Abstract
It is well recognised that zinc deficiency is a major global public health issue, particularly in young children in low-income countries with diarrhoea and environmental enteropathy. Zinc supplementation is regarded as a powerful tool to correct zinc deficiency as well as to treat a variety of physiologic and pathologic conditions. However, the dose and frequency of its use as well as the choice of zinc salt are not clearly defined regardless of whether it is used to treat a disease or correct a nutritional deficiency. We discuss the application of zinc stable isotope tracer techniques to assess zinc physiology, metabolism and homeostasis and how these can address knowledge gaps in zinc supplementation pharmacokinetics. This may help to resolve optimal dose, frequency, length of administration, timing of delivery to food intake and choice of zinc compound. It appears that long-term preventive supplementation can be administered much less frequently than daily but more research needs to be undertaken to better understand how best to intervene with zinc in children at risk of zinc deficiency. Stable isotope techniques, linked with saturation response and compartmental modelling, also have the potential to assist in the continued search for simple markers of zinc status in health, malnutrition and disease.
Highlights
Zinc is recognised as an essential micronutrient for normal growth and development as well as for achieving and maintaining health
The purpose of this paper is to review our current understanding of human zinc physiology and homeostasis, with a specific focus on tracer studies using zinc stable isotopes and compartmental modelling techniques
Multi-tracer techniques utilising kinetic data derived from administration of different zinc stable isotopes intravenously and/or orally under different conditions can be used for compartmental modelling of zinc metabolism
Summary
Zinc is recognised as an essential micronutrient for normal growth and development as well as for achieving and maintaining health. The beneficial effects of zinc administration include reduction in the incidence of diarrhoea and pneumonia [1,7], and the rate of mortality [8,9,10,11,12,13,14] among young children in low-middle income countries. Consensus statement [19], zinc plus vitamin A supplementation was the highest ranked solution for advancing global wellbeing and health. Despite this endorsement of zinc supplementation for children under the age of 5 years, dosage or scheduling frequency was not stipulated. We discuss how stable isotope techniques, linked with saturation response and compartmental modelling, have the potential to assist in the continued search for simple markers of zinc status in health, malnutrition and disease
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