THE evolution and breakthrough of medical sciences complemented by advance technology has improved quality of life and increased life expectancy. Hence, there is a growing elderly population (65 years and over) which demands a menu of requirements since their bodily functions no longer perform as efficiently.

Some studies found that in the developed countries about 25-30 per cent of the elderly suffer from deficiency of vitamins and minerals due to many factors such as reduced out-door activities, irregular and/or nutritionally unbalanced meals, dietary restrictions, other disease conditions such as digestive disorder, decreased earning/ spending power or simply limited mobility. This newly adopted lifestyle has contributed to known deficiencies in vitamin D, vitamins B6 and B12, folic acid and calcium.

The best nutritional solution is whole foods such as grains, nuts, fruits and vegetables, milk and dairy products. A fruit may provide more than one supplement, for example an orange not only provides Vitamin C but also calcium and fibre. It was found from studies done by the Mayo Clinic that phytochemicals, exclusively found in plant based foods such as legumes, fruits and vegetables, are linked to reduction of cancer, heart disease, diabetes and osteoporosis.

However, thanks to the pandemic (20 months and counting), along with the unprecedented climate change, the world is threatened by an economic and hunger crisis especially if measures are not implemented such as shrewd budgeting priorities and self-sustaining strategies. In the general adult population, apart from the elderly, there may be nutritional deficiencies due to the fast-paced hectic lifestyles and poor meal planning. Many persons are not afforded the luxury of time to have at least one “sit down” meal per day. In such situations, the use of vitamin and mineral supplements is convenient, cost-effective and affordable.

When affordability is not an issue, it was observed that less than 50 per cent of the elderly may take a “one daily” supplement with all the recommended daily requirements. There is a small subset who may consume three (3) supplements, so ensure that you are reading the labels and taking only what is needed to prevent overdose. A red flag alert is the use of some herbal supplements which can interact with other medications prescribed concurrently and in some cases cause undesirable effects or compromised organ function. So please inform your healthcare provider for proper advice; full disclosure is encouraged for your own safety.

The terms, required daily intake (RDI), recommended daily allowance (RDA), or the daily value (DV) refer to the amount of vitamins and minerals established by the Food and Drug Administration (FDA) which is essential for the healthy functioning of the body at a specific age range. See the table below to guide you on the amounts that are required, bearing in mind that a balanced diet also provides vitamins and minerals.

Adult Daily Value according to 2020-2025 Dietary Guidelines for American.
VITAMIN DV MINERAL DV Biotin 30 mcg Calcium 1000 – 1200mg depending on age and gender (below 50 yrs.) Women need more than men at same age. Max 2000mg. Folic Acid 400 mcg Chromium 20-35 mcg Niacin (B3) 14-16 mg Copper 900 mcg Pantothenic acid (B5) 5 mg Iodine 150 mg Riboflavin (B2) 1.1-1.3 mg Iron 8-18 mg Thiamin (B1) 1.1-1.2 mg Magnesium 310-420 mg Vitamin A 700-900 mcg Manganese 1.8-2.3 mg Pyridoxine (B6) 1.5 mg for women and 1.7 mg for men Molybdenum 45 mcg Cobalamin (B12) 2.4 mcg Phosphorus 700 mg Vitamin C 75-90 mg Potassium 4.7 g Vitamin D 15-20 mcg (600 – 800 IU) up to 70 yrs. but increases with age. Max 4000 IU. Selenium 55 mcg Vitamin E 15 mg Sodium 1.2 -1.5 g not found in supplements Vitamin K 90-120 mcg Zinc 8-11 mg

Note that some vitamins are fat soluble whilst others are water soluble. What this means is that excessive amounts of the fat soluble ones will be stored in the fat cells in the body causing unwanted effects. The mnemonic ADEK is the memory aid that the fat soluble vitamins are A, D, E and K. Vitamins B and vitamin C are water soluble so excessive amounts of the water soluble ones will pass out of the body in the urine.

Interestingly, unlike the mandatory FDA approval prior to the release for sale and consumption for all prescription and OTC (over the counter) meds, supplements are not required to be evaluated for safety and efficacy and hence authorisation is not a requirement. So on most labels you will see a disclaimer that these statements were not evaluated by the FDA. Also stated is that the product is not intended to diagnose, treat, cure or prevent any disease.

As a rule of thumb, adjustments to both diet and medication dosages for the elderly are required because of reduced renal clearance and delayed metabolism (diminished capacity to breakdown and process). If no adjustments are made intensified or prolonged effects are observed. So a 50 plus formulation will contain lesser amounts of ingredients (except Calcium and vitamin D) as seen on the label.

In addition, a senior may not consume enough fibre hence they may suffer with constipation. So if you were to check the active ingredients in a supplement like Centrum Silver, which is an appropriate multivitamin and mineral for the elderly, you will not see any iron.

A warning for someone with kidney stones (regardless of age) should be to avoid meat, milk and milk products or calcium supplements since these contribute to the size of the stone and hence pain and or difficulty of surgery.

For further advice consult the pharmacist at Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.