Biological role[edit]

Zinc is an essential trace element for humans[159] and other animals,[160] for plants[93] and for
microorganisms.[161] Zinc is found in nearly 100 specific enzymes[162] (other sources[163] say
300), serves as structural ions in transcription factors and is stored and transferred in
metallothioneins.[164] It is "typically the second most abundant transition metal in organisms"
after iron and it is the only metal which appears in all enzyme classes.[93]
In proteins, Zn ions are often coordinated to the amino acid side chains of aspartic acid,
glutamic acid, cysteine and histidine. The theoretical and computational description of this
zinc binding in proteins (as well as that of other transition metals) is difficult.[165]
There are 2-4 grams of zinc[166] distributed throughout the human body. Most zinc is in the
brain, muscle, bones, kidney, and liver, with the highest concentrations in the prostate and
parts of the eye.[167] Semen is particularly rich in zinc, which is a key factor in prostate gland
function and reproductive organ growth.[168]
In humans, zinc plays "ubiquitous biological roles".[6] It interacts with "a wide range of
organic ligands",[6] and has roles in the metabolism of RNA and DNA, signal transduction,
and gene expression. It also regulates apoptosis. A 2006 study estimated that about 10% of
human proteins (2800) potentially bind zinc, in addition to hundreds which transport and
traffic zinc; a similar in silico study in the plant Arabidopsis thaliana found 2367 zinc-related
proteins.[93]
In the brain, zinc is stored in specific synaptic vesicles by glutamatergic neurons[169] and can
"modulate brain excitability".[6] It plays a key role in synaptic plasticity and so in learning.[170]
However, it has been called "the brain's dark horse"[169] because it also can be a neurotoxin,
suggesting zinc homeostasis plays a critical role in normal functioning of the brain and
central nervous system.[169]
Enzymes[edit]

Ribbon diagram of human carbonic anhydrase II, with zinc atom visible in the
center

Zinc fingers help read DNA sequences.

Zinc is an efficient Lewis acid, making it a useful catalytic agent in hydroxylation and other
enzymatic reactions.[162] The metal also has a flexible coordination geometry, which allows
proteins using it to rapidly shift conformations to perform biological reactions.[171] Two
examples of zinc-containing enzymes are carbonic anhydrase and carboxypeptidase, which
are vital to the processes of carbon dioxide (CO
2) regulation and digestion of proteins, respectively.[172]
In vertebrate blood, carbonic anhydrase converts CO
2 into bicarbonate and the same enzyme transforms the bicarbonate back into CO
2 for exhalation through the lungs.[173] Without this enzyme, this conversion would occur about
one million times slower[174] at the normal blood pH of 7 or would require a pH of 10 or more.
[175]
The non-related -carbonic anhydrase is required in plants for leaf formation, the synthesis
of indole acetic acid (auxin) and alcoholic fermentation.[176]
Carboxypeptidase cleaves peptide linkages during digestion of proteins. A coordinate
covalent bond is formed between the terminal peptide and a C=O group attached to zinc,
which gives the carbon a positive charge. This helps to create a hydrophobic pocket on the
enzyme near the zinc, which attracts the non-polar part of the protein being digested.[172]
Other proteins[edit]

Zinc serves a purely structural role in zinc fingers, twists and clusters.[177] Zinc fingers form
parts of some transcription factors, which are proteins that recognize DNA base sequences
during the replication and transcription of DNA. Each of the nine or ten Zn2+
ions in a zinc finger helps maintain the finger's structure by coordinately binding to four
amino acids in the transcription factor.[174] The transcription factor wraps around the DNA
helix and uses its fingers to accurately bind to the DNA sequence.
In blood plasma, zinc is bound to and transported by albumin (60%, low-affinity) and
transferrin (10%).[166] Because transferrin also transports iron, excessive iron reduces zinc
absorption, and vice-versa. A similar reaction occurs with copper.[178] The concentration of
zinc in blood plasma stays relatively constant regardless of zinc intake.[179] Cells in the
salivary gland, prostate, immune system and intestine use zinc signaling as one way to
communicate with other cells.[180]
Zinc may be held in metallothionein reserves within microorganisms or in the intestines or
liver of animals.[181] Metallothionein in intestinal cells is capable of adjusting absorption of
zinc by 1540%.[182] However, inadequate or excessive zinc intake can be harmful; excess zinc
particularly impairs copper absorption because metallothionein absorbs both metals.[183]

