Eating Properly Is the Best Defense Against Illness as You Age
Once there was just Geritol, the elixir that was marketed for the health and well-being of the geriatric crowd. Today, dietary supplements aimed at seniors number in the thousands, and dangle the possibility of not only more energy and better health, but a robust libido, a stronger heart, healthier joints and much more. The products often tout “breakthrough” formulas in bold, large type but note in the fine print that these claims have not been evaluated by the U.S. Food and Drug Administration.
With baby boomers turning 50 at the rate of seven per minute, senior supplements are enormously popular. In 1999, 69% of those 50 and older--more than any other age group surveyed--reported taking vitamins, minerals or herbs. That totaled nearly $7.2 billion in sales, according to the Hartman Group, a consulting and market research firm that tracks health and wellness markets. Hartman, based in Bellevue, Wash., also found that:
* Multivitamins are the most popular dietary supplement among the 50-plus set, followed by, in this order: vitamin E, calcium, vitamin C, garlic, ginkgo biloba, glucosamine, zinc, vitamin B complex, potassium, magnesium, vitamin B12, selenium, folic acid and beta carotene.
* Promoting general health and wellness is the leading reason why people 50 and older reported taking supplements. They also turned to supplements for better nutrition, to battle aging, to lower cholesterol and high blood pressure, and to thwart such chronic conditions as osteoporosis, arthritis, heart disease, memory loss and absent-mindedness.
The question is, can these dietary supplements deliver what they promise--or what those who take them hope? Are these billions of health-care dollars being used wisely?
That depends on how they are used and by whom. “Dietary supplements should be considered exactly what they say they are,” says Jeffrey Blumberg, associate director of the Human Nutrition Research Center on Aging at Tufts University in Boston. “They’re supplements, not substitutes for good food.”
According to the FDA, dietary supplements are not approved to prevent, treat, cure or mitigate disease.
Food is the most important source of vitamins and minerals for people of all ages. Nutrition experts say that the greater the intake of a wide variety of fruit and vegetables, the better the level of not just vitamins and minerals, but a host of other phytonutrients, common natural substances that seem to play a major role in preventing disease and maintaining health.
Many dietary supplements are developed as attempts to isolate the beneficial chemicals contained in healthful foods, but it’s rarely known whether these compounds, isolated and taken in pill form, have benefits similar to those derived from eating the foods.
“The bottom line is that seniors should be relying on food for most of their nutrients,” says Alice H. Lichtenstein, senior scientist at the U.S. Department of Agriculture’s Lipid Metabolism Laboratory at Tufts. “Food provides a lot of things that are not in dietary supplements.”
Trouble is, many seniors live alone and may not cook frequently for themselves or eat three well-balanced meals a day. For those people, supplements--especially a daily multivitamin--can play an important role in meeting the recommended vitamin and mineral intake, nutrition experts say.
Just how important supplementation can be is illustrated by a study in this month’s Journal of the American College of Nutrition. Study participants, who were 50 and older, ate folate-fortified food. Half also took a dietary supplement providing 100% of the daily value of vitamins. The study, which was funded by the vitamin company Pharmavite, found that the combination of fortified food and daily supplements not only increased blood levels of folate (which seems to protect against heart disease), but also cut blood levels of homocysteine by 10%. (High levels of homocysteine are a leading risk factor for heart attack, stroke and circulatory-system disease.)
The findings suggest that healthy older adults who eat a well-balanced diet can still “benefit from adding a multivitamin supplement to their diet,” Blumberg says.
Certain supplements may also be necessary for seniors with special health needs. Those who spend little time outdoors can often be lacking in vitamin D, which is manufactured in the skin using ultraviolet light from the sun’s rays and is important for maintaining strong bones. By age 70, 30% of adults have reduced levels of stomach acid--a fact that makes it more difficult for them to absorb vitamin B12. “A lot of people are also on drugs that suppress stomach acid,” says Irwin Rosenberg, director of the USDA’s Nutrition Center at Tufts. “The result is that vitamin B12 absorption also goes down.”
Many seniors may also not get enough calcium, a mineral necessary (but not in itself sufficient) for strong bones and for a host of other functions in the body. Men and women age 51 and older need 1,200 milligrams a day of calcium, according to the National Academy of Sciences. That works out to about four servings a day of dairy products.
Nutrition experts are quick to underscore that mature adults ought not to abandon food for pills as they age. In most cases, a well-balanced diet--with five to 10 servings a day of fruit and vegetables as well as six to 11 servings of high-fiber grains and at least four servings of low-fat dairy products--can provide adequate amounts of vitamins and minerals.
There’s a financial benefit from that strategy too. With the exception of generic multivitamins that can cost just pennies a day, most dietary supplements are an expensive way to get nutrients: A range of pills targeting a few conditions can run hundreds of dollars a month. “To be taking a supplement that obligates a significant portion of the monthly food dollar is something that should be considered,” says Rosenberg. “For some people, price is important.”
Finally, there’s the question of adverse reactions from dietary supplements, whether because of too high a dose, mixing supplements with drugs or taking unknown and potentially dangerous combinations of herbals and dietary supplements.
Vitamin B6 and L-dopa can interact in a potentially dangerous way. Taking antacids can diminish the absorption of vitamin B12. Too much zinc can impair the absorption of copper. Too much calcium can interfere with the absorption of iron. Such issues are rarely addressed on labels, and some doctors and pharmacists are not aware of them.
So consumers need to be knowledgeable about supplements and target them to their particular needs, Rosenberg says. “The notion that one would take other potentially biologically active substances and add them to vitamin or mineral supplements is a strategy that defies logic,” Rosenberg says.
While many products list carefully worded statements about their use, supplements are not allowed to claim to prevent, treat or cure disease.
