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In chronic obstructive pulmonary disease, a disease with increased prevalence in aged individuals, zinc deficiency hinders the clearance of apoptotic epithelial cells by alveolar macrophages, contributing to persistent inflammation [234]

Non-randomized studies were assessed with the Risk of Bias in Non-randomized Studies of Interventions tool (ROBINS-I) [8]

These interventions carry no pharmacological risk and have well-established long-term benefits for metabolic health, cardiovascular risk reduction, and psychological wellbeing

A 2019 pooled analysis and a 2025 update confirm consistent reductions in MACE and hard kidney outcomes independent of baseline HbA1c