Dietary intake[edit]

Foods & spices containing zinc

In the U.S., the Recommended Dietary Allowance (RDA) is 8 mg/day for women and
11 mg/day for men.[184] Median intake in the U.S. around 2000 was 9 mg/day for women and
14 mg/day in men.[185] Oysters, lobster[186] and red meats, especially beef, lamb and liver have
some of the highest concentrations of zinc in food.[168]
Zinc supplements should only be ingested when there is zinc deficiency or increased zinc
necessity (e.g. after surgeries, traumata or burns).[187][188] Persistent intake of high doses of zinc
can cause copper deficiency.[187]
The concentration of zinc in plants varies based on levels of the element in soil. When there
is adequate zinc in the soil, the food plants that contain the most zinc are wheat (germ and
bran) and various seeds (sesame, poppy, alfalfa, celery, mustard).[189] Zinc is also found in
beans, nuts, almonds, whole grains, pumpkin seeds, sunflower seeds and blackcurrant.[190]
Other sources include fortified food and dietary supplements, which come in various forms. A
1998 review concluded that zinc oxide, one of the most common supplements in the United
States, and zinc carbonate are nearly insoluble and poorly absorbed in the body.[191] This
review cited studies which found low plasma zinc concentrations after zinc oxide and zinc
carbonate were consumed compared with those seen after consumption of zinc acetate and
sulfate salts.[191] However, harmful excessive supplementation is a problem among the
relatively affluent, and should probably not exceed 20 mg/day in healthy people,[192] although
the U.S. National Research Council set a Tolerable Upper Intake of 40 mg/day.[193]
For fortification, however, a 2003 review recommended zinc oxide in cereals as cheap, stable,
and as easily absorbed as more expensive forms.[194] A 2005 study found that various
compounds of zinc, including oxide and sulfate, did not show statistically significant
differences in absorption when added as fortificants to maize tortillas.[195] A 1987 study found
that zinc picolinate was better absorbed than zinc gluconate or zinc citrate.[196] However, a
study published in 2008 determined that zinc glycinate is the best absorbed of the four dietary
supplement types available.[197]

Deficiency[edit]
Main article: Zinc deficiency

Zinc deficiency is usually due to insufficient dietary intake, but can be associated with
malabsorption, acrodermatitis enteropathica, chronic liver disease, chronic renal disease,
sickle cell disease, diabetes, malignancy, and other chronic illnesses.[7] Groups at risk for zinc
deficiency include the elderly, children in developing countries, and those with renal
insufficiency.
Symptoms of mild zinc deficiency are diverse.[185] Clinical outcomes include depressed
growth, diarrhea, impotence and delayed sexual maturation, alopecia, eye and skin lesions,
impaired appetite, altered cognition, impaired host defense properties, defects in carbohydrate
utilization, and reproductive teratogenesis.[179] Mild zinc deficiency depresses immunity,[198]
although excessive zinc does also.[166] Animals with a diet deficient in zinc require twice as
much food in order to attain the same weight gain as animals given sufficient zinc.[125]
Despite some concerns,[199] western vegetarians and vegans have not been found to suffer from
overt zinc deficiencies any more than meat-eaters.[200] Major plant sources of zinc include
cooked dried beans, sea vegetables, fortified cereals, soyfoods, nuts, peas, and seeds.[199]
However, phytates in many whole-grains and fiber in many foods may interfere with zinc
absorption and marginal zinc intake has poorly understood effects. The zinc chelator phytate,
found in seeds and cereal bran, can contribute to zinc malabsorption.[7] There is some
evidence to suggest that more than the US RDA (15 mg) of zinc daily may be needed in those
whose diet is high in phytates, such as some vegetarians.[199] These considerations must be
balanced against the fact that there is a paucity of adequate zinc biomarkers, and the most
widely used indicator, plasma zinc, has poor sensitivity and specificity.[201] Diagnosing zinc
deficiency is a persistent challenge.[6]
Nearly two billion people in the developing world are deficient in zinc.[7] In children it causes
an increase in infection and diarrhea, contributing to the death of about 800,000 children
worldwide per year.[6] The World Health Organization advocates zinc supplementation for
severe malnutrition and diarrhea.[202] Zinc supplements help prevent disease and reduce
mortality, especially among children with low birth weight or stunted growth.[202] However,
zinc supplements should not be administered alone, because many in the developing world
have several deficiencies, and zinc interacts with other micronutrients.[203]

