The trace element zinc is indispensable for many processes in the human body. So it is not surprising that zinc deficiency is diagnosed as one of the causes of both physical and mental illness. The role of zinc in metabolism is essential and this is reflected in the results of a large number of studies. The constant flow of new results shows that the role of zinc is by no means definitively clarified.
The editorial team of Zink-Portal.de (owned by Koehler Pharma) dared to try to gather brief summaries of current research in an alphabetical and thematic overview. These small articles originally appeared in the bulletin of the company Medizin-Telegram. The newsletter provides about 15,000 subscribers with a monthly review of the latest results. Some of them relate to the role of zinc. These articles are subdivided into physical and mental illnesses in the following glossary. If you miss a survey, please email us. At this stage, it should be noted that the editorial selection does not claim to be complete.
Attention Deficit Hyperactivity Disorder (ADHD) is associated with changes in the metabolism of certain micronutrients that may be involved in the pathogenesis of this disorder. In a recent study, researchers found lower zinc levels and a higher copper / zinc ratio in children with ADHD than the control group. Copper values in children with ADHD were higher than in the control group, but not significant. The results of the study show that those affected have changes in the plasma levels of copper and zinc that correlate significantly with the symptoms of ADHD such as inattention.
(Viktorinova A et al., Changed Plasma Levels of Zinc and Copper to Zinc Ratio and Their Possible Associations with Parent- and Teacher-Rated Symptoms in Children with Attention-Deficit Hyperactivity Disorder. Biol Trace Elem Res. 2015 Jun 12)
A Polish study of 98 subjects showed that antihypertensive monotherapy reduced serum and erythrocyte zinc levels while increasing urinary zinc levels. In addition, serum CAT (catalase) and SOD (superoxide dismutase) activity as well as serum TNF-α concentration decreased, while serum NO (nitric oxide) levels increased. Higher zinc intake lowers serum glucose levels. Conclusion: Antihypertensive drugs worsen zinc status in newly diagnosed patients with high blood pressure. Antihypertensive monotherapy, combined with increased zinc intake through diet or appropriate preparations, has a positive effect on zinc homeostasis and regulates glucose status without adversely affecting the blood pressure of patients with hypertension.
(Suliburska J, Skrypnik K, Szulińska M et al.: Effect of hypotensive therapy combined with modified diet or zinc supplementation on biochemical parameters and mineral status in hypertensive patients. J Trace Elem Med Bio. 2018 May;47:140-148)
Antihypertensive drugs affect mineral metabolism, inflammatory processes and oxidative status. In a field study, 98 patients with newly diagnosed primary high blood pressure were treated monotherapeutically with diuretics, beta-blockers, calcium antagonists, ACE inhibitors or angiotensin II receptor antagonists for a period of 3 months. Concentrations of zinc, iron and copper in blood, urine and hair were determined. After taking diuretics, there is a decrease in serum and erythrocyte zinc levels. Calcium antagonists reduce the levels of zinc in erythrocytes. Decreased serum concentrations of zinc and triglycerides have been observed after taking ACE inhibitors. Decreased values of tumor necrosis factor (TNF-α has an anti-inflammatory effect) have been observed after administration of calcium antagonists. Antihypertensive agents also reduce serum catalase and superoxide dismutase concentrations. Antihypertensive monotherapy and changes in zinc metabolism obviously affect lipid metabolism as well as the oxidative and inflammatory status of the body.
(Suliburska J, Skrypnik K, Szulińska M et al.: Diuretics, Ca-Antagonists and Angiotensin-Converting Enzyme Inhibitors affect zinc status in hypertensive patients on monotherapy: A randomized trial. Nutrients. 2018 Sep 11;10(9))
According to a study, nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of heart attacks. Other studies have shown that both acute respiratory infections (ARIs) and the use of non-steroidal anti-inflammatory drugs (eg ibuprofen) can cause acute myocardial infarction. In some countries, these drugs are prescribed by doctors to relieve symptoms in patients with acute respiratory infections. Many sick people also buy their own anti-inflammatory drugs. The current Taiwanese study of 9,793 patients hospitalized for myocardial infarction showed that NSAID use during ARI was associated with a 3.4-fold increased risk of heart attack, while ARI without NSAID use was associated with a 2.7-fold increased risk of myocardial infarction. The use of NSAIDs without acute respiratory infection is associated with a 1.5-fold increase in the risk of myocardial infarction. The researchers concluded that the use of NSAIDs during acute respiratory infections, especially parenterally, is associated with a further increased risk.
