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 Dietary Supplements: Aging as a Modifier of Metabolism 
 
Robert Russell M. MD ©

Given the potentially devastating effects of vitamin B12 deficiency on the nervous system, the new uncertainties about how best to define vitamin B12 nutritional status and the high prevalence of a condition (atrophic gastritis) that can affect vitamin B12 metabolism in elderly people, it seems imprudent to have lowered the 1989 RDA for vitamin B12 in those age 51 and older. Until more data are available, an RDA of 3.0 lug seems safer for elderly people.

Vitamin A
Vitamin A requirements may be lower in the elderly than in younger people because of deceased clearance of the vitamin by hepatic and other peripheral tissues, and possible increased absorption from the gastrointestinal tract. There is no evidence that carotenoid metabolism is affected by age.

Minerals

Calcium Absorption
Calcium absorption efficiency falls with advancing age. Studies on calcium supplementation alone seem to show that calcium intakes of more than 800 mg/day will not result in preservation of bone mineral. However, in combination with vitamin D supplementation, calcium intakes in the range of 1-1.5 g/day, have been shown to be of benefit in both hip and spine sites (in terms of preservation of bone mineral).

Other Minerals
There is no evidence that other mineral requirements (except for lower iron requirements in postmenopausal females) are different in elderly versus younger individuals.


References

1. National Research Council. Recommended dietary allowances 10th edition. Washington, DC: National Academy Press, 1989.

2. Roberts SB, Fuss P. Heyman MB, Evans WJ, Tsay R. Rasmussen H. Fiatarone M, Cortiella J. Dallal GE, Young VR. Control of food intake in older men. JAMA 1994;272: 1601 6.

3. Boisvert W. Mendoza 1, Castaneda C, et al. Dietary intake requirements for riboflavin in healthy elderly do not differ from those recommended for adults. FASEB J 1991;5(4):A558.

4. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988;67(2):373-8.

5. MacLaughlin JA, Holick MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985;76:1536-8.

6. Dawson-Hughes B. Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991; 115(7):505-12.

7. Ribaya-Mercado JD, Russell RM, Sahyoun N. et al. Vitamin B-6 requirement of elderly men and women. J Nutr 1991;121:1062-74.

8. Krasinski SD, Russell RM, Samloff IM, et al. Fundic atrophic gastritis in an elderly population. J Am Geriatr Soc 1986;34:800-6.

9. Suter PM, Golner BB, Goldin BR, et al. Reversal of protein-bound vitamin B12 malabsorption witl. antibiotics in atrophic gastritis. Gastroenterology 1991;101:1039-45.

10. Lindenbaum J. Healton EB, Savage DG, et al. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med 1988;318:1720-8.

11. Krasinski SD, Cohn JS, Schaefer EJ, et al. Postprandial plasma retinyl ester response is greater in older subjects compared with younger subjects. J Clin Invest 1990;85:883-92.

12. Dawson-Hughes B. Dallal GE, Krall EA, et al. A controlled trial of the effect of calcium supplementation on bone density in post menopausal. N Engl J Med 1990;323:878-83.

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