Supplements and Older Adults

17

A recent study, published in The Journal of Nutrition, looked at nutrient and herbal supplement use in U.S. adults. The study surveyed over 3,400 people ages 60 and older between 2011 and 2014. “About 70 percent of respondents reported using at least one dietary supplement over the previous 30 days,” says study co-author Johanna Dwyer, DSc, RD, senior nutrition scientist with the Office of Dietary Supplements at the National Institutes of Health and director of the Frances Stern Nutrition Center at Tufts University. Older Americans may want to rethink this practice, however, since a growing number of studies have found that supplements may not have the intended health benefits. Additionally, more information is needed on potential interactions between supplements and prescription drugs.

Disappointing Outcomes: Vitamins, minerals, and other supplements have been touted over the years as a way to make up for nutritional deficiencies, prevent disease, and boost overall health. “Seventy-nine percent or more of survey respondents reported daily use of the most common products like multivitamin/mineral preparations, vitamin D, and omega-3 supplements,” says Dwyer. Unfortunately, these popular products and other supplements may not provide significant health benefits. “Early observational studies suggested we would see benefits from nutrient supplementation, but, unfortunately, many of those benefits have not been realized,” says Alice H. Lichtenstein, DSc, senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging and executive editor of Tufts Health & Nutrition Letter. Recently, a review published in the Journal of the American College of Cardiology reported that supplements generally showed no effect on either cardiovascular outcomes or death from any cause. Folic acid, which showed a modest statistically significant reduction in stroke and total cardiovascular disease, was the only exception reported in this study.

Sometimes widespread use of supplements is even associated with negative health effects. “Studies have found a small but significant increase in all-cause mortality in people taking high doses of vitamin E supplements,” says Lichtenstein. “And beta-carotene supplementation has been found to be associated with increased risk of cancer in smokers. These negative effects are not found when these nutrients are consumed in foods.”

That doesn’t mean that all supplement use is bad. “There are some cases where supplements are definitely valuable,” says Lichtenstein. “For example, as we get older, some of us have decreased capacity to absorb vitamin B12, so B12 supplements are important for avoiding pernicious anemia. And women of childbearing age may need extra iron or additional folate. A healthcare provider should decide if any supplements are appropriate on a patient-by-patient basis.”

Twenty-nine percent of the older adults surveyed reported taking more than four supplements a day. “We don’t see the issue as supplement use by itself,” says Jaime Gahche, MPH, a nutritional epidemiologist with the National Institutes of Health’s Office of Dietary Supplements and lead author of the study on supplement use in older adults. “The problem is the potential for overuse of dietary supplements, particularly when multiple products are being consumed, and in conjunction with prescription medications. This can increase the risk of consuming nutrients beyond what is recommended, and could increase the risk of drug-nutrient interactions.”

Supplements and Prescription Drugs: About 90% of older adults take prescription medications, and 39 percent take five or more, putting older Americans at special risk for any potential interactions between dietary supplements and prescription drugs. “We found that there was a high concurrent use of supplements with prescription and other medications,” says Gahche. “Those who reported three or more prescription medications were much more likely to be taking supplements than those who were not taking any prescription medications.” It is essential that patients tell their healthcare providers about any dietary supplements, including herbal and botanical preparations, they are using.

While it may seem like supplements are an insurance policy against poor nutrition, there is no substitute for a healthy dietary pattern. “It’s preferable to get one’s nutrients from food, rather than supplements,” says Lichtenstein. “Supplements won’t compensate for over-consuming sodium or under-consuming fruits and vegetables. You can’t pop a supplement on top of an unhealthy diet and expect better health.”

Take Charge!

Be smart when choosing supplements. These tips can help:

-A healthcare professional is the best person to determine if supplement use is necessary.

-Healthcare professionals should be informed of all dietary supplement intake, including special teas and other herbal or botanical preparations.

-A pharmacist or other healthcare professional should check for known interactions between an individual’s prescription and over-the-counter drugs and any supplements they wish to take.

-Supplements are not well regulated. For non-prescription supplements, look for seals of approval from USP or UL, or check ConsumerLabs.com to see if a supplement actually contains the ingredients it advertises.

17 COMMENTS

  1. Again, your article on supplements may be well intentioned but fear mongering is irresponsible. Of course there is no substitute for eating wholesome REAL foods and I know of NO supplement brand that says you can eat like crap so long as you take supplements.

    The fact remains that 90% (CDC STAT) of the total American public DOES NOT come close to eating the 5 servings per day of fruits & vegetables recommended by the CDC. Seniors, in particular, are commonly deficient in a number of key nutrients making supplements often the only way they’ll get these missing nutrients in their body. Supplements are not designed to replace a healthy diet. They are called supplements because that’s exactly what they are, supplements to a diet that’s lacking in nutrients.

  2. I tend to disagree with the study. I have been taking many supplements for years. I feel and look younger than almost all of my friends. I do have arthritis and the supplements I take help with it. I can tell because when I stop taking them I feel it. I have a lot of energy and I take no prescriptions except compounded estrogen and progesterone topically at very low doses to prevent hot flashes. I recently began taking Algecal and I have seen a big difference in my nail growth and health.

