Mineral bioavailability and metabolism determined by using stable isotope tracers.

Definitive data on mineral bioavailability in humans and animals can be obtained by using isotopic tracers. The use of stable isotope tracers to study important issues in mineral nutrition has expanded rapidly in the past two decades, particularly in human nutrition studies. Stable isotopes have a number of advantages over radioisotopes. There is no exposure to radiation with stable isotopes, and some minerals have no radioisotope that can be used satisfactorily as a tracer. Multiple stable isotopes of one mineral and isotopes of multiple minerals can be administered simultaneously or sequentially. The analytical methods of choice for stable isotopes are thermal ionization mass spectrometry and inductively coupled plasma mass spectrometry (ICPMS). Thermal ionization mass spectrometry offers the greatest precision and accuracy, but it is slower, more labor intensive, and more costly than ICPMS. Bioavailability data are critical to establishing reliable dietary mineral requirements and recommendations. Combined with a computer program for compartmental modeling, mineral kinetics can be studied, including mineral turnover, pool sizes, and transfer rates between compartments. Our laboratory conducts studies using stable isotopes of Zn, Cu, Fe, Ca, Mg, and Mo. We have studied the effect of the amount of dietary intake of minerals on bioavailability and use, pregnancy and aging, and interactions among minerals. The research resulted in establishing new dietary recommendations for Cu and Mo and developing compartmental models for these minerals. Although stable isotopes have been used more extensively to date in humans than in animals, the techniques applied to humans can be used to study a number of issues important to optimizing feeding strategies for animal production.

Effect of acute zinc depletion on zinc homeostasis and plasma zinc kinetics in men.

BACKGROUND: Zinc homeostasis and normal plasma zinc concentrations are maintained over a wide range of intakes. OBJECTIVE: The objective was to identify the homeostatic response to severe zinc depletion by using compartmental analysis. DESIGN: Stable zinc isotope tracers were administered intravenously to 5 men at baseline (12.2 mg dietary Zn/d) and after 5 wk of acute zinc depletion (0.23 mg/d). Compartmental modeling of zinc metabolism was performed by using tracer and mass data in plasma, urine, and feces collected over 6-14 d. RESULTS: The plasma zinc concentration fell 65% on average after 5 wk of zinc depletion. The model predicted that fractional zinc absorption increased from 26% to essentially 100%. The rate constants for zinc excretion in the urine and gastrointestinal tract decreased 96% and 74%, respectively. The rate constants describing the distribution kinetics of plasma zinc did not change significantly. When zinc depletion was simulated by using an average mass model of zinc metabolism at baseline, the only change that accounted for the observed fall in plasma zinc concentration was a 60% reduction in the rate constant for zinc release from the most slowly turning over zinc pool. The large changes in zinc intake, excretion, and absorption-even when considered together-only explained modest reductions in plasma zinc mass. CONCLUSION: The kinetic analysis with a compartmental model suggests that the profound decrease in plasma zinc concentrations after 5 wk of severe zinc depletion was mainly due to a decrease in the rate of zinc release from the most slowly turning over body zinc pool.

Molybdenum absorption and utilization in humans from soy and kale intrinsically labeled with stable isotopes of molybdenum.

BACKGROUND: Stable-isotope studies of molybdenum metabolism have been conducted in which molybdenum was added to the diet and was assumed to be absorbed and utilized similarly to the molybdenum in foods. OBJECTIVE: Our objective was to establish whether the molybdenum in foods is metabolized similarly to molybdenum added to the diet. DESIGN: We first studied whether sufficient amounts of molybdenum stable isotopes could be incorporated into wheat, kale, and soy for use in a human study. Enough molybdenum could be incorporated into soy and kale to study molybdenum absorption and excretion. Two studies were then conducted, one in women and one in men. In the first study, each meal contained approximately 100 microg Mo from soy, kale, and extrinsic molybdenum. In the second study, soy and extrinsic molybdenum were compared; the meal contained approximately 300 microg Mo. RESULTS: In the first study, molybdenum was absorbed equally well from kale and an extrinsic source. However, the molybdenum in soy was less well absorbed than the molybdenum in kale or that added to the diet. In the second study, absorption of molybdenum from soy was less than from the extrinsic label. Urinary excretion of soy molybdenum was also lower than urinary excretion of the extrinsic label, but excretion as a percentage of the absorbed dose was not significantly different between treatments. CONCLUSIONS: The molybdenum in soy is less available than molybdenum added to the diet, but the molybdenum in kale is as available as molybdenum added to the diet. Once absorbed, excretion is not significantly different for soy, kale, and extrinsic molybdenum.

