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There is increasing evidence that adherence to a Mediterranean dietary pattern reduces the incidence of diet-related diseases. To date, the habitual dietary intake of New Zealand (NZ) adults has not been examined in relation to its alignment with a Mediterranean-style dietary pattern. This study aimed to define the habitual dietary patterns, nutrient intakes, and adherence to the Mediterranean Diet in a sample of 1012 NZ adults (86% female, mean age 48 ± 16 years) who had their diabetes risk defined by the Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK). Dietary intakes were collected using a validated semi-quantitative NZ food frequency questionnaire, and dietary patterns were identified using principal component analysis. Reported intakes from the FFQ were used in conjunction with the Mediterranean-Style Dietary Pattern Score (MSDPS) to determine adherence to a Mediterranean dietary pattern. Mixed linear models were used to analyze the association between dietary patterns and MSDPS with demographics, health factors, and nutrient intakes. Two distinct dietary patterns were identified: Discretionary (positive loadings on processed meat, meat/poultry, fast food, sweet drinks, and sugar, sweets, and baked good) and Guideline (positive loadings on vegetables, eggs/beans, and fruits). Adherence to dietary patterns and diet quality was associated with age and ethnicity. Dietary patterns were also associated with sex. Adherence to a Mediterranean dietary pattern defined by the MSDPS was low, indicating that a significant shift in food choices will be required if the Mediterranean Diet is to be adopted in the NZ population.

Evidence suggests that consumer perceptions and acceptance of cultivated meat (CM) differ between countries, cultures, and consumer groups. Limited research specific to Aotearoa New Zealand (A-NZ) is available. Survey responses from 592 A-NZ residents were analysed to determine CM awareness, willingness to engage with CM, and perceived CM product attributes relative to conventional meat and plant-based meat alternatives (PBMAs). The effects of gender, age, meat/PBMA consumption frequency, CM awareness, and food neophobia on CM perceptions were determined. The statements were rated on a seven-point Likert scale. Half (52%) of the respondents agreed they were aware of CM. The awareness was higher in men compared to women (p = 0.036), higher in Millennials compared to Generation X (p = 0.022), and higher in regular compared to infrequent PBMA consumers (p = 0.0003). The willingness to engage with CM and perceived CM product attributes were consistently more positive in consumers who were aware, compared with consumers not aware of CM (p < 0.05). Being male, Millennial, low neophobic and a low meat, or high PBMA consumer was also associated with higher potential engagement and perceptions of CM to varying extents. Segmentation divided the respondents into three groups. The ‘positive’ cluster (41%) consumed more PBMAs and less meat and was more aware of CM than the ‘neutral’ (50%) and ‘negative’ (9%) clusters. In conclusion, consumers in A-NZ are not a homogenous group with regards to their perceptions and potential engagement with CM. Increasing awareness and familiarity with CM will be an important strategy to increase engagement with CM.

To investigate the relationship of metabolic syndrome severity score (MetSSS) with glucose regulatory and cardiovascular disease (CVD) status in Aotearoa New Zealand.MetSSS and MetSSS component coefficients were calculated for participants from the cross-sectional Workforce Diabetes Study (WDS) (n = 5,806) and Diabetes, Heart and Health Survey (DHAH) (n = 4,010) and compared by ethnicity (European, Māori, Pacific and Asian), glucose regulatory status [impaired fasting glucose, impaired glucose tolerance and type 2 diabetes) and history of cardiovascular disease.MetSSS positively associated with impaired glucose regulatory status and history of cardiovascular disease for all ethnic groups. Ethnicity significantly affected different coefficients of the MetSSS components, however all ethnicities had an approximately normal MetSSS distribution, with Māori and Pacific curves being right-shifted compared to European. While the MetSSS thresholds that capture 80% of participant with type 2 diabetes (T2D) were higher for Māori and Pacific, the difference in MetSSS between those participants with and without type 2 diabetes within an ethnicity group was similar across ethnicities.MetSSS may have utility as a tool to quantify an individual's cardiometabolic disease risk within the multi-ethnic population of Aotearoa New Zealand, however ethnic-specific categories for disease risk are likely to be required.

