-fed to the ethanol group. In the isolated AMs, we measured intracellular AM zinc levels, zinc transporter expression, alternative activation and phagocytic index. Zinc acetate was added to some cells prior to analysis.

RESULTS

Intracellular zinc levels in the AM decreased within 3 weeks of ethanol ingestion. After ethanol ingestion prior to and during pregnancy, zinc transporter expression and intracellular zinc levels were decreased in the AMs when compared with controls. Bacterial clearance was decreased because the AMs were alternatively activated. In vitro additions of zinc reversed these effects of ethanol.

CONCLUSION

Ethanol ingestion prior to and during pregnancy perturbed AM zinc balance resulting in impaired bacterial clearance, but these effects were ameliorated by in vitro zinc treatments.

Methods of assessment of zinc status in humans: a systematic review

BACKGROUND

Zinc is an essential micronutrient for human health and has numerous structural and biochemical roles. The search for a reliable, sensitive, and specific index of zinc status has been the subject of considerable research, which has resulted in the identification of a number of potentially useful biomarkers.

OBJECTIVE

The objective was to assess the usefulness of biomarkers of zinc status in humans.

DESIGN

The methods included a structured search strategy using Ovid MEDLINE, EMBASE (Ovid), and the Cochrane Library CENTRAL databases; formal inclusion and exclusion criteria; data extraction into an Access database; quality and validity assessment; and meta-analysis.

RESULTS

Data on 32 potential biomarkers from 46 publications were analyzed. Plasma zinc concentration responded in a dose-dependent manner to dietary manipulation in adults, women, men, pregnant and lactating women, the elderly, and those at low and moderate baseline zinc status. Urinary zinc excretion responded to zinc status overall and in all subgroups for which there were sufficient data. Hair zinc concentration also responded, but there were insufficient studies for subgroup analysis. Platelet, polymorphonuclear cell, mononuclear cell, and erythrocyte zinc concentration and alkaline phosphatase activity did not appear to be effective biomarkers of zinc status.

CONCLUSIONS

This systematic review confirms that in healthy individuals, plasma, urinary, and hair zinc are reliable biomarkers of zinc status. Further high-quality studies using these biomarkers are required, particularly in infants, adolescents, and immigrant population groups for whom there are limited data. Studies are also required to fully assess a range of additional potential zinc biomarkers.

Does promoter methylation of the SLC30A5 (ZnT5) zinc transporter gene contribute to the ageing-related decline in zinc status?

A decline in Zn status with ageing may contribute to the development of frailty, including impaired immune function, and increased incidence of age-related degenerative diseases. This decline may be a result of reduced dietary Zn intake and/or impaired Zn absorption in the gut. The Zn transporter ZnT5 may play a key role in the absorption of dietary Zn. The corresponding gene (SLC30A5) has a CpG island in its promoter region, so could be regulated by epigenetic mechanisms. It is hypothesised that methylation of the SLC30A5 promoter region is increased with age and that a resulting reduction in ZnT5 expression contributes to the decline in Zn status observed with ageing. This hypothesis has been addressed through (1) studies of effects of SLC30A5 promoter methylation on gene expression in vitro and (2) in vivo measurements of the DNA methylation status of this gene domain. It has been established in vitro that methylation of the human SLC30A5 promoter region results in reduced expression of an associated reporter gene. Second, this gene region shows variable levels of methylation in vivo. Correlation between the level of methylation at this locus and age would support the hypothesis that age-related hypermethylation of this region has the potential to modulate dietary Zn absorption. This premise is being investigated by analysis of additional samples from a human adult cohort to test the hypothesis that methylation of the SLC30A5 promoter region contributes to the age-related decline in Zn status.