The effects of zinc depletion on peak force and total work of knee and shoulder extensor and flexor muscles.

In this study we tested the effect of zinc (Zn) on muscle function in human. After receiving 12 mg Zn/day for 17 days, 8 male subjects received 0.3 mg Zn/day for either 33 or 41 days. Subjects were divided into two groups for repletion. Group A subjects received overnight infusions of 66 mg Zn on Days 1 and 10 and then were fed 12 mg Zn/day for another 16 days. Group B subjects were fed 12 mg Zn/day for 3 weeks. Peak force and total work capacity of the knee and shoulder extensor and flexor muscle groups were assessed using an isokinetic dynamometer at baseline, at two points during depletion, and at repletion. Plasma Zn declined significantly during depletion and remained below baseline levels after repletion. The peak force of the muscle groups tested was not affected by acute Zn depletion, however, total work capacity for the knee extensor muscles and shoulder extensor and flexor muscles declined significantly. The data suggest that acute Zn depletion alters the total work capacity of skeletal muscle.

Copper absorption, excretion, and retention by young men consuming low dietary copper determined by using the stable isotope 65Cu.

A study was conducted in young men to evaluate the effect of a low-copper diet on copper absorption, excretion, and retention. Eleven young men were confined to a metabolic research unit for 90 d. The study was divided into three periods, with dietary copper as the only variable. Dietary copper intake was 0.66 mg/d for 24 d, 0.38 mg/d for 42 d, and 2.49 mg/d for 24 d. The stable isotope 65Cu was fed to five of the subjects once during the first and last dietary period and twice, early and late, in the second period to determine copper absorption. 65Cu was infused into an arm vein of the other six subjects once during each dietary period to estimate excretion of endogenous copper. Total copper and 65Cu were determined by isotope dilution with thermal-ionization mass spectrometry. Fractional absorption was significantly higher during the low-copper period than in either period with higher dietary copper and excretion of the infused isotope was significantly lower in the low-copper period. Subjects were in negative balance early in the first two periods but achieved balance by the end of those periods. They retained copper during the highest dietary copper period (third period). The results suggest that endogenous copper excretion is a major point of regulation of the body's copper stores. Regulation of absorption and of endogenous excretion in response to dietary copper intake helps to protect against deficiency and toxicity. However, this regulation was not sufficient to maintain copper status at the lowest intake of dietary copper, 0.38 mg/d.

Human whole-body copper metabolism.

Whole-body copper metabolism is difficult to study in human subjects. However, the use of isotopic tracers and kinetics modeling has added a dimension beyond what can be learned in humans by direct measurement. Mechanisms regulating total body copper seem to be strong, given the relatively small and constant body pool, but they are not yet well understood. The efficiency of copper absorption varies greatly, depending on dietary intake. Changes in efficiency of absorption help to regulate the amount of copper retained by the body. In addition, endogenous excretion of copper into the gastrointestinal tract depends heavily on the amount of copper absorbed. When dietary copper is high and more is absorbed, endogenous excretion increases, protecting against excess accumulation of copper in the body. When intake is low, little endogenous copper is excreted, protecting against copper depletion. Regulation is not sufficient with very low amounts of dietary copper (0.38 mg/d) and appears to be delayed when copper intake is high. The use of isotopic tracers and kinetic modeling should aid in elucidating the regulatory mechanisms.

A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses.

To clarify the role of the intestine, kidney, and bone in maintaining calcium homeostasis during pregnancy and lactation and after the resumption of menses, a longitudinal comparison was undertaken of 14 well-nourished women consuming approximately 1200 mg Ca/d. Measurements were made before conception (prepregnancy), once during each trimester of pregnancy (T1, T2, and T3), early in lactation at 2 mo postpartum (EL), and 5 mo after resumption of menses. Intestinal calcium absorption was determined from the enrichment of the first 24-h urine sample collected after administration of stable calcium isotopes. Bone mineral of the total body and lumbar spine was measured by dual-energy X-ray absorptiometry and quantitative computerized tomography, respectively. Twenty-four-hour urine and fasting serum samples were analyzed for calcium, calcitropic hormones, and biochemical markers of bone turnover. Despite an increase in calcium intake during pregnancy, true percentage absorption of calcium increased from 32.9+/-9.1% at prepregnancy to 49.9+/-10.2% at T2 and 53.8+/-11.3% at T3 (P < 0.001). Urinary calcium increased from 4.32+/-2.20 mmol/d at prepregnancy to 6.21+/-3.72 mmol/d at T3 (P < 0.001), but only minor changes in maternal bone mineral were detected. At EL, dietary calcium and calcium absorption were not significantly different from that at prepregnancy, but urinary calcium decreased to 1.87+/-1.22 mmol/d (P < 0.001) and trabecular bone mineral density of the spine decreased to 147.7+/-21.2 mg/cm3 from 162.9+/-25.0 mg/cm3 at prepregnancy (P < 0.001). Calcium absorption postmenses increased nonsignificantly to 36.0+/-8.1% whereas urinary calcium decreased to 2.72+/-1.52 mmol/d (P < 0.001). We concluded that fetal calcium demand was met by increased maternal intestinal absorption; early breast-milk calcium was provided by maternal renal calcium conservation and loss of spinal trabecular bone, a loss that was recovered postmenses.