Nut-based products may aid low-glycaemic dietary strategies that are important for diabetes prevention in populations at increased risk of dysglycaemia, such as Asian Chinese. This randomised cross-over trial assessed the postprandial glycaemic response (0–120 min) of a higher-protein nut-based (HP-NB) snack formulation, in bar format (1009 kJ, Nutrient Profiling Score, NPS, −2), when compared with an iso-energetic higher-carbohydrate (CHO) cereal-based bar (HC-CB, 985 kJ, NPS +3). It also assessed the ability to suppress glucose response to a typical CHO-rich food (white bread, WB), when co-ingested. Ten overweight prediabetic Chinese adults (mean, sd: age 47⋅9, 15⋅7 years; BMI 25⋅5, 1⋅6 kg/m2), with total body fat plus ectopic pancreas and liver fat quantified using dual-energy X-ray absorptiometry and magnetic resonance imaging and spectroscopy, received the five meal treatments in random order: HP-NB, HC-CB, HP-NB + WB (50 g available CHO), HC-CB + WB and WB only. Compared with HC-CB, HP-NB induced a significantly lower 30–120 min glucose response (P < 0⋅05), with an approximately 10-fold lower incremental area under the glucose curve (iAUC0–120; P < 0⋅001). HP-NB also attenuated glucose response by approximately 25 % when co-ingested with WB (P < 0⋅05). Half of the cohort had elevated pancreas and/or liver fat, with 13–21 % greater suppression of iAUC0–120 glucose in the low v. high organ fat subgroups across all five treatments. A nut-based snack product may be a healthier alternative to an energy equivalent cereal-based product with evidence of both a lower postprandial glycaemic response and modulation of CHO-induced hyperglycaemia even in high-risk, overweight, pre-diabetic adults.

Health organizations throughout the world advocate diets that emphasize vegetables, fruits, pulses, grains, and minimally processed staple foods as beneficial throughout life and in old age. However, concern exists that the dietary exclusion or minimalization of flesh foods may compromise the nutritional status of some nutrients, including vitamin B12, iron, and zinc. The purpose of this study is to discuss the metabolism and dietary sources of vitamin B12, iron, and zinc and review observational studies that investigate the status of these micronutrients in older vegetarians compared to their non-vegetarian counterparts. The few comparative studies that are available suggest that vitamin B12 status is lower in older vegetarian compared to omnivorous populations; however, subclinical vitamin B12 deficiency due to malabsorption is prevalent regardless of dietary pattern. Zinc status appears comparable but not optimal in either group. Whether iron status is compromised in older vegetarians compared to non-vegetarians is unclear. Dietary practices that improve zinc and iron bioavailability are appropriate strategies in the management of suboptimal nutrient status in apparently healthy older vegetarian populations. Older populations may benefit from vitamin B12 and zinc supplementation, irrespective of dietary pattern.

Pregnant women are vulnerable to a low zinc status due to the additional zinc demands associated with pregnancy and foetal development. The present systematic review explores the relationship between habitual vegetarian diets and dietary zinc intake/status during pregnancy. The association between vegetarian diets and functional pregnancy outcome also is considered. A literature search was conducted of MEDLINE, PubMed, Embase, the Cochrane Library, Web of Science, and Scopus electronic databases up to September 2014. Six English-language observational studies qualified for inclusion in the systematic review. A meta-analysis was conducted that compared the dietary zinc intake of pregnant vegetarian and non-vegetarian (NV) groups, the zinc intake of vegetarians was found to be lower than that of NV (−1.38 ± 0.35 mg/day, p &lt, 0.001), and the exclusion of low meat eaters from the analysis revealed a greater difference (−1.53 ± 0.44 mg/day, p = 0.001). Neither vegetarian nor NV groups met the recommended dietary allowance (RDA) for zinc. In a qualitative synthesis, no differences were found between groups in serum/plasma zinc or in functional outcomes associated with pregnancy. In conclusion, pregnant vegetarian women have lower zinc intakes than NV control populations and both groups consume lower than recommended amounts. Further information is needed to determine whether physiologic adaptations in zinc metabolism are sufficient to meet maternal and foetal requirements during pregnancy on a low zinc diet.

