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      Zinc supplementation improves body weight management, inflammatory biomarkers and insulin resistance in individuals with obesity: a randomized, placebo-controlled, double-blind trial

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          Abstract

          Background

          The present study was designed to determine whether zinc supplementation would increase the effects of restricted calorie diet (RCD) on obesity.

          Methods and materials

          A randomized, double-blind clinical trial was performed on 40 obese subjects who were randomly assigned to receive zinc supplements (30 mg/day) or placebo for a period of 15-weeks. Both groups were under a restricted calorie diet (~ 300 kcal lower than the estimated energy requirement). Anthropometric measurements, biochemical markers, appetite, and dietary intakes were determined during the study period.

          Results

          The reductions of body weight, body mass index, waist circumference, and hip circumference were significantly higher in the zinc group compared to the placebo group ( P = 0.032, 0.025, 0.003, and 0.0001, respectively). Lower levels of high sensitivity C-reactive protein, apelin, homeostatic model assessment of insulin resistance (HOMA-IR), and appetite score were observed in the zinc group in comparison with the placebo group ( P = 0.0001, 0.001, 0.031 and 0.001 respectively).

          Conclusion

          This study indicates that Zn supplementation with a restricted calorie diet has favorable effects in reducing anthropometric measurements, inflammatory markers, insulin resistance and appetite in individuals with obesity, and may play an effective role in the treatment of obesity.

          Trial registration This clinical trial was registered at clinicaltrials.gov at the U.S. National Library of Medicine (NCT02516475).

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          Most cited references54

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          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.
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            Zinc and its role in immunity and inflammation.

            Zinc (Zn) nutritional importance has been known for a long time, but in the last decades its importance in immune modulation has arisen. This review aims at describing the mechanisms involved in the regulation of Zn homeostasis and their effects on the immune response focusing on those which are implicated in the physiopathology of rheumatoid arthritis. Zn functions as a modulator of the immune response through its availability, which is tightly regulated by several transporters and regulators. When this mechanism is disturbed, Zn availability is reduced, altering survival, proliferation and differentiation of the cells of different organs and systems and, in particular, cells of the immune system. Zn deficiency affects cells involved in both innate and adaptive immunity at the survival, proliferation and maturation levels. These cells include monocytes, polymorphonuclear-, natural killer-, T-, and B-cells. T cell functions and the balance between the different T helper cell subsets are particularly susceptible to changes in Zn status. While acute Zn deficiency causes a decrease in innate and adaptive immunity, chronic deficiency increases inflammation. During chronic deficiency, the production of pro-inflammatory cytokines increases, influencing the outcome of a large number of inflammatory diseases, including rheumatoid arthritis. Copyright © 2014 Elsevier B.V. All rights reserved.
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              Validation of a new self-report instrument for measuring physical activity.

              Development and validation of a physical activity scale for measuring physical activity in 24 h of sports, work, and leisure time on an average weekday. For development of the physical activity scale, 2500 randomly selected Danish men and women between the age of 20 and 60 were contacted by mail and asked to select frequent and relevant physical activities from a number of activities of known MET intensity. The activities were included in the physical activity scale, organized in nine different MET levels ranging from sleep/rest (0.9 METs) to high-intensity physical activities (>6 METs). Face validity of the physical activity scale was explored through interviews with 10 volunteer men and women. Concurrent validity was assessed against 4 d of accelerometry (CSA 7164) and physical activity diary in 40 volunteer men and women between 20 and 60 yr of age. The correlation between the activity scale and the diary was high (r = 0.74, P = 0.000), whereas correlation between the activity scale and accelerometer measurements was poor (r = 0.20, NS). The physical activity scale MET-time was systematically higher than average MET-time estimated from the diary, and the difference increased with increasing total MET-time. The physical activity scale appears to be a simple and valid alternative to measuring physical activity by diary in adult sedentary to moderately active Danes. The scale encompasses work, leisure time, and sports activity in one measure; it is easy to administer, and it provides detailed information on different activity levels as well as a single measure of the total amount of physical activity on an average weekday.
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                Author and article information

                Contributors
                nima.hosseinzadeh@sbmu.ac.ir
                atoosa.saidpour@gmail.com , a.saidpour@sbmu.ac.ir
                Journal
                Diabetol Metab Syndr
                Diabetol Metab Syndr
                Diabetology & Metabolic Syndrome
                BioMed Central (London )
                1758-5996
                2 December 2019
                2 December 2019
                2019
                : 11
                : 101
                Affiliations
                [1 ]GRID grid.411600.2, Department of Clinical Nutrition & Dietetics, , National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, ; 46, West Arghavan St., Farahzadi Blvd., Shahrak Qods, P.O. Box 19395-4741, Tehran, Islamic Republic of Iran
                [2 ]ISNI 0000 0001 2174 8913, GRID grid.412888.f, Student Research Committee, Nutrition Research Center, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [3 ]ISNI 0000 0001 2174 8913, GRID grid.412888.f, Department of Clinical Nutrition, Faculty of Nutrition and Food Science, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [4 ]GRID grid.411600.2, Faculty of Biostatistics, , Shahid Beheshti University of Medical Sciences, ; Tehran, Islamic Republic of Iran
                [5 ]GRID grid.411600.2, Department of Cellular and Molecular Nutrition, Faculty of Nutrition Science and Food Technology, , National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, ; Tehran, Iran
                Article
                497
                10.1186/s13098-019-0497-8
                6889702
                31827626
                80e3ac86-3a00-49f7-9289-2061ac8faaf5
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 September 2019
                : 21 November 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005851, Shahid Beheshti University of Medical Sciences;
                Categories
                Research
                Custom metadata
                © The Author(s) 2019

                Nutrition & Dietetics
                zinc supplement,obesity,anthropometric measurements,hs-crp,insulin resistance

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