(Wen, YC.; Hsiao, FY.; Chan, KA.; et. al.: Acute respiratory infection and use of non-steroidal anti-inflammatory drugs on risk of acute myocardial infarction: A nationwide case-crossover study. J Infect Dis (2017) jiw603. Publ. 01.02.2017)
To avoid such risks, taking medications with the trace element Zinc can be useful as current field work shows that zinc has
antioxidant and anti-inflammatory effects. Zinc deficiency in the context of pre-existing severe infection causes increased systemic activation of NF-κB.
(Jarosz, M.; Olbert, M.; Wyszogrodzka, G.; et. al.: Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling. Inflammopharmacology. 2017 Jan 12. doi: 10.1007/s10787-017-0309-4)
In this in vitro study (1), researchers from the Institute of Molecular and Clinical Immunology at the Otto von Guericke University in Magdeburg investigated the effect of zinc aspartate (an approved drug for the treatment of zinc deficiency) on pre-activated human T cells. For this purpose, T cells from healthy donors were stimulated with anti-CD3 / CD28 antibodies for a period of 48 hours. The study authors then added zinc aspartate or the immunosuppressants cyclosporine A, dexamethasone and rapamycin to the cell cultures for another 24 hours. They then determine T cell proliferation and cytokine production. Unlike cyclosporine A and dexamethasone, only zinc aspartate and rapamycin inhibit the proliferation of both Th1 (IFN-γ), Th2 (IL-5).
Conclusion: The results show that zinc aspartate can prevent proliferation
and cytokine production of pre-activated human T cells in vitro. Therefore, the use of zinc aspartate may have beneficial effects in T-cell-mediated autoimmune diseases, the researchers said.
About 5 to 8 percent of the German population suffers from one in about 80 to 100 different autoimmune diseases – and the trend is increasing (2). Zinc, which is required for many biological processes in living things, plays a regulatory role in maintaining immune function. Zinc deficiency affects both components of the innate and adaptive immune systems.
The basic trace element zinc also has antioxidant and anti-inflammatory properties (3).
Literature:
(1) Guttek K, Wagenbrett L, Reinhold A et al.: Zinc aspartate suppresses proliferation and Th1/Th2/Th17 cytokine production of pre-activated human t cells in vitro. J Trace Elem Med Biol. 2018 Sep;49:86-90. DOI: 10.1016/j.jtemb.2018.05.003.
(2) https://www.pharmazeutische-zeitung.de/ausgabe-232018/toleranzinduktion-als-option-auf-heilung/, abgerufen am 09.10.18.
(3) Mousavi SM, Djafarian K, Mojtahed A et al: The effect of zinc supplementation on plasma C-reactive protein concentrations: A systematic review and meta-analysis of randomized controlled trials. Eur J Pharmacol. 2018 Jul 19;834:10-16.
Women who eat strawberries or blueberries three or more times a week reduce their risk of heart attack by 32 percent compared to those who eat them once a week or even less often. Consumption of these fruits at an early age can even reduce the risk of heart attacks at a later age, regardless of known risk factors such as age, hypertension and obesity. U.S. researchers from the Harvard School of Public Health analyzed data from 93,600 women aged 25 to 42 who kept a diary of their eating habits for 4 years. Over the next 18-year study period, 405 subjects were diagnosed with a heart attack. The preventive effect is due to the anthocyanins contained in blueberries, which have a vasodilating effect and prevent the formation of blood clots. This probably applies to other anthocyanin-rich fruits and vegetables such as grapes, blackberries and eggplants.
(Aedin Cassidy et al., High Anthocyan Intake Is Associated With a Reduced Risk of Myocardial Infarction in Young and Middle-Aged Women. Circulation: Journal of the American Heart Association, 2013 DOI: 10.1161/CIRCULATIONAHA.112.122408)
Cereal ß-glucans, such as barley, have immunomodulatory properties and beneficial effects on obesity, cardiovascular disease, diabetes and cholesterol levels. They ferment from the intestinal flora in the caecum and colon and increase both the growth rate of microbes (4 strains of lactobacilli) isolated from the human intestine and their production of lactic acid. In vitro, ß-glucans also have a positive effect on the interaction between probiotics and enterocytes.