It is suggested that populations consuming plant-based diets require higher amounts of dietary zinc than omnivorous populations to maintain health. The present chapter explores dietary zinc intakes and requirements, zinc bioavailability, and zinc status in populations consuming plant-based diets across the life cycle, with consideration given to differences between populations from high-income and low- and middle-income countries. Many vegetarian groups have lower zinc status than their nonvegetarian counterparts; however, adults appear able to adapt to a wide range of zinc intakes with no apparent adverse effects on health. In populations with increased requirements, such as children and pregnant women, the relationships among zinc status, physiological adaptations to low zinc diets, and health outcomes require further investigation. To support the translation of zinc research in vegetarians into practice, consistency in study methodologies and design is required, as well as the further development of tools that assist the evaluation of zinc status.

Plant-based diets contain less saturated fat and cholesterol and more folate, fibre and phytochemicals than omnivorous diets, but some micronutrients, especially zinc, are poorly bioavailable. The findings of studies exploring the zinc intake and zinc status in populations that habitually consume vegetarian diets are inconsistent. This study aims to investigate the effects of plant-based diets on dietary zinc intake and status in humans using systematic review and meta-analysis techniques. Thirty-four studies were included in the systematic review. Of these, 26 studies (reporting 48 comparisons) compared males and/or females consuming vegetarian diets with non-vegetarian groups and were included in meta-analyses. Dietary zinc intakes and serum zinc concentrations were significantly lower (−0.88 ± 0.15 mg day−1, P < 0.001 and −0.93 ± 0.27 µmol L−1, P = 0.001 respectively; mean ± standard error) in populations that followed habitual vegetarian diets compared with non-vegetarians. Secondary analyses showed greater impact of vegetarian diets on the zinc intake and status of females, vegetarians from developing countries and vegans. Populations that habitually consume vegetarian diets have low zinc intakes and status. Not all vegetarian categories impact zinc status to the same extent, but a lack of consistency in defining vegetarian diets for research purposes makes dietary assessment difficult. Dietary practices that increase zinc bioavailability, the consumption of foods fortified with zinc or low-dose supplementation are strategies that should be considered for improving the zinc status of vegetarians with low zinc intakes or serum zinc concentrations at the lower end of the reference range. © 2013 Society of Chemical Industry

cope The involvement of zinc in multiple physiological systems requires tight control of cellular zinc concentration. This study aims to explore the relationships among selected mediators of cellular zinc homeostasis in an apparently healthy (AH) population and a cohort with type 2 diabetes mellitus (T2DM). Methods and results Baseline data of three trials forming two cohorts, AH (n = 70) and T2DM (n = 42), were used for multivariate analyses to identify groupings within ten zinc transporter and metallothionein (MT) gene expressions, stratified by health status. Multiple regression models were used to explore relationships among zinc transporter/MT groupings and plasma zinc. Gene expression of zinc transporters and MTs, with the exception of ZnT6, were significantly lower in the T2DM cohort (p < 0.01). Cluster analysis showed that the groupings of zinc transporters and MTs were largely similar between the two cohorts, with the exception for ZnT1 and ZIP7. Zinc transporters and MTs were significant determinants of plasma zinc (r2 = 0.48, p = 0.001) in the AH cohort, but not in the T2DM cohort. Conclusion The current study suggests altered cellular zinc homeostasis in T2DM and supports the use of multiple zinc transporters and MTs groupings to further understand zinc homeostasis in health and T2DM.