Dietary indicators for assessing the adequacy of population zinc intakes

The assessment of dietary zinc intakes is an important component of evaluating the risk of zinc deficiency in populations, and for designing appropriate food-based interventions, including fortification, to improve zinc intakes. The prevalence of inadequate zinc intakes can describe the relative magnitude of the risk of zinc deficiency in the population and identify subpopulations at elevated risk. As a cornerstone to evaluating the adequacy of population zinc intakes globally, a set of internationally appropriate dietary reference intakes must be defined. The World Health Organization/Food and Agriculture Organization/International Atomic Energy Agency (WHO/FAO/IAEA) and the Food and Nutrition Board/US Institute of Medicine (FNB/IOM) have presented estimated average requirements (EAR) for dietary zinc intake, and, more recently, the International Zinc Nutrition Consultative Group (IZiNCG) presented a revised set of recommendations for international use. A prevalence of inadequate zinc intakes greater than 25% is considered to represent an elevated risk of population zinc deficiency. As the requirement estimates are derived from smaller, clinical studies and, for children, most components of the estimates are extrapolated from data for adults, it was desirable to evaluate their internal validity. The estimated physiological requirements for adult men and women appear to adequately predict zinc status as determined by biochemical indicators of status and/or zinc balance. With the use of data from available studies, the reported prevalence of low serum zinc concentration and the estimated prevalence of inadequate zinc intakes predict similar levels of risk of zinc deficiency, particularly among pregnant and nonpregnant women. Conformity between these two indicators is less consistent for children, suggesting that further data and/or direct studies of zinc requirements among children are needed.

Magnesium requirements: new estimations for men and women by cross-sectional statistical analyses of metabolic magnesium balance data

BACKGROUND

Current recommendations for magnesium requirements are based on sparse balance data.

OBJECTIVE

To provide new estimates of the average magnesium requirement for men and women, we pooled magnesium data from 27 different tightly controlled balance studies conducted at the US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND.

DESIGN

Magnesium balance data (magnesium intake - [fecal magnesium + urinary magnesium]) (664 data points) were collected from 243 subjects (women: n = 150; weight: 71.6 +/- 16.5 kg; age: 51.3 +/- 17.4 y; men: n = 93, weight: 76.3 +/- 12.5 kg; age: 28.1 +/- 8.1 y). Data from the last 6-14 d of each dietary period (> or =28 d) of each study were analyzed and were excluded if individual intakes of calcium, copper, iron, phosphorus, or zinc fell below respective estimated average requirements (EARs) or exceeded 99th percentiles of usual intakes of those elements (iron: above the upper limit) from the 1994 Continuing Survey of Food Intakes by Individuals. Daily intakes of magnesium ranged between 84 and 598 mg. The relation between magnesium intake and magnesium output was investigated by fitting random coefficient models.

RESULTS

The models predicted neutral magnesium balance [defined as magnesium output (Y) equal to magnesium intake (M)] at magnesium intakes of 165 mg/d [95% prediction interval (PI): 113, 237 mg/d; Y = 19.8 + 0.880 M], 2.36 mg . kg(-1) . d(-1) (95% PI: 1.58, 3.38 mg . kg(-1) . d(-1); Y = 0.306 + 0.870 M), or 0.075 mg . kcal(-1) . d(-1) (95% PI: 0.05, 0.11 mg . kcal(-1) . d(-1); Y = 0.011 + 0.857 M). Neither age nor sex affected the relation between magnesium intake and output.

CONCLUSION

The findings suggest a lower magnesium requirement for healthy men and women than estimated previously.