Dietary supplement[edit]

GNC zinc 50 mg tablets (AU)

Zinc is included in most single tablet over-the-counter daily vitamin and mineral
supplements.[135] Preparations include zinc oxide, zinc acetate, and zinc gluconate.[135] It is
believed to possess antioxidant properties, which may protect against accelerated aging of the
skin and muscles of the body; studies differ as to its effectiveness.[136] Zinc also helps speed up
the healing process after an injury.[136] It is also suspected of being beneficial to the body's
immune system. Indeed, zinc deficiency may have effects on virtually all parts of the human
immune system.[137]
Zinc deficiency has been associated with major depressive disorder (MDD), and zinc
supplements may be an effective treatment.[138]
Zinc serves as a simple, inexpensive, and critical tool for treating diarrheal episodes among
children in the developing world. Zinc becomes depleted in the body during diarrhea, but
recent studies suggest that replenishing zinc with a 10- to 14-day course of treatment can
reduce the duration and severity of diarrheal episodes and may also prevent future episodes
for up to three months.[139]

Zinc gluconate is one compound used for the delivery of zinc as a dietary supplement.
The Age-Related Eye Disease Study determined that zinc can be part of an effective
treatment for age-related macular degeneration.[140] Zinc supplementation is an effective
treatment for acrodermatitis enteropathica, a genetic disorder affecting zinc absorption that
was previously fatal to babies born with it.[52]
Gastroenteritis is strongly attenuated by ingestion of zinc, and this effect could be due to
direct antimicrobial action of the zinc ions in the gastrointestinal tract, or to the absorption of
the zinc and re-release from immune cells (all granulocytes secrete zinc), or both.[141][142] In
2011, researchers at John Jay College of Criminal Justice reported that dietary zinc

supplements can mask the presence of drugs in urine. Similar claims have been made in web
forums on that topic.[143]
Although not yet tested as a therapy in humans, a growing body of evidence indicates that
zinc may preferentially kill prostate cancer cells. Because zinc naturally homes to the prostate
and because the prostate is accessible with relatively non-invasive procedures, its potential as
a chemotherapeutic agent in this type of cancer has shown promise.[144] However, other studies
have demonstrated that chronic use of zinc supplements in excess of the recommended
dosage may actually increase the chance of developing prostate cancer, also likely due to the
natural buildup of this heavy metal in the prostate.[145]

Zinc lozenges and the common cold[edit]

Main article: Zinc and the common cold
There is some evidence that zinc lozenges may shorten the duration of cold symptoms.[146] The
most positive results have been found in studies in which zinc acetate was used, apparently
because acetate does not bind zinc ions.[147][148]
There is no concern of zinc toxicity in the dosages that were used in the zinc acetate trials
with 80100 mg/day of elemental zinc. The effect of zinc lozenges seems to take place
locally in the oropharynx so that it is not a systemic effect, i.e., the effect is not a dietary
supplement effect.

Topical use[edit]
Further information: Zinc oxide Medical
Topical administration of zinc preparations include ones used on the skin, often in the form of
zinc oxide. Zinc preparations can protect against sunburn in the summer and windburn in the
winter.[52] Applied thinly to a baby's diaper area (perineum) with each diaper change, it can
protect against diaper rash.[52]
Chelated zinc is used in toothpastes and mouthwashes to prevent bad breath.[149] Zinc
pyrithione is widely applied in shampoos because of its anti-dandruff function.[150] Zinc ions
are effective antimicrobial agents even at low concentrations.[151]
Toxicity[edit]

Although zinc is an essential requirement for good health, excess zinc can be harmful.
Excessive absorption of zinc suppresses copper and iron absorption.[183] The free zinc ion in
solution is highly toxic to plants, invertebrates, and even vertebrate fish.[206] The Free Ion
Activity Model is well-established in the literature, and shows that just micromolar amounts
of the free ion kills some organisms. A recent example showed 6 micromolar killing 93% of
all Daphnia in water.[207]
The free zinc ion is a powerful Lewis acid up to the point of being corrosive. Stomach acid
contains hydrochloric acid, in which metallic zinc dissolves readily to give corrosive zinc

