Source: CHILDREN'S HOSPITAL OAKLAND RESEARCH INSTITUTE submitted to NRP
AN EVALUATION OF DIETARY ZINC REQUIREMENTS FOR THE ELDERLY
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0202058
Grant No.
2005-35200-15219
Cumulative Award Amt.
(N/A)
Proposal No.
2004-01842
Multistate No.
(N/A)
Project Start Date
Dec 1, 2004
Project End Date
Nov 30, 2008
Grant Year
2005
Program Code
[31.0]- (N/A)
Recipient Organization
CHILDREN'S HOSPITAL OAKLAND RESEARCH INSTITUTE
5700 MARTIN LUTHER KING, JR. WAY
OAKLAND,CA 94609
Performing Department
(N/A)
Non Technical Summary
13 percent of the U.S. population is elderly individuals over 65 years of age. They are the most rapidly growing population segment in the United States. National surveys show that their dietary zinc intakes are inadequate and that many of their health problems are conditions associated with poor zinc nutriture. As the elderly population grows, demands for health services will be increased by their health problems. Improved nutrition, especially zinc, could reduce some of those problems. Age-specific standards for zinc intake are essential to establish policies and programs to improve their zinc nutriture. However, dietary zinc requirements of the elderly have never been studied systematically. This gap must be addressed in order to assure that nutrition policies and feeding programs meet the zinc needs of this important population. In this study, we will complete a comprehensive study of the dietary zinc requirement of individuals over 70 years of age using data from individuals fed typical mixed diets.
Animal Health Component
75%
Research Effort Categories
Basic
25%
Applied
75%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70260101010100%
Goals / Objectives
To measure endogenous fecal zinc (EFZ) losses, urinary zinc, fractional zinc absorption (FZA), and total absorbable zinc in 12 men and 12 women over 70 years of age when fed three different levels of dietary zinc including the Estimated Average Requirement (EAR), 40 percent less than the EAR, and 40 percent above the EAR. To derive an estimate of an EAR for elderly men and for elderly women using data from individuals in DRI model and to calculate the EARs coefficient of variation and determine if variation in EFZ or FZA is related to fat-free mass, resting metabolic rates, enzymatic markers of liver function, biochemical markers of subclinical infection, or glomerular filtration rates. To evaluate the effect of changes in dietary zinc on the expression of cellular zinc transporter genes in elderly men and women fed diets ranging from 40 percent below to 40 percent above their EAR and to determine if there is a relationship between zinc transporter gene expression and endogenous zinc loss or absorption.
Project Methods
Our overall goal is to determine the dietary zinc requirements of the elderly and to define the relationship between cellular zinc transporter gene expression and measurements of whole body zinc homeostasis. Twelve men and 12 women over 70 years of age will participate in zinc metabolic studies to measure EFZ, urinary zinc, FZA, and total absorbed zinc using stable isotopes. Each participant will be fed three different levels of dietary zinc: the 2002 EAR, 40 percent less than the EAR, and 40 percent greater than the EAR. The women will be fed diets ranging from 4.1 to 9.5 mg per day; men will be fed intakes from 5.6 to 13.2 mg per day. These levels were chosen because they represent a range of typical zinc intakes from habitual diets by this population. For example, the median zinc intakes of elderly women in NHANES III ranged from 6.6 to 7.2; the range for men was 8.8 to 10.3. The participants will be adapted to each diet for seven days at home before entering the GCRC at San Francisco General Hospital (SFGH) for a week to conduct the metabolic studies. In addition to measuring zinc absorption, endogenous fecal, and urinary zinc losses, we will measure zinc balance, plasma zinc, the size and turnover of the exchangeable zinc pool (EZP), and cellular zinc transporter gene expression. We will also measure body composition, resting metabolic rates, enzymatic markers of liver function, biochemical markers of subclinical infection, and glomerular filtration rates to assess the possible effect of these physiological parameters on our measures of zinc homeostasis. After a 4 week wash-out period, while the participants consume their usual diets at home, a two-week study of the second diet will begin, and the third diet will be administered after a 4-week wash-out period. Thus, each participant will be studied for three 2-week periods over a 14-week period. The three dietary treatments will be administered randomly. Previous work in our laboratory has shown that a 4-week wash-out period is sufficient to reduce isotopic zinc enrichments in plasma, urine, and stools to natural abundance levels. However, a baseline urine and fecal sample is collected at the beginning of every metabolic period to determine background isotope levels.