Opioid Peptides, Adrenocorticotrophic Hormone and Dietary Copper Intake in Humans.

Copper plays an important role in cardiac and brain function possibly through endocrine and neuroendocrine systems. The syndrome of copper deficiency is worsened by dietary fructose and other trace metals such as zinc. We investigated the effect of a low copper diet on plasma opioid peptides in 11 healthy young volunteers who were fed foods low in copper but adequate in all other nutrients. The study was divided into three dietary periods. Copper was added to the diet so that the diet contained 0.66 mg/day for 24 days (marginal Cu), 0.38 mg/day for 42 days (low Cu) and 2.49 mg/day for 24 days (adequate Cu). The indices of copper status, ceruloplasmin and plasma copper concentrations, declined and were significantly lower (p < 0.05) at the end of the low Cu period than at the beginning of the study and the end of the marginal Cu period. They increased significantly at the end of the adequate Cu diet to the levels of the marginal Cu diet. Plasma ß-endorphin (BEN), Leu-enkephalin (LE), Met-enkephalin (ME) and Adrenocorticotropic hormone (ACTH) were measured by radioimmunoassay at the beginning of the study and at the end of each dietary period. No significant differences were observed in BEN, LE or ME during any of the periods. There were only small increases in LE and ME at the end of marginal and low copper diet periods and no significant changes were observed on copper repletion. Plasma ACTH was significantly lower at the end of low copper compared to baseline value but was not lower after marginal copper. Copper repletion had no significant effect on ACTH. The data show that plasma opioid peptides did not respond significantly to differential copper intake.

In vitro copper stimulation of plasma peptidylglycine alpha-amidating monooxygenase in Menkes disease variant with occipital horns.

We determined the concentrations of copper, the activities of ceruloplasmin and peptidylglycine alpha-amidating monooxygenase (PAM), and the stimulation index of PAM by the in vitro addition of copper in plasma samples obtained from three male patients with occipital horns and a milder Menkes disease phenotype, having severe copper deficiency due to the defect in copper transport. We found a decreased plasma ceruloplasmin activity and an increased copper stimulation index of plasma PAM in these patients compared with healthy control subjects. The combination of these two determinations may provide a means for the assessment of copper nutriture in humans using blood samples obtained in a single microhematocrit tube. Further investigation is warranted to evaluate whether these noninvasive measurements can be used for the diagnosis of mild copper deficiency in humans with sufficient specificity and sensitivity.

Copper status of young men consuming a low-copper diet.

A study was conducted in 11 young men to evaluate the effect of a low-copper diet on indexes of copper status and to define an amount of dietary copper at which adequate copper status could not be maintained. The young men were confined to a metabolic research unit for 90 d. The study was divided into three periods, with dietary copper as the only variable. Dietary copper was 0.66 mg/d for 24 d, 0.38 mg/d for 42 d, and 2.49 mg/d for 24 d. Plasma copper, ceruloplasmin activity, ceruloplasmin concentration, and erythrocyte superoxide dismutase (SOD) were measured at selected time points during each dietary copper period. Urine was collected throughout the study. Plasma copper, ceruloplasmin concentration and activity, and urinary copper declined significantly during the lowest dietary copper period. Plasma copper, ceruloplasmin concentration, and urinary copper increased in response to repletion. The average erythrocyte SOD concentration was lower during the depletion period than in the periods before or after depletion, but it did not decline significantly over time in the depletion period. The results suggest that these indexes are sensitive to copper depletion; that 0.38 mg Cu/d is not sufficient to maintain copper status in normal, healthy young men; and that the minimum dietary copper requirement is between 0.4 and 0.8 mg/d.

