https://orcid.org/0000-0002-6273-9017
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Abstract
Polypharmacy regimens may increase the susceptibility of older adults to micronutrient inadequacy and deficiency via impairment of nutritional status. We hypothesized that a multi-vitamin-mineral supplement (MVMS) could improve nutritional status in older adults prescribed diuretics, metformin, and/or proton pump inhibitors (PPIs). We conducted a randomized, double-blind, placebo controlled, parallel clinical trial in which eligible subjects were instructed to consume either a MVMS or placebo for 16 wk. Fasting blood was collected at baseline, 8, and 16 wk and the status of selected vitamins and minerals determined. Thirty-five and 19 men and women aged 45–75 yrs in the in MVMS and placebo arms, respectively, completed the trial. The mean total number of medications among the three drug classes taken by participants did not differ between two groups. The status of vitamins B1, B12, C and folate and calcium, copper, magnesium and zinc at baseline were within normal ranges. The MVMS group had a greater change in nutrient status after 16 wk compared to the placebo group for serum folate (7.5 vs. –1.6 ng/mL, p < 0.0001), vitamin B12 (159.2 vs. –33.9 pg/mL, p = 0.007), and plasma vitamin C (0.2 vs. 0.0 mg/dL, p = 0.004). Other measured vitamins and minerals were not significantly changed during the intervention. In conclusion, the status of vitamins B12, C and folate improved with MVMS but remained within normal ranges in older adults taking diuretics, metformin, and/or PPIs.
Acknowledgements
The authors’ responsibilities were: OC, JBB: designed this research; GTR: performed statistical analysis; OC: wrote the initial draft; KCM managed the conduct of the trial; OC, GTR, DLM, KCM, and JBB: critically reviewed and revised the manuscript; OC: has primary responsibility for final content; all authors: read and approved the final manuscript.
Declaration of interest
JBB reports service on scientific advisory boards of AdvoCare International, California Prune Board, California Walnut Commission, Church & Dwight, Cranberry Marketing Committee, Guiding Stars Licensing Co., Quaker Oats Co., Segterra, and SmartyPants (all outside the submitted work). KCM reports service on scientific advisory boards for National Dairy Council, Matinas BioPharma, Acasti Pharm and consulting and or research grant support from Blue California, Beef Checkoff, Almond Board of California, Pharmavite, Kellogg, General Mills, PepsiCo, and Hass Avocado Board. DLM reports service on the scientific advisory council of Nature’s Bounty Co. GTR report no conflicts of interest. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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Notes on contributors
Oliver Chen
Oliver Chen, PhD, is Director of Nutrition Science and Biostatistics at Biofortis Resarch, Mérieux NutriSciences, Addison, Illinois and an Adjunct Associate Professor in the Friedman School of Nutrition Science and Policy at Tufts University. His research efforts are focused on lifestyle and nutritional interventions for the prevention and management of cardiometabolic diseases with a particular interest in exploring the effect of phytochemicals and functional foods and nutraceuticals on healthy aging. Dr. Chen has published over 130 scientific articles and serves on the editorial board of scientific journals. He received the Mary Swartz Rose Young Investigator Award from the American Society for Nutrition.
Gail T. Rogers
Ms. Gail Rogers, MA is a Sr. Statistician in the Nutritional Epidemiology Program at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and Instructor at the Friedman School of Nutrition Science and Policy. Ms. Rogers has co-authored over 50 scientific papers. Her work includes analysis of survey data, large scale observational cohorts, and intervention studies with an emphasis on longitudinal analysis of cardiometabolic outcomes and dietary exposures.
Diane L. McKay
Diane L. McKay, PhD, FACN is an Assistant Professor at the Tufts University Friedman School of Nutrition Science and Policy, an Adjunct Assistant Professor at the Tufts School of Medicine, and Director of the Tufts Friedman Online Graduate Certificate Programs. Her research interests are focused on the role of nutrients and bioactive compounds in health promotion, as well as nutrient-drug interactions. Her prior research studies include human interventions using antioxidant- and phytochemical-rich foods, beverages, and dietary supplements to examine their effects on nutritional status, metabolic, and clinical outcomes in aging adults.
Kevin C. Maki
Kevin C Maki, PhD, CLS, FNLA, FACN, FTOS is Chief Scientist at Midwest Biomedical Research in Chicago, Illinois and Adjunct Professor in the Department of Applied Health Science at the Indiana University School of Public Health, Bloomington. His research efforts are focused on lifestyle and pharmacologic interventions for the prevention and management of cardiometabolic diseases, with a particular focus on management of dyslipidemias and abnormal carbohydrate metabolism. Dr. Maki has published over 300 scientific papers, is a certified Clinical Lipid Specialist, and is currently President Elect for the National Lipid Association and President of the Accreditation Council for Clinical Lipidology.
Jeffrey B. Blumberg
Jeffrey Blumberg, PhD, FASN, FACN, CNS-S is a Research Professor in the Friedman School of Nutrition Science and Policy at Tufts University. His research efforts are focused on the biochemical basis for the role of antioxidant nutrients and their dietary requirements in health promotion and disease prevention during the aging process via their modulation of oxidative stress status, glucoregulation, and inflammation. Dr. Blumberg has published over 400 scientific articles and, among other honors, received the Outstanding Investigator Award from the Vitamins and Minerals Research Interest Section at the American Society for Nutrition in 2018.