The zinc transporter (ZnT; SLC30) and Zrt- and Irt-like protein (Zip, SLC39) zinc transporter families are integral to the maintenance of intracellular zinc concentrations. Few studies have examined the expression patterns of zinc transporter genes in human primary tissues. This study investigated the expression levels of a range of zinc transporter mRNA in the peripheral blood mononuclear cells of healthy men and women (n = 40) using quantitative real-time PCR. It also explored the relationships among zinc transporter expression levels, plasma zinc concentrations, and dietary zinc intake. The relative expression of the zinc transporter mRNA varied considerably, with ZnT7, ZnT1, and Zip1 being the most abundantly expressed. ZnT1 and Zip1 mRNA were highly correlated with one another (r = 0.9; P < 0.001) and with ZnT5, ZnT7, Zip3, and Zip10 (P < 0.001). When analyzed by gender, a correlation between the mRNA of ZnT7 and Zip3 (r = 0.6; P < 0.01) was demonstrated only in women. Zip10 mRNA was correlated with ZnT1 and Zip1 (r = 0.9; P < 0.001) in men only. In a regression analysis, plasma zinc variability was not significantly explained by dietary zinc intake, gender, age, or any individual or combination of zinc transporters. This study expands what is known about both the levels of zinc transporter gene transcription in humans and the extent of its variation in healthy men and women. The positive association between the mRNA of ZnT1 and Zip1, which have reciprocal roles in zinc transport across the plasma membrane, provides insight into the coordinated control of zinc homeostasis in humans.

Cellular signal transduction pathways are influenced by the zinc and redox status of the cell. Numerous chronic diseases, including cardiovascular disease (CVD) and diabetes mellitus (DM), have been associated with impaired zinc utilization and increased oxidative stress. In humans, mutations in the MT-1A and ZnT8 genes, both of which are involved in the maintenance of zinc homeostasis, have been linked with DM development. Changes in levels of intracellular free zinc may exacerbate oxidative stress in CVD and DM by impacting glutathione homeostasis, nitric oxide signaling, and nuclear factor-kappa B-dependent cellular processes. Zinc ions have been shown to influence insulin and leptin signaling via the phosphoinositide 3′-kinase/Akt pathway, potentially linking an imbalance of zinc at the cellular level to insulin resistance and dyslipidemia. The oxidative modification of cysteine residues in zinc coordination sites in proteins has been implicated in cellular signaling and regulatory pathways. Despite the many interactions between zinc and cellular stress responses, studies investigating the potential therapeutic benefit of zinc supplementation in the prevention and treatment of oxidative stress-related chronic disease in humans are few and inconsistent. Further well-designed randomized controlled trials are needed to determine the effects of zinc supplementation in populations at various stages of CVD and DM progression.

The objective of this study was to compare the fatty acid composition of commercially available conventional, certified organic, and omega-3 eggs. Egg components were assessed, and the fatty acid composition of yolk lipids was determined by gas chromatography. Organic egg yolk contained a higher percentage of palmitic and stearic acids than did conventional yolk (P

The objective of this study is to compare the fatty acid composition of commercially available edible oils derived from certified organic and conventional agricultural methods. A total of 59 certified organic and 53 conventional oils were purchased from retail markets in Sydney, Australia. Organic and conventional products were matched for comparison according to the description of production methods, labelled total fat content, brand name (wherever possible), and country of origin. Total fat was extracted and the fatty acid composition of the oils was determined by gas chromatography. No consistent overall trend of difference in the fatty acid composition was observed between organic and conventional oils. Saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids were all significantly different between types of oil (P < 0.001 in all three), and each had significant interaction between type and production method (P = 0.002, P < 0.001 and P < 0.001, respectively) indicating that organic and conventional oils differed in these components in an inconsistent fashion. Despite this, there were large differences particularly between MUFA and PUFA components in specific pairs of oils, especially in sunflower and mustard seed oils. The absence of an overall difference in the fatty acid composition of organic and conventional oils does not support the tenet that organic foods are of a higher nutritional quality than their conventional counterparts.

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.