Progress 12/01/04 to 11/30/08

Outputs
OUTPUTS: Results of this research summarizing the Estimated Average Requirements (EARs) for zinc among older men and women (greater than 65 years of age) were presented at the 2008 annual meeting of the American Society for Nutrition in San Diego, CA. A manuscript to be submitted to the American Journal of Clinical Nutrition on the study results is under preparation. PARTICIPANTS: A postdoctoral fellow, Dr. Carolyn Chung, received training in the clinical management of a human nutrition study and in the analysis of zinc metabolism using stable isotopic zinc tracers. TARGET AUDIENCES: Not relevant to this project. PROJECT MODIFICATIONS: Not relevant to this project.

Impacts
Zn intake and metabolism are altered in elderly individuals, yet dietary requirements have not been studied for this group. We measured the fractional zinc absorption (FZA) in response to diets containing approximately the zinc Estimated Average Requirement (EAR) and the EAR plus or minus 40% consumed for 2 weeks in 21 healthy elderly, 12 women and 9 men. All subjects consumed three controlled mixed food diets with a 4 week washout period in between each diet period. 70Zn and 67Zn stable isotopic tracers were given orally and intravenously on d8 and 9 of each 2-week diet period, respectively. Urine collected 3-5 d after tracer administration was analyzed by mass spectrometry for 67:66 Zn ratios and by inductively coupled plasma emission spectrometry for total urinary and plasma Zn. FZA was determined using tracer/tracee ratios and averaged from d 3-5. Total absorbed zinc equaled the total dietary zinc intake multiplied by FZA. FZA differed across all diet groups (p<0.0001, Analysis of Covariance), regardless of age or sex. But, total absorbed zinc did not vary by diet group, nor did plasma and urinary Zn. When fed the recommended estimated average zinc requirements, FZA averaged 29 and 37% in men and women, respectively. It was 40 and 10% lower than the values used to determine zinc requirements (48 and 41%). Mean total absorbed zinc was 2.99 and 2.73 mg/d in men and women, respectively, and was 21 and 17% lower than absorbed Zn values used for EARs (3.8 and 3.3 mg/d). The coefficient of variation for FZA and total absorbed zinc in the elderly was 31% compared to the assumed 10% used to estimate the RDA. Potential Impact: The lower measured FZA for these healthy elderly individuals suggests that the current estimated Zn average requirement by the Institute of Medicine (IOM) underestimates the their true needs. Thus,older individuals fed diets based on the IOM standards may not receive adequate amounts of zinc.

Publications

  • Chung, C.S., Montelius, L., Nguyen, T., Gildengorin, V., Dare,D., and King,J.C.(2008). Fractional Zn absorption (FZA) and total absorbed Zn (TAZ) in elderly are lower than values used to derive the adult Zn Estimated Average Requirement (EAR) FASEB Journal. Abstract 697.2.


Progress 12/01/04 to 11/30/05

Outputs
Approval of the study protocol and consent form was obtained from the Children's Hospital & Research Center at Oakland and the University of California at San Francisco. Menus for the six different study diets were developed and analyzed for zinc and phytate concentrations. Modifications were made as necessary and specific amounts of food for each menu was finalized. A process for recruiting elderly men and women through Senior Centers in Oakland, Berkeley, and San Franciso was established. To date, 2 men and 6 women have been recruited, screened, and approved for the study. One man has completed the entire 14 week protocol and his laboratory data are being analyzed. Four women are currently participating in the first metabolic period of the study.

Impacts
Results from this study will enable scientists to establish science-based dietary zinc recommendations in individuals over 65 years of age. Knowledge of the zinc requirements of this vulnerable group will enable policy makers to determine the prevalence of inadequate zinc intakes in the U.S.

Publications

  • No publications reported this period