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Meta-Analysis
. 2020 Mar 1;11(2):398-411.
doi: 10.1093/advances/nmz084.

Zinc Supplementation and Body Weight: A Systematic Review and Dose-Response Meta-analysis of Randomized Controlled Trials

Shima Abdollahi  1   2 , Omid Toupchian  1 , Ahmad Jayedi  3 , David Meyre  4   5 , Vivian Tam  4 , Sepideh Soltani  2   6
Affiliations
Meta-Analysis

Zinc Supplementation and Body Weight: A Systematic Review and Dose-Response Meta-analysis of Randomized Controlled Trials

Shima Abdollahi et al. Adv Nutr. .

Abstract

The aim of this study was to determine the effect of zinc supplementation on anthropometric measures. In this systematic review and dose-response meta-analysis, we searched PubMed, Scopus, ISI Web of Science, and the Cochrane Library from database inception to August 2018 for relevant randomized controlled trials. Mean differences and SDs for each outcome were pooled using a random-effects model. Furthermore, a dose-response analysis for zinc dosage was performed using a fractional polynomial model. Quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Twenty-seven trials (n = 1438 participants) were included in the meta-analysis. There were no significant changes in anthropometric measures after zinc supplementation in the overall analysis. However, subgroup analyses revealed that zinc supplementation increased body weight in individuals undergoing hemodialysis (HD) [3 trials, n = 154 participants; weighted mean difference (WMD) = 1.02 kg; 95% CI: 0.38, 1.65 kg; P = 0.002; I2 = 11.4%] and decreased body weight in subjects who are overweight/obese but otherwise healthy (5 trials, n = 245 participants; WMD = -0.55 kg; 95% CI: -1.06, -0.04 kg; P = 0.03; I2 = 31.5%). Dose-response analyses revealed a significant nonlinear effect of supplementation dosage on BMI (P = 0.001). Our data suggest that zinc supplementation increases body weight in patients undergoing HD and decreases body weight in individuals who are overweight/obese but otherwise healthy, although after normalization for study duration, the association observed in subjects who are overweight/obese disappeared. Although more high-quality studies are needed to reach a definitive conclusion, our study supports the view that zinc may be associated with body weight.

Keywords: body mass index; body weight; dose–response; meta-analysis; obesity; zinc.

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Figures

FIGURE 1
FIGURE 1
Flow diagram of the study selection process.
FIGURE 2
FIGURE 2
Forest plot of randomized controlled trials showing weighted mean differences in weight change (in kilograms) between zinc supplementation and control groups for all eligible studies. Analysis was conducted using a random-effects model. Solid squares depict the weight assigned to the corresponding study; the black diamond represents the summary effect. ES, effect size.
FIGURE 3
FIGURE 3
Forest plot of randomized controlled trials showing weighted mean differences in BMI change (in kg/m2) between zinc supplementation and control groups for all eligible studies. Analysis was conducted using a random-effects model. Solid squares depict the weight assigned to the corresponding study; the black diamond represents the summary effect. ES, effect size.
FIGURE 4
FIGURE 4
Forest plot of randomized controlled trials showing weighted mean differences in waist circumference change (in centimeters) between zinc supplementation and control groups for all eligible studies. Analysis was conducted using a random-effects model. Solid squares depict the weight assigned to the corresponding study; the black diamond represents the summary effect. ES, effect size.
See this image and copyright information in PMC

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