chloride. Swallowing a post-1982 American one cent piece (97.5% zinc) can cause damage to
the stomach lining due to the high solubility of the zinc ion in the acidic stomach.[208]
There is evidence of induced copper deficiency in those taking 100300 mg of zinc daily. A
2007 trial observed that elderly men taking 80 mg daily were hospitalized for urinary
complications more often than those taking a placebo.[209] The USDA RDA is 11 and 8 mg
Zn/day for men and women, respectively.[184] Levels, of 100300 mg may interfere with the
utilization of copper and iron or adversely affect cholesterol.[183] Levels of zinc in excess of
500 ppm in soil interfere with the ability of plants to absorb other essential metals, such as
iron and manganese.[94] There is also a condition called the zinc shakes or "zinc chills" that
can be induced by the inhalation of freshly formed zinc oxide formed during the welding of
galvanized materials.[125] Zinc is a common ingredient of denture cream which may contain
between 17 and 38 mg of zinc per gram. There have been claims of disability, and even death,
due to excessive use of these products.[210]
The U.S. Food and Drug Administration (FDA) has stated that zinc damages nerve receptors
in the nose, which can cause anosmia. Reports of anosmia were also observed in the 1930s
when zinc preparations were used in a failed attempt to prevent polio infections.[211] On June
16, 2009, the FDA said that consumers should stop using zinc-based intranasal cold products
and ordered their removal from store shelves. The FDA said the loss of smell can be lifethreatening because people with impaired smell cannot detect leaking gas or smoke and
cannot tell if food has spoiled before they eat it.[212] Recent research suggests that the topical
antimicrobial zinc pyrithione is a potent heat shock response inducer that may impair
genomic integrity with induction of PARP-dependent energy crisis in cultured human
keratinocytes and melanocytes.[213]
Poisoning[edit]

In 1982, the US Mint began minting pennies coated in copper but made primarily of zinc.
With the new zinc pennies, there is the potential for zinc toxicosis, which can be fatal. One
reported case of chronic ingestion of 425 pennies (over 1 kg of zinc) resulted in death due to
gastrointestinal bacterial and fungal sepsis, whereas another patient, who ingested 12 grams
of zinc, only showed lethargy and ataxia (gross lack of coordination of muscle movements).
[214]
Several other cases have been reported of humans suffering zinc intoxication by the
ingestion of zinc coins.[215][216]
Pennies and other small coins are sometimes ingested by dogs, resulting in the need for
medical treatment to remove the foreign body. The zinc content of some coins can cause zinc
toxicity, which is commonly fatal in dogs, where it causes a severe hemolytic anemia, and
also liver or kidney damage; vomiting and diarrhea are possible symptoms.[217] Zinc is highly
toxic in parrots and poisoning can often be fatal.[218] The consumption of fruit juices stored in
galvanized cans has resulted in mass parrot poisonings with zinc.[52]

Classification[edit]
Zinc deficiency can be classified as acute, as may occur during prolonged inappropriate zincfree total parenteral nutrition; or chronic, as may occur in dietary deficiency or inadequate

absorption.[1] Zinc deficiency can also be considered as mild, as typically accompanies dietary
deficiency; or severe, as typically accompanies congenital defective absorption.[2]

Signs and symptoms[edit]

Skin, nails and hair[edit]

Zinc deficiency may manifest as acne,[3] eczema,[2] xerosis (dry, scaling skin),[2] seborrheic
dermatitis,[2] or alopecia (thin and sparse hair).[2][4] There may also be impaired wound healing.
[4]

Mouth[edit]

Zinc deficiency can manifest as non-specific oral ulceration, stomatitis, or white tongue
coating.[2] Rarely it can cause angular cheilitis (sores at the corners of the mouth)[5] and
burning mouth syndrome.[6]
Vision, smell and taste[edit]

Severe zinc deficiency may disturb the sense of smell[4] and taste.[7][8][9][10][11][12] Night blindness
may be a feature of severe zinc deficiency,[4] however most reports of night blindness and
abnormal dark adaptation in humans with zinc deficiency have occurred in combination with
other nutritional deficiencies (e.g. vitamin A).[13]
Immune system[edit]

Impaired immune function in children with zinc deficiency can lead to the development of
respiratory infections especially pneumonia.[4][14][15]
Diarrhea[edit]

Zinc deficiency contributes to an increased incidence and severity of diarrhea.[14][15]

Hunger[edit]