Deliberations and evaluations of the approaches, endpoints and paradigms for manganese and molybdenum dietary recommendations.

The background of the current dietary recommendations for manganese and molybdenum are described. This article reviews how the previous and current estimated safe and adequate daily dietary intakes (ESADDI) were set, shortcomings in the methods used, concerns about the current recommendations, and brief summaries of new research reports. New approaches, endpoints and paradigms to use for the development of useful recommendations are given.

Molybdenum metabolism in men with increasing molybdenum intakes: changes in kinetic parameters.

Molybdenum metabolism was studied in four young men to determine the effect of the amount of dietary molybdenum on molybdenum kinetics. A compartmental model, developed by using data from a study with low dietary molybdenum, was adapted to accommodate five levels of molybdenum. Each level, ranging from 22 to 1,470 micrograms molybdenum/day, was fed for 24 days. Kinetics of absorption and excretion were traced by using 97Mo (intravenous) and 100 Mo (oral) stable-isotope tracers at selected intervals. Urinary and fecal isotope excretion data for 6-day pooled collections were fit to a kinetic model by using SAAM/CONSAM software. Residence times for molybdenum were estimated at 2.4 days in the gastrointestinal tract, 40 min in plasma, from 3.3 to 0.3 days in fast-turnover tissue, and from 63 to 237 days in slow-turnover tissue. As dietary molybdenum increased, residence time decreased in fast-turnover tissue and increased in slow-turnover tissue. The model closely approximated the highly efficient homeostatic mechanisms of molybdenum metabolism over a wide range of intakes.

Kinetic model of molybdenum metabolism developed from dual stable isotope excretion in men consuming a low molybdenum diet.

The aim of this study was to develop a compartmental model of molybdenum metabolism based on stable isotope excretion patterns. Molybdenum (Mo) is an essential trace element in humans, with an estimated safe and adequate daily dietary intake (ESADDI) of 75-250 micrograms Mo/d. Four adult men were fed low molybdenum diets, 22 micrograms Mo/d for a period of 102 d. 97Mo+ and 100Mo stable isotopes, in intravenous and oral doses, respectively, were administered at selected intervals. The resulting 6-d cumulative urinary and fecal isotope excretion data were used to model molybdenum metabolism using SAAM/CONSAM software. A kinetic model, including gastrointestinal (GI), plasma, slow-turnover tissue and fast-turn-over tissue compartments, accurately simulated the observed pattern of urinary and fecal excretion for both stable isotopes in all four subjects. Residence time for molybdenum in the GI tract was estimated at 1.7 +/- 0.4 d. Predicted residence time for plasma molybdenum was 22 +/- 4 min, whereas slow-turnover tissue (possible hepatic) retention averaged 58 +/- 16 d. The model thus permitted estimation of kinetic parameters for molybdenum metabolism in tissues not readily accessible or measurable in humans.

Effect of calcium supplements and stage of lactation on the calcium absorption efficiency of lactating women accustomed to low calcium intakes.

The effect of calcium intake on the calcium absorption efficiency from 100 mL cow milk was measured in lactating Gambian mothers habituated to a low-calcium diet [mean intake 7.08 mmol (283 mg)/d], and compared with UK lactating mothers consuming high-calcium diets [mean intake 29.2 mmol (1168 mg)/d] by using a double stable-isotope technique (oral 44Ca and intravenous 42Ca). In a double-blind trial starting 9 d postpartum, Gambian mothers were given a calcium supplement [17.85 mmol (714 mg)/d] or placebo for 12 mo. At 3 and 12 mo postpartum, mean (+/- SEM) calcium absorption from isotopically enriched milk was 52.3 +/- 3.1% (n = 25) and 47.2 +/- 4.8% (n = 24) in the unsupplemented Gambian mothers and 48.8 +/- 2.8% (n = 28) and 42.9 +/- 3.7% (n = 24) in the supplemented mothers, respectively. There was no effect of supplementation or stage of lactation on the efficiency of calcium absorption. At 3 mo postpartum the UK mothers absorbed 32.2 +/- 3.8% of the isotopically enriched calcium added to milk, which was significantly less than that of the Gambian mothers (P < 0.01).

Molybdenum absorption, excretion, and retention studied with stable isotopes in young men at five intakes of dietary molybdenum.