(Arena MP et al., Barley ß-glucans-containing food enhances probiotic performances of beneficial bacteria. Int J Mol Sci. 2014 Feb 20;15(2):3025-39)
Zinc plays a central role in wound healing, tissue regeneration and the immune response. Although zinc deficiency is common in patients with IBD, the effect of low serum zinc levels on the course of the disease was not previously known. A total of 773 patients with Crohn’s disease and 223 patients with ulcerative colitis participated in a US study. The researchers found that zinc deficiency in patients with IBD was associated with an increased risk of later hospitalizations, surgeries, and disease-related complications. Normalization of zinc content led to improved results. Therefore, the authors of the study recommend careful monitoring of zinc levels and correction of possible deficiencies.
(Siva, S.; Rubin, DT.; Gulotta, G. et. al.: Zinc deficiency is associated with poor clinical outcomes in patients with inflammatory bowel disease. Inflamm Bowel Dis. 2016 Dec 7., DOI: 10.1097/MIB.0000000000000989)
A Canadian meta-analysis shows that depression is associated with lower concentrations of zinc in the peripheral blood. 17 studies with 1,643 depressed patients and 804 controls were evaluated. It has been found that the lower the zinc levels, the greater the severity of depression.
(Swardfager W et al.: Zinc in Depression: A Meta-Analysis. Biol Psychiatry, 2013 Jun 24. pii: S0006-3223(13)00451-4).
In Germany, the 12-month prevalence of major depressive disorder in adult men is 4.2% and 9.9% in adult women. The figures are based on a comprehensive and fully standardized interview procedure for the Diagnostic Classification of Mental Disorders (CIDI) according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. Recent studies show that depression is often associated with inflammation and zinc deficiency. Zinc deficiency weakens the immune system and stimulates inflammation.
Zinc is also an important antioxidant, as oxidative stress is also involved in the onset and development of the disease.
Heike Lück-Knobloch, alternative physician / medical journalist
(Maurya, PK; Noto, C.; Rizzo, LB.; et. al.: The role of oxidative and nitrosative stress in accelerated aging and major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2016 Feb 4;65:134-44 | Maares, M.; Haase, H.: Zinc and immunity: An essential interrelation. Arch Biochem Biophys. 2016 Mar 26. doi: 10.1016/j.abb.2016.03.022 | Roomruangwong, C.; Kanchanatawan, B.; Sirivichayakul, S.; et. al.: Lower serum zinc and higher CRP strongly predict prenatal depression and physio-somatic symptoms, which all together predict postnatal depressive symptoms. Mol Neurobiol. 2016 Feb 5, doi: 10.1007/s12035-016-9741-5 | Siwek, M.; Sowa-Kucma, M.; Styczen, K.; et. al.: Decreased serum zinc concentration during depressive episode in patients with bipolar disorder. J Affect Disord. 2016 Jan 15;190:272-7 | Styczen, K.; Sowa-Kucma, M.; Siwek, M.; et. al.: The serum zinc concentration as a potential biological marker in patients with major depressive disorder. Metab Brain Dis. 2016 Aug 8).
Zinc plays an important role in the behavior, mental function and proper functioning of intracellular signal transduction, cellular transport, membrane transport, protein synthesis and the antioxidant system. Researchers from Charité in Berlin recruited 1,514 adults (aged 60-84, including 772 women) from the Berlin Aging Study II. 18.7% of participants had zinc deficiency in their blood plasma. 15.7% of patients suffered from depressive symptoms. Adults with depression
symptoms had, among other things, lower plasma zinc levels. The researchers found that deficient zinc plasma concentrations were strongly associated with a higher risk of depressive symptoms in women. Increasing dietary zinc intake may reduce the risk of depressive symptoms. For this reason, researchers believe that older people at increased risk of depression should be tested for malnutrition or plasma zinc deficiency.
(Jung, A.; Spira, D.; Steinhagen-Thiessen, E.; et. al.: Zinc deficiency is associated with depressive symptoms – results from the Berlin aging study II. J Gerontol A Biol Sci Med Sci. 2016 Oct 27. DOI: 10.1093/gerona/glw218)
Preclinical and clinical studies have shown that zinc has antidepressant properties and that it can improve therapy with conventional monoamine-based antidepressants (SSRIs or TCAs). The beneficial effects of zinc in patients with depression may be based on the activation of signaling pathways that are associated with neuronal plasticity processes, according to Polish researchers in this review. This neuroplasticity is the dynamic ability of the brain to change cellular architecture, structure and function. Further clinical trials are currently needed to determine whether zinc may improve therapy with other antidepressants.