Zinc requirements and the risks and benefits of zinc supplementation

The adult human contains 2-3g of zinc, about 0.1% of which are replenished daily. On this basis and based on estimates of bioavailability of zinc, dietary recommendations are made for apparently healthy individuals. Absent chemical, functional, and/or physical signs of zinc deficiency are assumed indicative of adequacy. More specific data are seldom available. Changing food preferences and availability, and new food preparation, preservation, and processing technologies may require re-evaluation of past data. Conservative estimates suggest that 25% of the world's population is at risk of zinc deficiency. Most of the affected are poor, and rarely consume foods rich in highly bioavailable zinc, while subsisting on foods that are rich in inhibitors of zinc absorption and/or contain relatively small amounts of bioavailable zinc. In contrast, among the relatively affluent, food choice is a major factor affecting risk of zinc deficiency. An additional problem, especially among the relatively affluent, is risk of chronic zinc toxicity caused by excessive consumption of zinc supplements. High intakes of zinc relative to copper can cause copper deficiency. A major challenge that has not been resolved for maximum health benefit is the proximity of the recommended dietary allowance (RDA) and the reference dose (RfD) for safe intake of zinc. Present recommendations do not consider the numerous dietary factors that influence the bioavailability of zinc and copper, and the likelihood of toxicity from zinc supplements. Thus the current assumed range between safe and unsafe intakes of zinc is relatively narrow. At present, assessment of zinc nutriture is complex, involving a number of chemical and functional measurements that have limitations in sensitivity and specificity. This approach needs to be enhanced so that zinc deficiency or excess can be detected early. An increasing number of associations between diseases and zinc status and apparently normal states of health, where additional zinc might be efficacious to prevent certain conditions, point at the pharmacology of zinc compounds as a promising area. For example, relationships between zinc and diabetes mellitus are an area where research might prove fruitful. In our opinion, a multidisciplinary approach will most likely result in success in this fertile area for translational research.

[Alcohol and nutrition]

Alcoholism and alcohol-associated organ injury is one of the major health problems worldwide. Alcohol may lead to an alteration in intermediary metabolism and the relation between alcohol intake and body weight is a paradox. The effect of alcohol intake on resting metabolic rate, assessed by indirect calorimetry, and lipid oxidation, is still controversial. Small quantities of ethanol seem to have no effect on body weight. Ingestion of moderate amounts may lead to an increase in body weight, via a lipid-oxidizing suppressive effect. Chronic intake of excessive amounts in alcoholics leads to a decrease in body weight, probably via increased lipid oxidation and energy expenditure. Chronic ethanol abuse alters lipid-soluble (vitamins A, D and E) and water-soluble (B-complex vitamins, vitamin C) vitamins status, and some trace elements status such as magnesium, selenium or zinc.

Changes in dietary zinc and copper affect zinc-status indicators of postmenopausal women, notably, extracellular superoxide dismutase and amyloid precursor proteins

BACKGROUND

Zinc is an essential trace element for human health and well-being; however, methods currently available for the assessment of zinc status in humans are unsatisfactory.

OBJECTIVE

The objective was to critically evaluate the use of various indicators of zinc status in humans in a controlled metabolic ward study.

DESIGN

Indicators of zinc status were measured in 25 healthy postmenopausal women aged 64.9 +/- 6.7 y. After a 10-d equilibration period, volunteers consumed a diet with either a low (1 mg/d; n = 12) or a high (3 mg/d; n = 13) copper content based on a total energy content of 8.4 MJ. They received the same amount of copper throughout the study. Both groups were fed the basal diet (3 mg Zn/d) with no zinc supplement for one 90-d period, and the diet supplemented with 50 mg Zn/d for another 90-d period.

RESULTS

Zinc supplementation significantly increased (P < 0.0001) extracellular but not erythrocyte superoxide dismutase activity. This increase was more apparent when subjects were fed the low-copper diet. Zinc supplementation in combination with the low-copper diet significantly decreased (P < 0.01) amyloid precursor protein expression in platelets. Other indicators of zinc status that were significantly elevated after zinc supplementation were as follows: plasma zinc and free thyroxine concentrations and mononuclear 5'-nucleotidase activity.

CONCLUSION

The measurement of serum extracellular superoxide dismutase activity may be useful as a marker for the functional assessment of zinc status in humans.