A study of molybdenum absorption, excretion, and balance was conducted in four young men fed five amounts of dietary molybdenum, ranging from 22 to 1490 micrograms/d, for 24 d each. The study was conducted to obtain scientific data on which to base a recommendation on dietary molybdenum intake for healthy young men. Stable isotopes of molybdenum were used as tracers. 100Mo was fed five times during the study and 97Mo was infused three times. 94Mo was used to quantify the molybdenum isotopes and total molybdenum in urine, fecal collections, and diets by isotope dilution. Adverse effects were not observed at any of the dietary intakes. Molybdenum was very efficiently absorbed, 88-93%, at all dietary molybdenum intakes, and adsorption was most efficient at the highest amounts of dietary molybdenum. The amount and percentage of molybdenum excreted in the urine increased as dietary molybdenum increased, suggesting that molybdenum turnover is slow when dietary molybdenum is low and increases as dietary molybdenum increases. We conclude from these results that dietary intakes between 22 and 1500 micrograms/d by adult men are safe for > or = 24 d and that molybdenum retention is regulated by urinary excretion. Molybdenum is conserved at low intakes and excess molybdenum is rapidly excreted in the urine when intake is high.

Effects of low-copper diets on human immune response.

We examined the effects of low-copper diets on indexes of immune response of 11 healthy men (aged 21-32 y) during a 90-d metabolic suite study. Daily copper intake for the first 24 d, next 42 d, and the last 24 d of the study was 0.66, 0.38, and 2.49 mg, respectively. Feeding the diet with 0.38 mg Cu/d was associated with a significant (P < or = 0.05) decrease in the proliferation of peripheral blood mononuclear cells cultured with phytohemagglutinin, Concanavalin A, or pokeweed, and an increase in the percentage of circulating B cells (CD 19+), but had no effect on the concentration of serum interleukin 2 receptor, the percentage of peripheral monocytes, neutrophils, CD3+, CD4+, or CD8+ T cells; or on the neutrophil phagocytic activity. Feeding 2.49 mg Cu/d for 24 d prevented further decreases in the indexes affected by the low-copper diet but did not restore them to the prestudy concentrations, even though plasma copper and ceruloplasmin concentrations were restored to normal.

Molybdenum absorption, excretion, and retention studied with stable isotopes in young men during depletion and repletion.

A study of molybdenum absorption, excretion, and balance was conducted in four young men fed a low-molybdenum diet (22 micrograms/d) for 102 d followed by 18 d of the same diet supplemented to contain 467 micrograms/d. The study was conducted to determine the minimum dietary molybdenum requirement of healthy young men. Stable isotopes of molybdenum were used as tracers. 100Mo was fed four times during the study, 97Mo was infused twice, and 94Mo was used as an isotopic diluent to quantify the molybdenum isotopes and total molybdenum in complete urine and fecal collections and in the diets. The study demonstrated that subjects could not consistently attain balance with the low-molybdenum diet, but balance improved with time, and no signs of molybdenum deficiency were observed. Molybdenum was very efficiently absorbed at both intakes of dietary molybdenum and urinary excretion increased as dietary molybdenum increased. Molybdenum turnover was significantly slower when dietary molybdenum was low. We estimate from these results that the minimum dietary molybdenum requirement is approximately 25 micrograms/d or possibly less. This suggests that the lower end of the recommended range could be less than the current recommended amount of 75 micrograms/d.

Future directions for establishing mineral/trace element requirements.

The amount of an element needed to prevent frank deficiency may not be sufficient to support optimal nutrition, but amounts to support optimal nutrition have not been established. Minerals and trace elements are toxic in excess and the interval between the required and toxic amount of some elements is narrow. Thus, lower and upper limits of an optimal range must be established. Before establishing dietary recommendations to support optimal nutriture for minerals, we need (1) sensitive and reliable methods for assessing status of most elements and (2) a better understanding of the influence of nutrient and non-nutrient components of diets upon requirements. Functions such as immune function, anti-oxidant status, muscle strength, glucose metabolism, and blood clotting can be affected by inadequate or excessive amounts of an element and may be more sensitive than specific status indices. Since such functions are not specific, studies must be designed so that a cause and effect relationship between the mineral and the functional index can be established. Two approaches to mineral status assessment may be both sensitive and specific: (1) tests of metalloenzyme function and (2) tracer studies using stable isotopes of minerals. Not only can stable isotopes be used to follow the metabolic fate of a mineral without exposure to radioactivity, they can be used in conjunction with compartmental modeling to predict kinetics and pool sizes in tissues not accessible in humans.