(Doboszewska U, Wlaz P, Nowak G, et al.:
Zinc in the monoaminergic theory of depression: Its relationship to neural plasticity. Neural Plast. 2017;2017:3682752)
Zinc is essential for all physiological systems, including neuronal functions. More and more research shows that zinc homeostasis plays a key role in depression and psychosis. Intracellular deficiency may be the result of low circulating zinc concentrations due to inadequate dietary intake or impaired absorption in old age or due to diseases such as alcohol dependence.
In addition, various medications that psychiatric patients sometimes take, including anticonvulsants, oral antidiabetic drugs, hormones, antacids, anti-inflammatory drugs, etc., affect zinc intake. Clinical studies have shown beneficial effects of zinc supplements on depression. Meta-analyzes support the adjuvant use of zinc in severe depressive episodes, and one
study supports the use of zinc in psychotic symptoms.
(Petrilli MA, Kranz TM, Kleinhaus K, et al.: The emerging role for zinc in depression and psychosis. Front Pharmacol. 2017 Jun 30;8:414)
A study of 171 Polish postmenopausal women who were not treated with hormones showed that women with higher serum levels of magnesium and zinc had fewer symptoms of depression.
(Stanislawska M et al., The severity of depressive symptoms vs. Serum Mg and Zn levels in postmenopausal women.
Biol Trace Elem Res. 2014 Jan;157(1):30-5)
Australian researchers used two prospective cohort studies to examine whether there could be a link between zinc intake and the incidence of depression. Both cohort studies show an inverse relationship between zinc intake and the risk of depression. Men and women with the highest zinc intake had a 30 to 50 percent lower risk of developing depression.
(Vashum KP et al.: Dietary zinc is associated with a lower incidence of depression: Findings from two Australian cohorts; J Affect Disord. 2014 Sep; 166: 249-57)
Diabetics are often zinc deficient. Chinese researchers used a mouse model to study the effect of zinc deficiency or zinc supplements on the development of heart or kidney secondary diseases caused by diabetes. By applying zinc therapy, both cardiac and renal oxidative damage can be repaired. Sub-optimal micronutrient delivery, on the other hand, can significantly accelerate kidney damage caused by diabetes. Clinical observations also show this. Therefore, zinc levels in patients with diabetes mellitus should be monitored and, if necessary, adjusted with supplements.
(Li B, Tan Y, Sun W et al., The role of zinc in the prevention of diabetic cardiomyopathy and nephropathy. Toxicol Mech Methods. 2013 Jan;23(1):27-33)
Transmembrane tumor necrosis factor-α (TNF-α) on monocytes is one of the body’s key defenses against cancer. In patients with type 2 diabetes and metabolic syndrome, the immune system is weakened. This leads to a high risk of inflammation and cancer. 17 patients with type 2 diabetes mellitus and metabolic syndrome received 30 mg zinc per day, or placebo, for a period of 8 weeks. Transmembrane TNF-α-expressing monocytes and lymphocytes as well as plasma levels of TNF-α were examined before and after zinc addition. As a result of the addition of zinc, the proportion of monocytes expressing transmembrane TNF-α in the verum group increased significantly compared with the placebo group, while plasma levels of TNF-α and TNF-α -expressing lymphocytes in both groups did not changed significantly. Because transmembrane TNF-α affects defense mechanisms, the results of the study indicate that zinc administration may be beneficial in patients with diabetes mellitus and metabolic syndrome for the immune response to cancer.