      • I am sorry that I am just now seeing your question. I eat a very healthy diet which is a modified Keto diet. I take mostly herbals but with Covid, I began to take D, Magnesium, and B6. I take no Iron and do not take a multi and just Vitamin C and B50. I take Quercetin, Pycnogenol, Zyflamend and a few others.

  3. I would like you to comment on the use of I-Caps and/or AREDS which are frequently recommended by ophthalmologists to reduce the risk of the progression of age-related macular degeneration.

  4. The problem with your advice is that most drs. have no clue about most supplements other than the most common. They’ve never even heard of many that boost cardiovascular health for instance, or common ones like CoQ10.

    • You might be surprised. There is a whole field of alternative medicine that is taught in continuing medical education programs and some medical schools. CoQ10 has only been shown to possibly have an effect on patients with heart failure.

  5. Years ago my vital signs were not in the normal range. I made a decision to no longer take statins, urological medications which are notorious for robbing us of our short-term memories, which is what was happening to me. Instead, I went on a regime of herbal products, including these natural products for other vital signs. Well, all of my vital signs came within normal range as a result. I only take one big pharma medication, a heart medication, mostly to make my Cardiologist happy.. Here I am 20 years later, at 86 years of age, still going strong, outperforming most 65-year-olds.

    In doing my due diligence nutritional research, I learned a long time ago, that every five years there’s a measurable reduction in the nutritional value of our crops. Even so-called organically grown crops are at times questionable, when it’s not known what the source of there oganic fertilizer came from. Was it an organic farm, or a less expensive source as a non-organic dairy farm. So I eat organic but take a wide variety of supplements as nutritional insurance. So far combining a wide variety of supplements has had no negative medical effects for me.

  6. I am also put off by this overgeneralized article. I take very few prescriptions and take them more than an hour before I take supplements. I splkt them up throughout the day, and read all instructions about what not to mix. I read extensively, and am very careful about what I choose, and the sources I buy from. They DO make a difference. Functional and Integrative physicians know more than “regular” doctors about this subject…what to take and what to not waste money on. Like with all medications, it is very individual, and needs deliberate study and consideration.
    Medical schools are way behind in teaching about nutrition and the value of certain supplements.
    Remember, the FDA also makes its share of “mistakes” when approving medications that cause great harm. No matter what, EDUCATION is the key–not a blanket statement dismissing the value of vitamins and supplements.

  7. The problem with most supplements is that they are not in “food form” and also have insufficient amounts. This is especially true with Omega-3s which should be in rTG form and contain at least 2 grams/daily to compensate for the excessive amounts of Omega-6 in the Western Diet. Additionally, “Mother Nature” never intended for us to get all our nutrients in one package like a multi-vitamin. Indeed, supplements should be in food form and surrounded by the appropriate matrix. This is why multi-vitamins have never proven to be beneficial and may even be associated with an increased all-cause mortality over time. Finally, the AREDS2 formula is only useful in intermediate to advanced AMD which only includes 8% of those with the condition. Omega-3s that are high in DHA in the right form are appropriate for prevention and early AMD.

  8. Managing my weight is a life-long issue, and now at 68 years old, I need to limit my calories 1500/day to just prevent more weight gain, and if I wanted to actually lose the weight I should, it would need to be around 1200 calories/day.. then the maintenance of desired weight would be about 1350 calories. I really don’t find I can get the RDA servings of meat, veggies, and dairy products within the calorie restrictions I would need. Yes, I can exercise more (already moderately active) which drives my appetite more. I am really skeptical that an elder’s nutrition needs can be met with the calorie limits needed to manage weight. That is not to say that supplements are absorbed and are effective.

  9. My review of the literature is consistent with your findings. However, your doctor, as you noted, may find reasons to give a supplement. For example, my triglycerides were > 2,000. Statins were not effective and caused myopathy with elevated CPK. Prescription Zetia with 2 grams of fish oil twice a day brought the triglycerides < 200, along with a vegan diet that is well researched and balanced along with B12 supplements because I am elderly, have severe GERD, PUD, and a history of H Pylori, with a family history of those GI ailments leading to esophageal cancer, requiring Nexium for myself worsening B12 absorption. I was treated by a lipidologist.

  10. I take 400 IU of vitamin D3 daily because I have to avoid sunlight as much as possible. At 76, I’ve already had 6 MOS surgeries for basal cell and squamous cell carcinomas. I’m not sure avoidance of sun at my age will make much difference, since most of the damage was done in my youth, but I do feel that if it protects me even a little bit, it’s worth it, as each surgery tends to impede my ability to maintain a good level of physical fitness owing to wound-healing time. And since I have osteoporosis from having been overmedicated for asthma and hypothyroidism through adolescence and into my twenties, maintaining physical fitness is a prime concern. The vitamin D3 helps with building bone density.

  11. I wish the Tufts professionals would consider the readership intelligent enough to care about how the research is conducted. Is this correlation or causation? What variables are controlled in the research that is reported? For example, I bet if you count the number of Rx meds taken, the higher the med count, the poorer the health. Same may be true with supplements–because some people likely take supplements due to weakness in their health, as do people who take Rx meds. True experimental research requires random sample groups, then dosing some with supplement and some with placebo. Maybe dosing some with a healthy diet? That is a true effect study and gives more information than a numbers study (correlation).

LEAVE A REPLY

Please enter your comment!
Please enter your name here