The relationship between zinc intake and serum/plasma zinc concentration in adults: a systematic review and dose–response meta-analysis by the EURRECA Network

Dietary zinc recommendations vary widely across Europe due to the heterogeneity of pproaches used by expert panels. Under the EURRECA consortium a protocol was designed to systematically review and undertake meta-analyses of research data to create a database that includes “best practice” guidelines which can be used as a resource by future panels when setting micronutrient recommendations. As part of this process, the objective of the present study was to undertake a systematic review and meta-analysis of previously published data describing the relationship between zinc intake and status in adults. Searches were performed of literature published up to February 2010 using MEDLINE, Embase, and Cochrane Library. Data extracted included population characteristics, dose of zinc, duration of study, dietary intake of zinc, and mean concentration of zinc in plasma or serum at the end of the intervention period. An intake-status regression coefficient was estimated for each individual study, and pooled meta-analysis undertaken. The overall pooled for zinc supplementation on serum/plasma zinc concentrations from RCTs and observational studies was 0.08 (95% CI 0.05, 0.11; p<0.0001; I2 84.5%). An overall of 0.08 means that for every doubling in zinc intake, the difference in zinc serum or plasma concentration is (20.08 = 1.06), which is 6%. Whether the dose-response relationship, as provided in this paper, could be used as either qualitative or quantitative evidence to substantiate the daily zinc intake dose necessary to achieve normal or optimal levels of biomarkers for zinc status, remains a matter of discussion

Beverage Consumption Habits and Association with Total Water and Energy Intakes in the Spanish Population: Findings of the ANIBES Study

Background: Inadequate hydration is a public health issue that imposes a significant economic burden. In Spain, data of total water intake (TWI) are scarce. There is a clear need for a national study that quantifies water and beverage intakes and explores associations between the types of beverages and energy intakes. Methods: The Anthropometry, Intake and Energy Balance Study ANIBES is a national survey of diet and nutrition conducted among a representative sample of 2285 healthy participants aged 9–75 years in Spain. Food and beverage intakes were assessed in a food diary over three days. Day and time of beverage consumption were also recorded. Results: On average, TWI was 1.7 L (SE 21.2) for men and 1.6 L (SE 18.9) for women. More than 75% of participants had inadequate TWI, according to European Food Safety Authority (EFSA) recommendations. Mean total energy intake (EI) was 1810 kcal/day (SE 11.1), of which 12% was provided by beverages. Water was the most consumed beverage, followed by milk. The contribution of alcoholic drinks to the EI was near 3%. For caloric soft drinks, a relatively low contribution to the EI was obtained, only 2%. Of eight different types of beverages, the variety score was positively correlated with TWI (r = 0.39) and EI (r = 0.23), suggesting that beverage variety is an indicator of higher consumption of food and drinks. Conclusions: The present study demonstrates that well-conducted surveys such as the ANIBES study have the potential to yield rich contextual value data that can emphasize the need to undertake appropriate health and nutrition policies to increase the total water intake at the population level promoting a healthy Mediterranean hydration pattern.The ANIBES study was supported by Coca-Cola Iberia through an agreement with the Spanish Nutrition Foundation (FEN) who assisted with the technical advice. The current analysis included in this paper was financially supported by a Grant from the European Hydration Institute to the Canarian Foundation Science and Technology Park of the University of Las Palmas de Gran Canaria

The Relationship between Zinc Intake and Serum/Plasma Zinc Concentration in Children: A Systematic Review and Dose-Response Meta-Analysis

Recommendations for zinc intake during childhood vary widely across Europe. The EURRECA project attempts to consolidate the basis for the definition of micronutrient requirements, taking into account relationships among intake, status and health outcomes, in order to harmonise these recommendations. Data on zinc intake and biomarkers of zinc status reported in randomised controlled trials (RCTs) can provide estimates of dose-response relationships which may be used for underpinning zinc reference values. This systematic review included all RCTs of apparently healthy children aged 1–17 years published by February 2010 which provided data on zinc intake and biomarkers of zinc status. An intake-status regression coefficient was calculated for each individual study and calculated the overall pooled and SE using random effects meta-analysis on a double log scale. The pooled dose-response relationship between zinc intake and zinc status indicated that a doubling of the zinc intake increased the serum/plasma zinc status by 9%. This evidence can be utilised, together with currently used balance studies and repletion/depletion studies, when setting zinc recommendations as a basis for nutrition policies