(Meksawan K, Sermsri U, Chanvorachote P., Zinc supplementation improves anticancer activity of monocytes in type-2 diabetic patients with metabolic syndrome, Anticancer Res. 2014 Jan;34(1):295-9)
Previous research has shown the importance of zinc in several metabolic processes. The results of a recent Brazilian review article revealed low levels of zinc in the body of type 2 diabetics and high levels of zinc excretion in the urine. The researchers also found a negative correlation between HbA1c levels and plasma zinc concentrations. Zinc supplements improve glycemic control in patients, leading to significant reductions in HbA1c levels. The importance of zinc for insulin homeostasis became clear once again in this work.
de Carvalho, GB.; Brandão-Lima, PN.; Maia, CS.; et. al.: Zinc’s role in the glycemic control of patients with type 2 diabetes: A systematic review. Biometals. 2017 Apr;30(2):151-162)
DNA chain breaks can occur whenever DNA doubles and therefore every time 10 to 100 billion cells in the body divide vitally. This process can also be triggered by UV radiation, X-rays and cosmic radiation. Cancer patients receiving chemotherapy are also at risk. Natural repair mechanisms ensure that we do not usually get sick, despite recurring ones chain breaks.
A study in 18 men showed that a moderate increase in zinc intake of 4 mg / day over a 4-week period improved overall zinc intake and repair of DNA strand breaks in leukocytes, but plasma zinc levels remained unchanged. In addition, concentrations of serum proteins that are involved in the process of DNA repair and are associated with antioxidant and immune functions increase.
(Zyba, SJ.; Shenvi, SV.; Killilea, DW.; et. al.: A moderate increase in dietary zinc reduces DNA strand breaks in leucocytes and alters plasma proteins without changing plasma zinc concentrations. Am J Clin Nutr. 2016 Dec 21. doi: 10.3945/ajcn.116.135327)
According to a US meta-analysis of 3 randomized, placebo-controlled studies with a total of 199 patients, mostly women (80% of them aged 20-50 years), suffering from colds (1/3 also from allergies), the use of zinc acetate lozenges, reduces the duration of the common cold by approximately 2.73-2.94 days. Subjects usually suffered from infections for 7 days. However, the optimal composition of zinc lozenges and the frequency of their use require further research. In any case, patients with colds may be encouraged to try zinc lozenges to treat colds.
(Hemilä, H.; Petrus, EJ.; Fitzgerald, JT.; et. al.: Zinc acetate lozenges for treating the common cold: An individual patient data meta-analysis. Br J Clin Pharmacol. 2016 Nov;82(5):1393-1398)
A systematic review and meta-analysis, including 20 randomized controlled trials, showed that probiotics (particularly lactobacilli and / or bifidobacteria) can reduce the duration of upper respiratory tract infections in otherwise healthy children and adults by one day compared to placebo.
(King, S. et al., Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis, Br J Nutr. 2014 Apr 29:1-14)
Zinc contributes to normal fertility and reproduction. If there is a zinc deficiency, the resistance to environmental toxins decreases. A Chinese meta-analysis showed that men with low fertility had higher levels of lead and cadmium, as well as lower levels of zinc in their semen.
(Sun, J.; et. al.: Heavy metal level in human semen with different fertility: A meta-analysis. Biol Trace Elem Res. 2016 Jul 22. DOI: 10.1007/s12011-016-0804-2)
Blueberries are rich in flavonoids, which have antioxidant and anti-inflammatory properties. High flavonoid intake attenuates age-related cognitive decline, according to a British, randomized, placebo-controlled study. 12 healthy adults (5 women and 7 men) received 30 ml of blueberry concentrate (387 mg anthocyanins) daily for 12 weeks, while 14 healthy adults (8 women, 6 men) received placebo. Before and after the supplement, participants had to complete several tests to assess cognitive
features, among other things. In the verum group, the researchers found a significant increase in brain activity compared to the placebo group, as well as significant improvements in blood flow to the gray matter in the parietal and occipital lobes.
(Bowtell, JL.; Aboo-Bakkar, Z.; Conway, M.; et. al.: Enhanced task related brain activation and resting perfusion in healthy older adults after chronic blueberry supplementation. Appl Physiol Nutr Metab. 2017 Mar 1. doi: 10.1139/apnm-2016-0550)
A US study examines which substances can relieve the symptoms of influenza infection in both children and adults. Among other things, zinc reduces the severity of symptoms in children. Prophylactic intake of probiotics and zinc, among other things, reduces the incidence of flu-like infections in them. In adults, there is a moderate reduction in the severity and duration of symptoms when taking zinc. With preventive intake of vitamin C, the duration of the disease decreases moderately in both adults and children.
(Fashner J. et al., Treatment of the common cold in children and adults. Am Fam Physician. 2012 Jul 15;86(2):153-9)
Researchers at Ohio State University in the United States have found in a model of a cell culture with human monocytes that if there is not enough zinc in the body during infection, excessive inflammation and even sepsis can occur. The addition of the trace element at the beginning of a flu-like infection can help control the symptoms of the disease.