Zinc levels may increase or decrease hunger depending on the status of other nutrients, the
developmental stage of the animal, and percentage body fat. There is evidence zinc
deficiency decreases hunger, and, in contrast, evidence that zinc supplementation can also
decrease hunger, by increasing leptin levels.
Zinc deficiency may lead to anorexia and anorexia nervosa.[16] Appetite disorders can, in turn,
cause malnutrition and inadequate zinc intake, leading to a vicious cycle.[citation needed] The use of
zinc in the treatment of anorexia has been advocated since 1979 by Bakan. At least 15 clinical
trials have shown that zinc improved weight gain in anorexia. A 1994 trial showed that zinc
doubled the rate of body mass increase in the treatment of anorexia nervosa. Deficiency of
other nutrients such as tyrosine, tryptophan and thiamine could contribute to this
phenomenon of "malnutrition-induced malnutrition".[17]
The way zinc influences hunger may depend on the sodium/osmotic status of the organism,
with low sodium/low zinc levels increasing hunger and conversely.[citation needed] An organism with
a low level of zinc has an increased susceptibility to hypoosmotic stress and cell rupture. Zinc

is known to affect osmolality by increasing sodium retention.[citation needed] In rats, the first visible
sign of zinc deficiency is decreased food seeking behaviour.[18]
Cognitive and motor function[edit]

Cognitive and motor function may be impaired in zinc deficient children. Zinc deficiency can
interfere with many metabolic processes when it occurs during infancy and childhood, a time
of rapid growth and development when nutritional needs are high.[19] Low maternal zinc status
has been associated with less attention during the neonatal period and worse motor
functioning.[20] In some studies, supplementation has been associated with motor development
in very low birth weight infants and more vigorous and functional activity in infants and
toddlers.[20]
Psychological disorders[edit]

Plasma zinc levels have been alleged to be associated with many psychological disorders. An
increasing amount of evidence suggests that zinc deficiency could play a role in depression.[21]
[22]
Zinc may be an effective treatment.[23]
Growth[edit]

Zinc deficiency in children can cause delayed growth,[2] and has been claimed to be the cause
of stunted growth in one third of the world's population.[1]
During pregnancy[edit]

Zinc deficiency during pregnancy can negatively affect both the mother and fetus. Animal
studies indicate that maternal zinc deficiency can upset both the sequencing and efficiency of
the birth process. An increased incidence of difficult and prolonged labor, hemorrhage,
uterine dystocia and placental abruption has been documented in zinc deficient animals.[24]
These effects may be mediated by the defective functioning of estrogen via the estrogen
receptor, which contains a zinc finger protein.[24] A review of pregnancy outcomes in women
with acrodermatitis enteropathica, reported that out of every seven pregnancies, there was one
abortion and two malfunctions, suggesting the human fetus is also susceptible to the
teratogenic effects of severe zinc deficiency. However, a review on zinc supplementation
trials during pregnancy did not report a significant effect of zinc supplementation on neonatal
survival.[24]
Testosterone production[edit]

Zinc is required to produce testosterone. Thus, zinc deficiency can lead to reduced circulating
testosterone, hypogonadism,[2] and delayed puberty.[2]

Causes[edit]
Dietary deficiency[edit]

A diet which is high in phytate containing whole grains, high in foods grown in zinc deficient
soil, or high in processed foods containing little or no zinc can result in zinc deficiency.[25][26]
Conservative estimates suggest that 25% of the world's population is at risk of zinc
deficiency.[27]

The following table summarizes most of the foods with significant quantities of zinc, listed in
order of quantity per serving, unfortified.[28] Note that all of the top 10 entries are meat, beans,
or nuts. The recommended intake per day of zinc is 15 mg for adults and children over the
age of four.
Food

mg in one
serving

Percentage of
recommended daily
intake

Oysters, cooked, breaded and fried, 3

ounces (about 5 average sized oysters)

74.0

493%

Beef chuck roast, braised, 3 ounces

7.0

47%

Crab, Alaska king, cooked, 3 ounces

6.5

43%

Beef patty, broiled, 3 ounces

5.3

35%

Cashews, dry roasted, 3 ounces

4.8

33%

Lobster, cooked, 3 ounces

3.4

23%

Pork chop, loin, cooked, 3 ounces

2.9

19%

Baked beans, canned, plain or vegetarian,

2.9
cup

19%

Almonds, dry roasted, 3 ounces

2.7

18%

Chicken, dark meat, cooked, 3 ounces

2.4

16%

Yogurt, fruit, low fat, 8 ounces

1.7

11%

Chickpeas, cooked, cup

1.3

9%

Cheese, Swiss, 1 ounce

1.2

8%

Oatmeal, instant, plain, prepared with

water, 1 packet

1.1

7%

Milk, low-fat or non fat, 1 cup

1.0

7%

Kidney beans, cooked, cup

0.9

6%

Chicken breast, roasted, skin removed,

0.9
breast

6%

Cheese, cheddar or mozzarella, 1 ounce

0.9

6%

Peas, green, frozen, cooked, cup

0.5

3%

Flounder or sole, cooked, 3 ounces

0.3

2%

Inadequate absorption[edit]

