Nutritional Supplements for Older Adults: Review and Recommendations—Part I

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.

KEYWORDS:

• antioxidants
• calcium
• multivitamin/minerals
• nutritional supplements
• selenium
• vitamin A
• vitamin C
• vitamin D
• vitamin E

Notes

Note: RAE, retinol activity equivalents.

Note: RR, relative risk; CI, confidence interval. If the CI contains 1.0, then the RR is not significant, p > 0.05.; CVD, cardiovascular disease; CABG, coronary artery bypass grafting; CV, cardiovascular; CVA, cerebrovascular accident; MI, myocardial infarction; PTCA, percutaneous transluminal coronary angioplasty.

A note from the authors: Reports on the effects—and the lack of effects—of nutritional supplements appear frequently in health-related headlines. Recognizing the relevance and abundance of recently published information on this topic, we reviewed the evidence for health effects of nutritional supplements and current recommendations for their use by older adults. The wealth of information exceeded our available space in this issue, so we divided it into two parts. Part I of this review covers multivitamin and mineral supplements, antioxidant nutrients, Vitamin D, and calcium. In the next issue of JNE, Part II will cover the remaining topics, including Vitamin B₁₂, folate, and omega-3 fatty acids.