(Ming-Jie Liu et al., ZIP8 Regulates Host Defense through Zinc-Mediated Inhibition of NF-kB, Cell Reports, doi: 10.1016/j.celrep.2013.01.009)
In ß and α cells of the pancreas, zinc has certain functions in the biochemistry of insulin and glucagon.
(Maret W.: Zinc in pancreatic islet biology, insulin sensitivity and diabetes. Prev Nutr Food Sci. 2017 Mar;22(1):1-8).
Zinc is an important trace element that stimulates insulin secretion and increases insulin sensitivity. A systematic review by Brazilian researchers, which included 6 clinical trials, showed that zinc supplements improved insulin resistance in obese men and women.
(Cruz KJ, Morais JB, de Oliveira AR et al.:
The effect of zinc supplementation on insulin resistance in obese subjects: A systematic review. Biol Trace Elem Res. 2017 Apr;176(2):239-243)
Oxidative stress is a metabolic dysfunction that contributes to cell and tissue damage and thus to the development of some chronic diseases. The literature provides strong evidence that zinc has an antioxidant effect and therefore protects against oxidative stress in some diseases such as type 2 diabetes, obesity and cancer.
(Marreiro DD, Cruz KJ, Morais JB, et al.: Zinc and oxidative stress: Current echanisms. Antioxidants (Basel). 2017 Mar 29;6(2).
A Chinese meta-analysis of 11 observational studies with a total of 822 Parkinson’s patients and 777 healthy controls showed that serum zinc levels in subjects with Parkinson’s were significantly lower than in healthy participants.
(Sun, H.; Liu, X.; Ge, H.; et. al.: Association between serum zinc levels and the risk of Parkinson’s disease: A meta-analysis. Biol Trace Elem Res. 2017 Feb 3. doi: 10.1007/s12011-017-0941-2)
Zinc plays a central role in the immune system. Deficiency increases susceptibility to infectious diseases. According to a Chinese meta-analysis of 6 randomized, double-blind, placebo-controlled studies with a total of 2,216 patients with severe pneumonia, adjuvant zinc use resulted in a significant reduction in mortality in the subjects.
(Wang L, Song Y: Efficacy of zinc given as an adjunct to the treatment of severe pneumonia: A meta-analysis of randomized, double-blind and placebo-controlled trials. Clin Respir J. 2017 May 9. doi: 10.1111/crj.12646)
Changes in zinc metabolism caused by aging and life in nursing homes contribute to zinc deficiency in the elderly. Hypozincemia leads to changes in blood sugar, fat and inflammatory parameters. In a Brazilian cross-sectoral study of 255 elderly residents of nursing homes, decreased plasma zinc concentrations were associated with longer periods of stay in the nursing home and a poorer lipid and inflammatory profile.
(Sales MC, de Oliveira LP, de Araujo Cabral NL et al.: Plasma zinc in institutionalized elderly individuals: Relation with immune and cardiometabolic biomarkers. J Trace Elem Med Biol. 2018 Apr 24. doi: 0.1016/j.jtemb.2018.04.026)
Increasing evidence suggests a link between suboptimal zinc levels and depression. Little is known about zinc status in older people with other psychiatric diagnoses. In 100 psycho-geriatric patients over the age of 64, psychiatric and cognitive complaints were identified, among other things, using various tests. In addition, zinc levels have been recorded. Of the 882 elderly patients in a population study, the prevalence of zinc deficiency in depressed individuals was compared with that in depressed individuals and in the control group. While in the control group only 14.4% had zinc deficiency, the patient group had 41%. Zinc deficiency is also more pronounced in psychogeriatric patients without depression (but with other psychiatric disorders) than in patients with depression as a primary diagnosis or suffering from comorbid depression.
(Gronli O et al. Zinc deficiency is common in several psychiatric disorders; PLOS One. 2013 Dec 19;8(12):e82793).
Patients with chronic liver disease had significantly higher concentrations of malondialdehyde (MDA), nitric oxide (NO) and CRP than the healthy control group. In addition, serum levels of the antioxidants vitamin C and zinc were lower in patients than in healthy volunteers, apparently contributing to increased inflammatory parameters and markers of oxidative stress.
