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Dr. Kings research focuses on metabolic adjustments to changes in
nutrient intakes in humans; she is especially interested in metabolism
and nutrient utilization of pregnant and lactating women. Nutrients of
interest include zinc, calcium, and energy. King has discovered that 1)
the increased needs for zinc and calcium during pregnancy are met, in
part, by an increase in the efficiency of absorption, 2) that individuals
adapt to low intakes of zinc by increasing the efficiency of zinc absorption,
reducing zinc excretion, and conserving tissue zinc in slowing turning
over tissues such as the bone and muscle, and 3) that excessive fat stores
in women at conception alters hormonal concentrations and raises the rates
of energy expenditure at rest.
To accomplish her studies of zinc metabolism, Dr. King developed tracer
methods using kinetic models and stable (not radioactive) isotopes, which
are now used world-wide. She employs similar techniques to study calcium,
carbohydrate, and lipid metabolism.
We are interested in determining how the body adjusts metabolic pathways
and physiological functions when nutrient intakes are insufficient or
when demands increase, such as in pregnancy. Our studies have focused
on zinc, calcium, and energy metabolism in healthy adults and pregnant
women. We have shown that the body makes multiple adjustments in nutrient
utilization (i.e., rates of absorption, excretion, and tissue distribution)
to maintain nutrient homeostasis when intakes are low. But, intakes below
a certain threshold compromise physiological functions. That threshold
can be raised by the individuals health (i.e., obesity, malabsorptive
disease, oxidative stress) or by the type of diet consumed (i.e., plant-
or animal-based). In other words, the nutritional needs of individuals
are altered by their diet and state of health. We are beginning to evaluate
the effect of genetics on nutritional needs as well.
About one-half of the worlds population consumes diets that are
insufficient in zinc. Low zinc intakes are associated with stunting, or
growth retardation, in children and an increased susceptibility to infections.
Disadvantaged populations around the world subsist primarily on cereal-based
diets, which are high in phytate, a compound that binds zinc and reduces
its absorption. Furthermore, their intake of good sources of zinc, shellfish
and red meat, is limited. Using kinetic models and stable isotopic tracers
of zinc, we found that zinc absorption and endogenous excretion fall dramatically
when zinc intakes are insufficient [1]. But, those adjustments do not
prevent a decline in plasma zinc concentrations because zinc is sequestered
in slowing turning over tissues, such as bone and muscle [2-4]. This sequestration
of zinc makes less available for zinc-demanding functions such as growth
and immunity. The response to zinc deficiency is quite variable among
individuals, however. We think that genetics influences a persons
response to zinc depletion. We are currently evaluating the effect of
zinc depletion on the genetic expression of two proteins involved in zinc
metabolism, metallothionein 1 and zinc transporter protein 1. Phytate,
the phosphorus storage compound in cereals, reduces zinc absorption [5,
6] . We are also investigating the effect of a small amount of beef, which
contains a factor that improves zinc absorption, on the absorption of
zinc from beans, a stable in the Mexican diet. In the future, we also
plan to study the effect of changes in zinc status on DNA integrity and
gene expression.
The need for calcium and zinc increases during pregnancy to support fetal
growth and development; the needs are particularly high during the last
trimester when fetal growth is most rapid. In a longitudinal study of
healthy pregnant women consuming good diets, we found that the efficiency
of calcium and zinc absorption increased in late pregnancy. In lactation,
calcium needs were met by mobilization of bone mineral and reduced urinary
losses while a further increase in zinc absorption provided the zinc need
[7-9]. The effect of maternal calcium and zinc intake on the adjustments
made in pregnancy was studied in two groups of women consuming diets low
in those minerals, a group of Southeast Asian immigrants to California
and a group of Brazilian women. The efficiency of calcium and zinc absorption
was much higher in these women, but the total amount of mineral absorbed
was lower suggesting that the amount of calcium and zinc provided to the
fetus was reduced. Pregnant women world-wide are advised to take an iron
supplement. In our longitudinal study of California women [7], we found
that supplemental iron reduced zinc absorption during lactation. We are
currently completing a study to determine if the negative effect of iron
on zinc absorption can be avoided by taking the iron supplements at bedtime.
It is estimated that pregnant women need about 80,000 additional calories
[10]. In a longitudinal study, we found that the changes in energy metabolism
were quite variable among seemingly similar women [11]; women delivering
larger babies tended to gain less fat during pregnancy and have larger
increases in resting energy expenditure. We also observed that obese women
had much higher rates of resting energy expenditure than did lean women
[12]; the more obese the woman, the greater the rate of energy expenditure.
We subsequently showed that the marked increase in energy expenditure
among obese pregnant women was related to circulating leptin concentrations
(a hormone secreted by adipocytes and placental tissue). Although obese
women seem to waste energy by this large increase in their resting energy
expenditure in pregnancy, they still have larger babies than do lean women.
Maternal blood glucose is the primary fuel for the fetus. We hypothesize
that obese women have higher blood glucose levels that provide excessive
fuel to the fetus and increases fetal growth. We plan to test that hypothesis
by comparing the metabolic response to a low and high glycemic diet in
obese pregnant women.
Obesity is attributed to an excessive supply of energy. We hypothesize,
however, that the quality of the diet also influences appetite and energy
metabolism. To test that hypothesize, we evaluated the effects of a calcium
supplement on body fat and rates of lipolysis in overweight women. There
were no effects on the rates of fat oxidation and breakdown. But, the
women tended to lose body fat and the activity of fatty acid synthease
in adipose tissue tended to decline. We plan to further investigate the
effects of zinc and calcium on glucose and lipid metabolism in experimental
animals.
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