Optimal zinc status is an important consideration when evaluating the nutritional adequacy of vegetarian diets. In the absence of animal tissue sources of zinc and with increased intake of inhibitors of zinc absorption, phytic acid in particular, the bioavailability of zinc is thought to be lower from vegetarian as compared to omnivorous diets. The aim of this chapter is to review the research that examines the effects of vegetarian compared to omnivorous diets on zinc intake and zinc status in the elderly, adults, children, pregnancy, and lactation. A narrative review of the published literature was undertaken, focusing on observational studies in humans that reported zinc intake and biomarkers of zinc status at various stages of the life cycle. Compared to their respective nonvegetarian control groups, adult male and female vegetarians have lower dietary zinc intakes and serum zinc concentrations. However in the elderly, children, and in women during pregnancy and lactation, there is insufficient evidence to determine whether zinc intake and status are lower in vegetarians compared to omnivores. Inconsistencies in study findings reflect variations inherent in the definition of vegetarian diets, and in many instances compromised statistical power due to a small sample size. Improved methods for the assessment of zinc status are required to determine whether homeostatic responses are sufficient to maintain an adequate zinc status in vegetarians, particularly during times of increased requirement. Appropriate dietary advice to increase the zinc content and bioavailability of vegetarian diets throughout the life cycle is prudent.

Optimal zinc status is an important consideration when evaluating the nutritional adequacy of vegetarian diets. In the absence of animal tissue sources of zinc and with increased intake of inhibitors of zinc absorption, phytic acid in particular, the bioavailability of zinc is thought to be lower from vegetarian as compared to omnivorous diets. The aim of this chapter is to review the research that examines the effects of vegetarian compared to omnivorous diets on zinc intake and zinc status in the elderly, adults, children, pregnancy, and lactation. A narrative review of the published literature was undertaken, focusing on observational studies in humans that reported zinc intake and biomarkers of zinc status at various stages of the life cycle. Compared to their respective nonvegetarian control groups, adult male and female vegetarians have lower dietary zinc intakes and serum zinc concentrations. However in the elderly, children, and in women during pregnancy and lactation, there is insufficient evidence to determine whether zinc intake and status are lower in vegetarians compared to omnivores. Inconsistencies in study findings reflect variations inherent in the definition of vegetarian diets, and in many instances compromised statistical power due to a small sample size. Improved methods for the assessment of zinc status are required to determine whether homeostatic responses are sufficient to maintain an adequate zinc status in vegetarians, particularly during times of increased requirement. Appropriate dietary advice to increase the zinc content and bioavailability of vegetarian diets throughout the life cycle is prudent.

Zinc is involved in a number of metabolic processes including the synthesis and action of insulin [1,2]. The primary inhibitor of zinc absorption is phytic acid (PA), which forms poorly soluble complexes with zinc and other minerals in the gastrointestinal tract, resulting in their reduced absorption [3]. The inhibitory effect of PA can be estimated by the molar ratio of PA to zinc in the diet, and WHO has identified 3 grades (low, moderate, high) of zinc bioavailability based on the dietary PA:Zn molar ratio [4]. PA is abundant in unrefined cereals, pulses, and whole grains [5]. Pulses and cereals are major sources of zinc in many populations, and the co-existence of PA and zinc in these staple foods explains much of the association between suboptimal zinc status and plant-based diets. Unrefined pulses, cereals, and whole grains are, in addition, important food sources of dietary fibre. The consumption of a diet that is rich in dietary fibre is recommended as part of healthy eating guidelines and in the dietary management of chronic diseases such as cardiovascular disease and Type 2 diabetes mellitus (DM). Dietary fibre has been shown to decrease plasma cholesterol concentrations and improve glycaemic control [6], and moderate obesity by altering energy expenditure and substrate oxidation [7]. Whilst these outcomes are advantageous in maintaining health and managing disease risk, the presence of PA in fibre-rich foods is likely to lower the bioavailability of zinc in populations that are already at risk of zinc deficiency. The importance of zinc in numerous biological processes and the significant contribution of zinc to the global burden of disease suggest that it warrants special attention when evaluating the nutritional adequacy of therapeutic diets.