EURRECA-Estimating Zinc Requirements for Deriving Dietary Reference Values

Zinc was selected as a priority micronutrient for EURRECA, because there is significant heterogeneity in the Dietary Reference Values (DRVs) across Europe. In addition, the prevalence of inadequate zinc intakes was thought to be high among all population groups worldwide, and the public health concern is considerable. In accordance with the EURRECA consortium principles and protocols, a series of literature reviews were undertaken in order to develop best practice guidelines for assessing dietary zinc intake and zinc status. These were incorporated into subsequent literature search strategies and protocols for studies investigating the relationships between zinc intake, status and health, as well as studies relating to the factorial approach (including bioavailability) for setting dietary recommendations. EMBASE (Ovid), Cochrane Library CENTRAL, and MEDLINE (Ovid) databases were searched for studies published up to February 2010 and collated into a series of Endnote databases that are available for the use of future DRV panels. Meta-analyses of data extracted from these publications were performed where possible in order to address specific questions relating to factors affecting dietary recommendations. This review has highlighted the need for more high quality studies to address gaps in current knowledge, in particular the continued search for a reliable biomarker of zinc status and the influence of genetic polymorphisms on individual dietary requirements. In addition, there is a need to further develop models of the effect of dietary inhibitors of zinc absorption and their impact on population dietary zinc requirements.This is the peer-reviewed version of the article: Lowe Nicola M., Dykes Fiona C., Skinner Anna-Louise, Patel Sujata, Warthon-Medina Marisol, Decsi Tamas, Fekete Katalin, Souverein Olga W., Dullemeijer Carla, Cavelaars Adrienne E., Serra-Majem Lluis, Nissensohn Mariela, Bel Silvia, Moreno Luis A., Hermoso Maria, Vollhardt Christiane, Berti Cristiana, Cetin Irene, Gurinović Mirjana A., Novaković Romana, Harvey Linda, Collings Rachel, Hall-Moran Victoria, "EURRECA-Estimating Zinc Requirements for Deriving Dietary Reference Values" 53, no. 10 (2013):1110-1123, [https://doi.org/10.1080/10408398.2012.742863

Reply to C. Ferreira-Pêgo’s Letter to the Editor Re: Nissensohn M. et al.; Nutrients 2016, 8, 232

n/

Beverage Consumption Habits around the World: The Burden of Disease Attributable to Hydration

Dehydration occurs when the body loses more water than is taken in.[...

Beverage Consumption Habits around the World: Association with Total Water and Energy Intakes

Fluid intake has barely been assessed, and hydration status has only rarely been measured in epidemiological studies. This hampers attempts to assess the adequacy of water intake at a population level. However, although guidelines have been established to determine how much water humans require to avoid dehydration and to optimize physical and psychological function, limited data are available on the total water and beverages intake. Therefore, the percentage of population with inadequate water intake is unknown. There is a clear need for studies in different settings around the world that quantify total water and beverage intake and explore associations between types of beverages consumed and energy intake

Beverage Consumption Habits among the European Population: Association with Total Water and Energy Intakes

Background: Fluid and water intake have received limited attention in epidemiological studies. The aim of this study was to compare the average daily consumption of foods and beverages in adults of selective samples of the European Union (EU) population in order to understand the contribution of these to the total water intake (TWI), evaluate if the EU adult population consumes adequate amounts of total water (TW) according to the current guidelines, and to illustrate the real water intake in Europe. Methods: Three national European dietary surveys have been selected: Spain used the Anthropometry, Intake, and Energy Balance Study (ANIBES) population database, Italy analyzed data from the Italian National Food Consumption Survey (INRAN-SCAI 2005-06), and French data came from the NutriNet-Sante database. Mean daily consumption was used to compare between individuals. TWI was compared with European Food Safety Authority (EFSA) reference values for adult men and women. Results: On average, in Spain, TWI was 1.7 L (SE 22.9) for men and 1.6 L (SE 19.4) for women; Italy recorded 1.7 L (SE 16.9) for men and 1.7 L (SE 14.1) for women; and France recorded 2.3 L (SE 4.7) for men and 2.1 L (SE 2.4) for women. With the exception of women in France, neither men nor women consumed sufficient amounts of water according to EFSA reference values. Conclusions: This study highlights the need to formulate appropriate health and nutrition policies to increase TWI in the EU population. The future of beverage intake assessment requires the use of new instruments, techniques, and the application of the new available technologies