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ABSTRACT: The use of nutritional supplements (NS) with the intention of improving health and delaying age-related chronic disease is a common practice among older adults; however, randomized controlled trials have yielded mixed results regarding the likelihood that these NS provide true health benefits. We reviewed the findings of these studies regarding the effects of NS of folic acid, vitamin B(12), vitamin B(6), and omega-3 fatty acids on health outcomes in older adults. Our conclusions include the following: Supplements of the B vitamins folate, B(12) and B(6) have been studied with regards to primary and secondary prevention of a number of major age-related chronic diseases, including cardiovascular disease (CVD), stroke, cognitive decline, and cancer. While there are some encouraging findings with regards to stroke, depression, and macular degeneration (although in only one study in the latter case), there is little evidence of benefit of B vitamin NS for delaying CVD or age-related cognitive changes. In the few cancer-related studies, the evidence of benefit is coupled with concerns about enhancing the growth of existing undiagnosed cancers. In contrast, clear health benefits have been shown with modest increases in consumption of fatty fish or fish oil supplements, including a reduction in the risk of sudden cardiac death. In addition, there is evidence that high dose fish oil supplements may lower serum triglyceride levels.
Journal of Nutrition for the Elderly 01/2010; 29(1):42-71.
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ABSTRACT: The majority of older adults take nutritional supplements (NS) to prevent deficiencies and/or because they are interested in the potential health promoting effects of these nutrients. This review explores the evidence of benefit for supplements of multivitamin/minerals (MVM), antioxidant nutrients, and vitamin D/calcium. Major conclusions include the following: While recommendations that older adults take a daily MVM are common, there is limited scientific support for the health-related efficacy of these supplements. In contrast, a number of antioxidant nutrients have been extensively studied. The evidence does not support a recommendation for vitamins A, C, E, or antioxidant combinations in the prevention of CVD or cancer. Based on encouraging preliminary findings, more study is recommended on the benefit of antioxidant supplements for age-related macular degeneration and of selenium for cancer prevention. In contrast to the state of the art for antioxidant supplements, there is strong and compelling support for the health benefits of supplements of Vitamin D and calcium when intake/status of these nutrients is not optimal. Thus, specific recommendations for these supplements in older adults are warranted.
Journal of Nutrition for the Elderly 02/2009; 28(1):5-29.
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ABSTRACT: The purpose of this review was to describe the characteristics of late-life obesity, including prevalence, pathophysiology, and influences on morbidity and mortality. A second objective was to systematically review the empiric evidence on the effects of intentional weight loss interventions in older individuals.
We summarized the characteristics and known impact of late-life obesity and conducted a systematic review of the outcomes of weight loss interventions in obese older subjects. The inclusion criteria for the review were the following: randomized controlled trial; subjects aged 60 years or older; baseline BMI 27 or higher; weight loss versus baseline 3% or more or 2 kg; and trial duration 6 months or longer.
The search strategy yielded 16 articles on weight loss interventions that were examined in detail. Overall, these interventions led to significant benefits for those with osteoarthritis, coronary heart disease, and type 2 diabetes mellitus (DM-2), while having slightly negative effects on bone mineral density and lean body mass.
Longitudinal trials examining mortality and body weight suggest that maintaining weight is beneficial in older persons who become obese after age 65; in contrast, intervention trials show clinically important benefits of weight reduction with regard to osteoarthritis, physical function, and possibly DM-2 and coronary heart disease. Given these findings, we recommend that decisions about whether or not to institute a weight loss intervention for obese older persons be carefully considered on an individualized basis with special attention to the weight history and the medical conditions of each individual.
Journal of the American Medical Directors Association 06/2008; 9(5):302-12. · 4.64 Impact Factor