[Diagnosis of zinc deficiency]

Though far more common, particularly in elderly people, than was previously assumed, marginal zinc deficiency does not lead to the classical manifestations of zinc deficiency and is therefore difficult to diagnose. There is therefore a need for sensitive parameters that can reliably demonstrate even marginal zinc deficiency, as suboptimal zinc status can seriously impair human health, performance, reproductive functions, and mental and physical development. The most important criteria for the diagnosis of zinc deficiency are critically discussed. The laboratory parameters currently considered to be the most useful indicators of marginal zinc deficiency are zinc-binding capacity and serum/plasma alkaline phosphatase activity before and after zinc supplementation (zinc tolerance test!). In order to obtain a reliable assessment of a patients zinc status, a number of different diagnostic parameters should always be measured.

Erythrocytes, erythrocyte membranes, neutrophils and platelets as biopsy materials for the assessment of zinc status in humans

During a controlled zinc depletion-repletion study, fifteen men aged 25.3 (SD 3.3) years were fed on a low-Zn diet with high phytate:Zn and phytate x calcium:Zn molar ratios for 7 weeks, followed by a 2 week repletion period when 30 mg supplemental Zn/d was given. Changes in plasma, urine, and hair Zn concentrations, taste acuity, and cellular immune response confirmed the development of mild Zn deficiency. Zn concentrations in neutrophils, platelets, erythrocytes and erythrocyte membranes, mean platelet volume, and activities of alkaline phosphatase (EC 3.1.3.1) and alpha-D-mannosidase (EC 3.2.1.24) in neutrophils did not respond to changes in Zn status. In contrast, alkaline phosphatase activity in erythrocyte membranes showed a significant decline which was consistent in all subjects (nmol product formed/min per mg protein; baseline v. 7-week Zn depletion, 0.656 (SD 0.279) v. 0.506 (SD 0.230), at 7 weeks; P < 0.05); neutral phosphatase activity remained unchanged. Alkaline phosphatase activity in erythrocyte membranes may be a potential index of Zn status in humans.

Symptomatic zinc deficiency in experimental zinc deprivation

An evaluation of indices of poor zinc status was undertaken in five male subjects in whom dietary zinc intake was reduced from 85 mumol d-1 in an initial phase of the study to 14 mumol d-1. One of the subjects developed features consistent with zinc deficiency after receiving the low zinc diet for 12 days. These features included retroauricular acneform macullo-papular lesions on the face, neck, and shoulders and reductions in plasma zinc, red blood cell zinc, neutrophil zinc and plasma alkaline phosphatase activity. Alcohol induced hepatitis, which was suspected in this subject, may have caused a predisposition to altered zinc metabolism and possible zinc deficiency which was exacerbated by subsequent zinc deprivation. The report supports the value of neutrophil zinc concentration as an indicator of poor zinc status.

Monocyte zinc and in vitro prostaglandin E2 and interleukin-1 beta production by cultured peripheral blood monocytes in patients with Crohn's disease

This study investigated the relationship between zinc status and prostaglandin E2 and interleukin-1 beta production by cultured monocytes in patients with Crohn's disease. Monocyte zinc was significantly decreased in both 12 inpatients and 22 outpatients compared with controls (P less than 0.001) but lymphocyte and polymorphonuclear cell zinc were normal. When cultured monocytes from 10 outpatients with Crohn's disease were stimulated with lipopolysaccharide, prostaglandin E2 production increased markedly, coupled with a fall in monocyte zinc. In matched controls, prostaglandin E2 production was significantly less and monocyte zinc remained stable. No difference in interleukin-1 release was noted between patients and controls. The addition of prednisolone to cell cultures suppressed prostaglandin E2, interleukin-1 synthesis, and monocyte zinc did not change. Zinc chloride augmented prostaglandin E2 production in patients, but not controls, and interleukin-1 remained stable. These results demonstrate a link between low monocyte zinc concentration and excessive prostaglandin production in patients with Crohn's disease.