Chronic low-grade inflammation in type 2 diabetes mellitus (DM) can elicit changes in whole-body zinc metabolism. The interaction among the expression of inflammatory cytokines, zinc transporter and metallothionein (MT) genes in peripheral blood mononuclear cells in type 2 DM remains unclear. In a 12-week randomized controlled trial, the effects of zinc (40 mg/day) supplementation on the gene expression of cytokines, zinc transporters and MT in women with type 2 DM were examined. In the zinc-supplemented group, gene expression of tumour necrosis factor (TNF)-α tended to be upregulated by 27 ± 10 % at week 12 compared to baseline (P = 0.053). TNF-α fold change in the zinc-treated group was higher than in those without zinc supplementation (P

Type 2 diabetes mellitus (DM) is associated often with underlying zinc deficiency and nutritional supplements such as zinc may be of therapeutic benefit in the disease. In a randomized, double-blind, placebo-controlled, 12-week trial in postmenopausal women (n=48) with Type 2 DM we investigated the effects of supplementation with zinc (40mg/d) and flaxseed oil (FSO; 2g/d) on the gene expression of zinc transporters (ZnT1, ZnT5, ZnT6, ZnT7, ZnT8, Zip1, Zip3, Zip7, and Zip10) and metallothionein (MT-1A, and MT-2A), and markers of glycemic control (glucose, insulin, glycosylated hemoglobin [HbA1c]). The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. No significant effects of zinc or FSO supplementation were observed on glycemic marker concentrations, HOMA-IR or fold change over 12 weeks in zinc transporter and metallothionein gene expression. In multivariate analysis, the change over 12 weeks in serum glucose concentrations (P=0.001) and HOMA-IR (P=0.001) predicted the fold change in Zip10. In secondary analysis, marginal statistical significance was observed with the change in both serum glucose concentrations (P=0.003) and HOMA-IR (P=0.007) being predictive of the fold change in ZnT6. ZnT8 mRNA expression was variable; HbA1c levels were higher (P=0.006) in participants who exhibited ZnT8 expression compared to those who did not. The significant predictive relationships between Zip10, ZnT6, serum glucose and HOMA-IR are preliminary, as is the relationship between HbA1c and ZnT8; nevertheless the observations support an association between Type 2 DM and zinc homeostasis that requires further exploration.

Plant-based diets contain more folate, fibre, and phytochemicals than omnivorous diets, however some micronutrients, especially zinc, are poorly bioavailable. The findings of studies exploring the ...

Zinc is an essential trace element with proposed therapeutic effects in Type 2 diabetes mellitus (DM), however, the associations between zinc status and the prospective risks of cardiovascular diseases (CVD) and Type 2 DM have not been evaluated. The current systematic review aims to determine the relationships between zinc intake or plasma/serum zinc levels and prospective incidence of CVD and Type 2 DM. Fourteen papers describing prospective cohort studies were included, reporting either CVD (n = 91,708) and/or Type 2 DM (n = 334,387) outcomes. Primary analyses from four out of five studies reported no association between zinc intake and CVD events, when adjusted for multiple variables. Higher serum zinc level was associated with lower risk of CVD in three out of five studies; pronounced effects were observed in vulnerable populations, specifically those with Type 2 DM and patients referred to coronary angiography. The limited evidence available suggests no association between zinc status and Type 2 DM risk. Further investigations into the mechanisms of zinc’s action on the pathogenesis of chronic diseases and additional evidence from observational studies are required to establish a recommendation for dietary zinc in relation to the prevention of CVD and Type 2 DM.

