Which of the following could be causes of zinc deficiency?

• A. Chronic malnutrition
• B. Cirrhosis
• C. Chronic stress
• D. All of the above

Answer: (D)

Zinc status hinges on intake, absorption efficiency, losses, and how the body redistributes zinc during stress or illness. Chronic malnutrition directly lowers zinc intake and can reduce its bioavailability, setting the stage for deficiency. Cirrhosis affects zinc in several ways: it can impair absorption, alter metabolism and distribution, and increase losses, all of which can deplete zinc stores. Chronic stress also drives deficiency by increasing zinc needs and promoting its sequestration into tissues via inflammatory processes (like induction of metallothionein), which lowers circulating zinc. Because each of these situations can contribute to zinc deficiency, the best choice is that all of the above could cause zinc deficiency.