(Uddin MG, Hossain MS, Rahman MA et al.: Elemental zinc is inversely associated with C-reactive protein and oxidative stress in chronic liver disease. Biol Trace Elem Res. 2017 Aug;178(2):189-193)
The zinc intake values on which the current nutrient intake reference values are based are based on data from published studies. However, the inhibitory effect of phytate has been underestimated in studies due to the low content of phytate in diets.
To explain: Phytate or phytic acid serves as a storage place for phosphate in plants, among other things, necessary for photosynthesis. Phytate is therefore essential for plants. In humans, however, the consumption of phytate-rich foods – such as grains and legumes – means that many of the minerals contained in the food cannot be absorbed because they bind to the phytate. Therefore, a monotonous diet with basic nutrients can lead to symptoms of micronutrient deficiency (source www. Pflanzen-forschung.de). A US study suggests that zinc absorption in men, women and adolescents, on which current benchmarks are based, is overestimated. Therefore, the current zinc reference values need to be adjusted upwards for this group of people.
(Seth M Armah: Fractional zinc absorption for men, women, and adolescents is overestimated in the current dietary reference intakes. J. Nutr. June 1, 2016, doi: 10.3945/jn.115.225607)
One study compared the micronutrient status of patients with sarcopenia with that of patients without sarcopenia over a period of 6 months. Forty-four (10%) of 432 patients were diagnosed with sarcopenia at study enrollment. Baseline serum albumin and plasma zinc were already lower in patients with sarcopenia than in participants without this diagnosis. Similar results were found in deceased patients with sarcopenia compared to those who were still alive after 6 months.
(Gariballa S, Alessa A: Association between nutritional blood-based biomarkers and clinical outcome in sarcopenia patients. Clin Nutr ESPEN. 2018 Jun;25:145-148)
The trace element zinc is also apparently involved in regulating sleep, according to a Japanese review article. Current research shows that zinc consumption can increase both the amount and quality of sleep.
(Cherasse Y, Urade Y.: Dietary zinc acts as a sleep modulator. Int J Mol Sci. 2017 Nov 5;18(11))
The current study “Sleep well, Germany”, which Techniker Krankenkasse (TK) presented on November 15, 2017, shows that every third person in Germany sleeps mediocre, bad or very bad. According to the study, “bad sleepers” have significantly more health problems. 54 percent suffer from muscle tension and back pain, and only 35 percent of “good sleepers.” Those who sleep poorly are more than twice as likely to feel exhausted, irritable and depressed.
( https://www.tk.de/tk/pressemitteilungen/bundesweit-pressemitteilungen/965008 )
Dietary disorders are thought to be an important causative factor that may exacerbate or cause a painful reaction in individuals with chronic musculoskeletal pain. A Brazilian case control study of 31 affected patients and 31 pain-free participants showed that intracellular zinc and selenium erythrocyte stores in patients with chronic myofascial pain were lower than in the control group and that the nutrient intake of these micronutrients was insufficient.
(Barros-Neto, JA.; Souza-Machado, A.; Kraychete, DC.; et. al.: Selenium and zinc status in chronic myofascial pain: Serum and erythrocyte concentrations and food intake. PloS One. 2016 Oct 18;11(10):e0164302)
This was discovered by New Zealand scientists in a study with students, in which they examined the links between iron, zinc, selenium, the state of vitamin D and hemoglobin levels, as well as anemia. The results underscore the importance of addressing multiple micronutrient deficiencies in addition to iron levels in anemia. However, zinc is the only variable associated with the risk of anemia.
(Houghton, LA.; et. al.: Serum zinc is a major predictor of anemia and mediates the effect of selenium on hemoglobin in school-aged children in a nationally representative survey in New Zealand. J Nutr. 2016 Jul 27. pii. Jn235127)
Zinc deficiency is considered a risk factor for the onset and development of esophageal cancer. According to a Chinese review article, in addition, zinc deficiency affects disease progression by regulating micro RNA expression.