The essentiality of zinc in human nutrition was reported in the 1960s with the identification of young males who had short stature and exhibited hypogonadism. The root cause of the condition was traced back to the consumption of large quantities of dietary phytate, and the practice of geophagia, which was noted often among children in rural or pre-industrial societies. Both of these factors were thought to be responsible for inhibiting zinc absorption and ultimately lead to the diagnosis of zinc deficiency. We now recognize a plethora of symptoms associated with zinc deficiency that include high rates of infections, diverse forms of skin lesions, and impaired wound healing. These wide ranging symptoms point to the involvement of zinc in diverse cellular activities [1,2]. Other evidence implicates zinc in the etiologies of chronic diseases, particularly risk factors that are associated with cardio-vascular disease (CVD) and Type 2 diabetes mellitus (DM) In a recent evaluation of randomized controlled clinical trials that were aimed at determining the effect of zinc supplementation on glycaemic control, we showed a small reduction in fasting glucose concentrations after zinc supplementation. In secondary analyses of participants with chronic metabolic diseases (Types 1 and 2 DM, metabolic syndrome, obesity), zinc supplementation resulted in a greater reduction in plasma glucose concentrations compared to the effect that was observed in healthy participants. These observations are supported further by other reports, mainly of cross-sectional surveys, which suggest that improved zinc status affects favorably the cardiometabolic profile in people with DM [5]. The potential mechanisms that are responsible for the observed effects on glycaemic control may be mediated through the association of zinc with insulin. Under physiological conditions, zinc is abundant throughout the pancreas, but is particularly concentrated in the secretary vesicles of the beta-cells where it forms an integral component of the insulin crystalline structure [6] serving to confer stability to the insulin granule [7]. Zinc transporter 8 (ZnT8) belongs to the CDF/ ZnT (SLC30) family of zinc transporters, and is abundantly expressed in the pancreas. ZnT8 co-localizes with insulin in pancreatic islets and appears to be involved in zinc accumulation and regulation of insulin secretion in beta-cells [8]. Recent evidence suggests that single nucleotide polymorphisms in ZnT8 are associated with impaired proinsulin conversion [9] and increased risk of developing type 2 DM [10,11] .

Plant-based diets contain less saturated fat and cholesterol and more folate, fibre and phytochemicals than omnivorous diets, but some micronutrients, especially zinc, are poorly bioavailable. The findings of studies exploring the zinc intake and zinc status in populations that habitually consume vegetarian diets are inconsistent. This study aims to investigate the effects of plant-based diets on dietary zinc intake and status in humans using systematic review and meta-analysis techniques. Thirty-four studies were included in the systematic review. Of these, 26 studies (reporting 48 comparisons) compared males and/or females consuming vegetarian diets with non-vegetarian groups and were included in meta-analyses. Dietary zinc intakes and serum zinc concentrations were significantly lower (-0.88 ± 0.15 mg day(-1), P0.001 and -0.93 ± 0.27 µmol L(-1), P = 0.001 respectively; mean ± standard error) in populations that followed habitual vegetarian diets compared with non-vegetarians. Secondary analyses showed greater impact of vegetarian diets on the zinc intake and status of females, vegetarians from developing countries and vegans. Populations that habitually consume vegetarian diets have low zinc intakes and status. Not all vegetarian categories impact zinc status to the same extent, but a lack of consistency in defining vegetarian diets for research purposes makes dietary assessment difficult. Dietary practices that increase zinc bioavailability, the consumption of foods fortified with zinc or low-dose supplementation are strategies that should be considered for improving the zinc status of vegetarians with low zinc intakes or serum zinc concentrations at the lower end of the reference range.

The pathology of type 2 diabetes mellitus (DM) often is associated with underlying states of conditioned zinc deficiency and chronic inflammation. Zinc and omega-3 polyunsaturated fatty acids each exhibit anti-inflammatory effects and may be of therapeutic benefit in the disease. The present randomized, double-blind, placebo-controlled, 12-week trial was designed to investigate the effects of zinc (40 mg/day) and α-linolenic acid (ALA; 2 g/day flaxseed oil) supplementation on markers of inflammation [interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, C-reactive protein (CRP)] and zinc transporter and metallothionein gene expression in 48 postmenopausal women with type 2 DM. No significant effects of zinc or ALA supplementation were observed on inflammatory marker concentrations or fold change in zinc transporter and metallothionein gene expression. Significant increases in plasma zinc concentrations were observed over time in the groups supplemented with zinc alone or combined with ALA (P=.007 and P=.009, respectively). An impact of zinc treatment on zinc transporter gene expression was found; ZnT5 was positively correlated with Zip3 mRNA (P

