Older Adults, Dietary Supplements, and Multivitamins, Oh My!
Dietary supplements and vitamins are all around us, easily accessible on the shelf, and so easy to begin taking. But what is the role of the supplement or vitamin? As adults age, this question becomes more and more important to ask because they may have unwanted side effects, adverse drug interactions with other prescribed medications, and in some cases, elevate the risk of death.
Dietary supplements may be used by older adults in order to combat common problems such as osteoporosis or arthritis. These supplements are often used when the individual is not consuming enough of the particular nutrient, such as fiber, calcium, or amino acids, by mouth. Supplements can seem like a "quick fix," but be aware that many companies make money off of these products. Also, supplements marketed as "natural" do not make them necessarily good for you. These additives often can have negative effects on the other medications being taken, either making the medications less effective (inhibiting them) or stronger (antagonizing them). This can present as either an exacerbation of a preexisting medical condition or even a new medical problem, resulting in the prescription of more medications.
The Iowa Women's Health Study (2011) examined the relationship of total mortality in older women from 1986-2008. The study included nearly 39,000 women (note, all caucasian) with a mean age of 61.6 for the duration of 19 years (p. 4). Findings yielded that while many supplements studied were not associated with a higher mortality rate, several commonly used dietary supplements were, including "multivitamins, vitamins B6 and folic acid, and minerals iron, magnesium, zinc and copper" (p. 6). Multivitamins were found to be associated with an increased risk of total mortality when compared to nonuse. This study raised concern over the long-term effect and safety of supplement use, specifically multivitamins and iron, and concluded there is "little justification for the general and widespread use of dietary supplements" (p. 7).
There are several dietary supplements that are indicated in older (those over age 50) adults, such as calcium or vitamin D. Be aware that more is not always better, and detailed conversations should be had regarding the risks and benefits of these supplements before taking them. Working with a registered dietitian is a great way to make small, meaningful changes in your diet that can eliminate the need for these supplements altogether. When considering a supplement remember the recommended dosages for younger adults (those under 50) are different than those for older, as is the recommended dosage for men and women. The Dietary Guidelines for Americans, 2020-2025 can be a good resource for men and women of different ages, but it is best to talk to a doctor, geriatrician, pharmacist, or registered dietitian who understands the interactions of these items in older adults before starting to take a supplement.
The best way to ensure you are consuming enough of these nutrients is to eat a healthier diet. A "plate of color" is the best way to ensure you are getting what you need. The U.S. Food and Drug Administration (FDA) does not have the authority to test and ensure the safety of dietary supplements before they are sold to the public. Just because you may find the item on the shelf does not mean they are safe. Overall, whether you decide to take supplements or not, talk to your doctor and try to incorporate a healthier diet, more exercise, and ongoing cognitive engagement.
Dietaryguidelines.gov. (n.d.). Retrieved November 18, 2021, from https://dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans_2020-2025.pdf.
Mursu, J. (2011). Dietary supplements and mortality rate in older women. Archives of Internal Medicine, 171(18), 1625. https://doi.org/10.1001/archinternmed.2011.445
U.S. Department of Health and Human Services. (n.d.). Dietary supplements for older adults. National Institute on Aging. Retrieved November 18, 2021, from https://www.nia.nih.gov/health/dietary-supplements-older-adults.
U.S. Department of Health and Human Services. (n.d.). Smart Food Choices for Healthy Aging. National Institute on Aging. Retrieved November 18, 2021, from https://www.nia.nih.gov/health/smart-food-choices-healthy-aging.