(Liu CM, Liang D, Jin J et al.: Research progress on the relationship between zinc deficiency, related microRNAs, and esophageal carcinoma. Thorac Cancer. 2017 Sep 11. doi: 10.1111/1759-7714)
Exercise and the subsequent recovery process cause disturbances in zinc homeostasis. New Zealand and Australian researchers found an acute increase in serum zinc levels in athletes immediately after exercise. A systematic review and meta-analysis by these scientists revealed that serum zinc levels during the post-workout recovery phase were significantly lower than before pre-workout. The researchers found that exercise-induced fluctuations in zinc homeostasis were related to post-workout muscle recovery mechanisms. The next step is to determine the potential of zinc in terms of improving the recovery process.
Chu A, Petocz P, Samman S: Plasma/serum zinc status during aerobic exercise recovery: A systematic review and meta-analysis. Sports Med. 2017 Jan;47(1):127-134)
The essential trace element zinc is important for immunity, energy metabolism and antioxidant processes. Further systematic review and meta-analysis of current status studies showed that serum zinc levels in athletes were significantly lower, although they consumed significantly more zinc through their diet than controls. This suggests that athletes have higher needs for zinc than those who are physically inactive, according to researchers from New Zealand and Australia.
(Chu A, Holdaway C, Varma T et al: Lower serum zinc concentration despite higher dietary zinc intake in athletes: A systematic review and meta-analysis. Sports Med. 2018 Feb;48(2):327-33
Zinc has also been identified as a critical trace element in high-income countries. Researchers from the University of Vienna (Austria) determined the plasma concentrations of zinc in a national sample of 872 people aged 6 to 80 years (55.5% women). Zinc status was found to be below normal in school children (40% of boys and 22% of girls) as well as in the elderly (28% of men and 33% of women). The dietary intake of zinc in these groups is also unsatisfactory, ie. in 38% of boys, 32% of girls and 64.5% of older men it is below the recommended intake in the country. Conclusion: The results show a suboptimal supply of zinc in Austria, especially among students and the elderly.
(Elmadfa I, L Meyer A, Kuen T et al.: Zinc intake and status in Austria in the light of different reference values. Int J Vitam Nutr Res. 2018 Feb 1:1-10)
Zinc is a key trace element with antioxidant and anti-inflammatory action. The liver plays an important role in maintaining systemic zinc homeostasis. Therefore, chronic liver diseases, such as chronic hepatitis or fatty liver, lead to impaired zinc metabolism and consequently to zinc deficiency. This in turn causes a number of metabolic abnormalities, including insulin resistance, hepatic steatosis, and hepatic encephalopathy. Conversely, metabolic abnormalities such as hypoalbuminemia often lead to zinc deficiency in patients with cirrhosis. New studies have uncovered the putative mechanisms by which zinc deficiency causes multiple metabolic abnormalities in chronic liver disease.
(Himoto T, Masaki T: Associations between zinc deficiency and metabolic abnormalities in patients with chronic liver disease. Nutrients. 2018 Jan 14;10(1))
Age-related regression of the thymus is associated with decreased T-cell production, which probably also contributes to reduced T-cell diversity in the elderly, which in turn is associated with increased susceptibility to infections, autoimmune diseases and cancer.
(Donald B. Palmer, The effect of age on thymic function, Front. Immunol; 07.10.13, doi:10.3389/fimmu.2013.00316)
Vitiligo is characterized by idiopathic destruction of melanocytes, which leads to depigmented areas of skin and mucosal surface. The etiology is probably autoimmune. Oxidative stress may contribute to the pathogenesis of the disease. Zinc, a trace element with antiapoptotic properties, plays a major role in the process of melanogenesis and the elimination of free radicals. Serum zinc levels are determined in Iranian case control study of 103 patients with vitiligo and 103 healthy controls. A significant difference was found between patients with generalized vitiligo (81.3 mcg / dl zinc) and controls (91.8 mcg / dl zinc). Lower serum zinc concentrations also correlate with longer disease duration.
(Mirnezami M, Rahimi H: Serum zinc level in vitiligo: A case-control study. Indian J Dermatol. 2018 May-Jun;63(3):227-230)
Zinc, copper and iron are the main trace elements responsible for the growth, development and maintenance of healthy bones. A meta-analysis of 8 relevant studies with a total of 2188 subjects showed that patients with osteoporosis had lower serum concentrations of zinc, copper or iron compared to healthy controls.
Zheng J et al., Low Serum Levels of Zinc, Copper, and Iron as Risk Factors for Osteoporosis: a Metaanalysis. Biol Trace Elem Res. 2014 Jul;160(1):15-23. Epub 2014 Jun 8