Background Impaired zinc metabolism is prominent in chronic disorders including cardiovascular disease and diabetes. Zinc has the potential to affect glucose homeostasis in animals and humans and hence impact the risk of type 2 diabetes mellitus. Methods A systematic review and meta-analysis of randomised placebo controlled trials was conducted to determine the effect of zinc supplementation on fasting blood glucose, HbA1c, serum insulin and serum zinc concentrations. Relevant studies for inclusion were identified from a literature search of electronic databases up to July 2011. Results Fourteen reports ( n = 3978 subjects) were included in the meta-analysis. In the overall analysis, a small but statistically significant reduction in fasting glucose concentrations was observed (−0.19 ± 0.08 mmol/L, P = 0.013) after zinc supplementation. HbA1c tended to decrease in zinc-supplemented individuals (−0.64 ± 0.36%, P = 0.072). No significant effect was observed for serum insulin concentrations. Plasma zinc concentrations increased significantly following supplementation (+4.03 ± 0.81 μmol/L, P = 0.001). In secondary analyses of participants with chronic metabolic disease (types 1 and 2 diabetes mellitus, metabolic syndrome and obesity), zinc supplementation produced a greater reduction in glucose concentrations (−0.49 ± 0.11 mmol/L, P = 0.001) compared to the effect that was observed in healthy participants. Conclusion The significant albeit modest reduction in glucose concentrations and tendency for a decrease in HbA1c following zinc supplementation suggest that zinc may contribute to the management of hyperglycemia in individuals with chronic metabolic disease.

Phytic acid is a major determinant of zinc bioavailability. Little is known about phytic acid intakes or indices of zinc bioavailability in type 2 diabetes mellitus (DM), a condition that predisposes to zinc deficiency. The aim of this cross-sectional study was to measure and explore the relationships among phytic acid intake, zinc bioavailability, and molecular markers of zinc homeostasis in 20 women with DM compared to 20 healthy women. The phytate/zinc, (calcium)(phytate)/zinc, and (calcium + magnesium)(phytate)/zinc molar ratios were used to indicate zinc bioavailability. Plasma zinc concentrations and zinc transporter (ZnT1, ZnT8, and Zip1) gene expression in mononuclear cells were measured. Participants with DM consumed 1,194 ± 824 mg/day (mean ± SD) phytic acid, an amount similar to the intake of healthy women (1,316 ± 708 mg/day). Bread products and breakfast cereals contributed more than 40 % of the phytic acid intake in each group. A positive relationship was observed in all participants between phytic acid and dietary fiber (r = 0.6, P < 0.001) and between dietary fiber and the (calcium)(phytate)/zinc ratio (r = 0.5, P < 0.001). Compared to the healthy group, the messenger RNA ratio of ZnT1 (zinc export) to Zip1 (zinc import) was lower in participants with DM, which may indicate perturbed zinc homeostasis in the disorder. The plasma zinc concentration was not predicted by age, body mass index, health status, zinc bioavailability, or zinc transporter expression. Healthy and diabetic women consume phytic acid in amounts that are likely to decrease the bioavailability of dietary zinc. Recommendations to consume greater amounts of dietary fiber, much of which is associated with phytate, increase the risk of zinc deficiency.

Background Studies in humans and animals suggest that zinc has the potential to affect lipoprotein metabolism and hence impact cardiovascular disease risk. Methods A meta-analysis of controlled clinical trials was conducted to determine the effect of zinc supplementation on plasma cholesterol and triglyceride concentrations in humans. Potentially relevant studies were identified from a literature search covering the period 1980–2008 (inclusive), and additional citation searches. Results Thirty three interventions ( n =14,238 subjects) were included in the random effects meta-analysis. No overall significant effects of zinc supplementation were observed for plasma cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol or plasma triglyceride concentrations. Plasma zinc concentrations increased significantly (+2.42±0.25μmol/L, P n =14,047). Secondary analyses in individuals classified as healthy revealed that zinc supplementation is associated with a significant decrease in plasma HDL cholesterol concentrations (−0.10±0.02mmol/L, P n =13,215), equivalent to a 7% decrease from baseline. Conclusion No effect of zinc supplementation on plasma lipoproteins was detected in the overall analysis. In individuals classified as healthy, zinc supplementation is associated with a decrease in HDL cholesterol concentrations and thus contributes to an increased risk of coronary heart disease.

Background: Nutritional supplements are used commonly by people with type 2 diabetes mellitus (T2DM). We aimed to investigate the effects of zinc and α-linolenic acid (ALA) supplementation on markers of