Acrodermatitis enteropathica is an inherited deficiency of the zinc carrier protein ZIP4

resulting in inadequate zinc absorption.[4] It presents as growth retardation, severe diarrhea,

hair loss, skin rash (most often around the genitalia and mouth) and opportunistic candidiasis
and bacterial infections.[4]
Numerous small bowel diseases which cause destruction or malfunction of the gut mucosa
enterocytes and generalized malabsorption are associated with zinc deficiency.[citation needed]
Increased loss[edit]

Exercising, high alcohol intake, and diarrhea all increase loss of zinc from the body.[2][29]
Changes in intestinal tract absorbability and permeability due, in part, to viral, protozoal, or
bacteria pathogens may also encourage fecal losses of zinc.[30]
Increased utilization[edit]

Exercising, childhood growth, and pregnancy[31] all increase utilization.[clarification needed]

Chronic disease[edit]

The mechanism of zinc deficiency in some diseases has not been well defined; it may be
multifactorial.
Wilson's disease, sickle cell disease, chronic kidney disease, chronic liver disease have all
been associated with zinc deficiency.[32][33] It can also occur after bariatric surgery, mercury
exposure[34][35] and tartrazine.[citation needed]
Although marginal zinc deficiency is often found in depression, low zinc levels could either
be a cause or a consequence of mental disorders and their symptoms.[21]

Mechanism[edit]
The mechanism for the clinical manifestations of zinc deficiency is best appreciated by
recognizing that zinc functions in the body in three arenas: catalytic, structural, and
regulatory.[36][37] In its catalytic role, zinc is a critical component of the catalytic site of
hundreds of metalloenzymes. In its structural role, zinc coordinates with certain protein
domains, facilitating protein folding and producing structures such as zinc fingers. In its
regulatory role, zinc is involved in the regulation of nucleoproteins and the activity of various
inflammatory cells. For example, zinc regulates the expression of metallothionein, which has
multiple functions, such as intracellular zinc compartmentalization[38] and antioxidant function
[39][40]
Thus zinc deficiency results in disruption of hundreds of metabolic pathways, causing
numerous clinical manifestations, including impaired growth and development, and
disruption of reproductive and immune function.[2]

Prevention[edit]
Five interventional strategies can be used:

Adding zinc to soil, called agronomic biofortification, which both increases

crop yields and provides more dietary zinc.

Adding zinc to food, called fortification.

Adding zinc rich foods to diet. The foods with the highest concentration of
zinc are proteins, especially animal meats, the highest being oysters. [2] Per
ounce, beef, pork, and lamb contain more zinc than fish. The dark meat of
a chicken has more zinc than the light meat. Other good sources of zinc
are nuts, whole grains, legumes, and yeast. [41] Although whole grains and
cereals are high in zinc, they also contain chelating phytates which bind
zinc and reduce its bioavailability. [2]

Oral repletion via tablets (e.g. zinc gluconate) or liquid (e.g. zinc acetate).
Oral zinc supplementation in healthy infants more than six months old has
been shown to reduce the duration of any subsequent diarrheal episodes
by about 10 hours.[42]

Oral repletion via multivitamin/mineral supplements containing zinc

gluconate, sulfate, or acetate. It is not clear whether one form is better
than another.[41] Zinc is also found in some cold lozenges, nasal sprays, and
nasal gels.[41]

Epidemiology[edit]
Severe zinc deficiency is rare, and is mainly seen in persons with acrodermatitis
enteroathica,a severe defect in zinc absorption due to a congenital deficiency in the zinc
carrier protein ZIP4 in the enterocyte.[2] Mild zinc deficiency due to reduced dietary intake is
common.[2] Conservative estimates suggest that 25% of the world's population is at risk of
zinc deficiency.[27] Zinc deficiency is thought to be a leading cause of infant mortality.[citation needed]
Providing micronutrients, including zinc, to humans is one of the four solutions to major
global problems identified in the Copenhagen Consensus from an international panel of
economists.[43]

History[edit]
Significant historical events related to zinc deficiency began in 1869 when zinc was first
discovered to be essential to the growth of an organism (Aspergillus Niger).[44] In 1929 Lutz
measured zinc in numerous human tissues using the dithizone technique and estimated total
body zinc in a 70 kg man to be 2.2 grams. Zinc was found to be essential to the growth of rats
in 1933.[45] In 1939 beriberi patients in China were noted to have decreased zinc levels in skin
and nails. In 1940 zinc levels in a series of autopsies found it to be present in all tissues
examined. In 1942 a study showed most zinc excretion was via the feces. In 1950 a normal
serum zinc level was first defined, and found to be 17.3 - 22.1 micromoles/liter. In 1956
cirrhotic patients were found to have low serum zinc levels. In 1963 zinc was determined to
be essential to human growth, three enzymes requiring zinc as a cofactor were described, and
a report was published of a 21 year old Iranian man with stunted growth, infantile genitalia,
and anemia which were all reversed by zinc supplementation.[46] In 1972 fifteen Iranian
rejected army inductees with symptoms of zinc deficiency were reported: all responded to
zinc. In 1973 the first case of acrodermatitis enteropathica due to severe zinc deficiency was
described. In 1974 the National Academy of Sciences declared zinc to be an essential element
for humans and established a recommended daily allowance. In 1978 the Food and Drug
Administration required zinc to be in total parenteral nutrition fluids. In the 1990s there was
increasing attention on the role of zinc deficiency in childhood morbidity and mortality in
developing countries.[47] In 2002 the zinc transporter protein ZIP4 was first identified as the

mechanism for absorption of zinc in the gut across the basolateral membrane of the
enterocyte. By 2014 over 300 zinc containing enzymes have been identified, as well as over
1000 zinc containing transcription factors.[citation needed]

Soils and crops[edit]

Soil zinc is an essential micronutrient for crops. Almost half of the worlds cereal crops are
deficient in zinc, leading to poor crop yields.[48] Many agricultural countries around the world
are affected by zinc deficiencies. In China, zinc deficiency occurs on around half of the
agricultural soils, affecting mainly rice and maize. Areas with zinc deficient soils are often
regions with widespread zinc deficiency in humans. A basic knowledge of the dynamics of in
soils, understanding of the uptake and transport of zinc in crops and characterizing the
response of crops to zinc deficiency are essential steps in achieving sustainable solutions to
the problem of zinc deficiency in crops and humans.[49]
Biofortification[edit]

Soil and foliar application of zinc fertilizer can effectively increase grain zinc and reduce the
phytate:zinc ratio in grain.[50][51] People who eat bread prepared from zinc enriched wheat have
a significant increase in serum zinc.[citation needed]
Zinc fertilization not only increases zinc content in zinc deficient crops, it also increases crop
yields.[49] Balanced crop nutrition supplying all essential nutrients, including zinc, is a cost
effective management strategy. Even with zinc-efficient varieties, zinc fertilizers are needed
when the available zinc in the topsoil becomes depleted.
Plant breeding can improve zinc uptake capacity of plants under soil conditions with low
chemical availability of zinc. Breeding can also improve zinc translocation which elevates
zinc content in edible crop parts as opposed to the rest of the plant.
Central Anatolia, in Turkey, was a region with zinc-deficient soils and widespread zinc
deficiency in humans. In 1993, a research project found that yields could be increased by 6 to
8-fold and child nutrition dramatically increased through zinc fertilization.[52] Zinc was added
to fertilizers. While the product was initially made available at the same cost, the results were
so convincing that Turkish farmers significantly increased the use of the zinc-fortified
fertilizer (1 per cent of zinc) within a few years, despite the repricing of the products to
reflect the added value of the content. Nearly ten years after the identification of the zinc
deficiency problem, the total amount of zinc-containing compound fertilizers produced and
applied in Turkey reached a record level of 300,000 tonnes per annum. It is estimated that the
economic benefits associated with the application of zinc fertilizers on zinc deficient soils in
Turkey is around US$100 million per year. Zinc deficiency in children has been dramatically
reduced.

Research[edit]
There is some evidence that zinc may have an effect on cancer and further study is
recommended.[53]

References[edit]
1.

^ Jump up to: a b Brian R. Walker, Nicki R Colledge, Stuart H. Ralston, Ian

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