Older adults receive particular benefit from omega-3 and vitamin D supplementation.
Niacin has promising benefits for older adults, as it can help prevent atherosclerosis and adverse cardiovascular events by lowering LDL, VLDL, and triglyceride levels.
When it comes to ensuring sufficient levels of vitamins and minerals in a healthy diet, there isn’t a strong rationale for supplements without a deficiency.
For thousands of generations, people have searched tirelessly for the fountain of youth. In today’s modern world, the ever-expanding supplement industry has capitalized on human’s innate desire to stay young and nimble.
While no dietary supplement can deliver on the promise of immortality, these three options may help buy some extra time.
The omega-3 fatty acids EPA and DHA have well-established benefits, particularly for aging populations with chronic disease.
In a 4-week randomized controlled trial on people with COPD, daily low doses (2 grams) and high doses (3.5 grams) of omega-3 supplementation improved protein homeostasis.
Both doses effectively reduced post-absorptive net protein breakdown. The higher dose also boosted meal-induced protein anabolism. The study researchers concluded that omega-3 supplementation may enhance protein anabolism in a dose-dependent manner for patients with low protein intake and chronic wasting.
Omega-3s benefit people with high triglycerides and have a modest impact on blood pressure and cholesterol levels. In addition, for patients with rheumatoid arthritis, fish oil can reduce pain and inflammation. Fish oil supplements are generally considered safe, but patients on blood thinners should be cautious about compounding effects and bleeding risk.
Niacin and NAD+
Niacin is a B vitamin produced from the metabolism of tryptophan or gut bacteria. As the “oldest lipid-lowering drug,” niacin is proven to help prevent atherosclerosis and adverse cardiovascular events by lowering LDL, VLDL, and triglyceride levels.
The body uses niacin to manufacture nicotinamide adenine dinucleotide (NAD+), a vital cofactor in various cellular processes. Functions of NAD+ range from the regulation of gene expression, mitochondrial function, inflammation, DNA repair, cell death, and more.
The high-profile animal studies that established the benefits of calorie restriction for life extension depended on NAD+’s activation of Sir2. In humans, NAD+ levels are known to decrease with age and are altered in age-related diseases, such as heart disease, diabetes, cancer, and neurodegenerative disorders.
Restoring these levels benefits disease management and longevity, but clinical trials to establish supplement recommendations haven’t been concluded.
However, excessive doses can be hepatotoxic and cause unpleasant symptoms like skin flushing. Clinicians should advise patients not to exceed the recommended daily dose, while encouraging those with underlying conditions to use caution.
Vitamin D is a popular supplement for older adults, and most experts agree that’s probably a good thing.
As noted by the authors of an editorial in the Journal of Nutrition, Health & Aging, a meta-analysis of 18 randomized controlled trials, including 57,311 participants, associated vitamin D supplements with a 7% decrease in all-cause mortality.
Studies often credit the positive effects of supplementation to the correction of underlying deficiencies. Nonetheless, older adults are less efficient at synthesizing and using vitamin D. They also may not get as much UV exposure as younger individuals. As a result, insufficient vitamin D is prevalent in up to 50% of older adults. Whether it’s best to supplement at-risk patients only, or if there are benefits to supplementation across the board, remains to be seen.
Vitamin D may help protect older adults from infections and disease by regulating the immune system and reducing inflammation. Researchers have also suspected that vitamin D supplementation may positively influence telomere length, but studies thus far haven’t produced high-quality evidence to support this claim.
Considerations to discuss with your patients
Supplement needs vary based on a person’s health status, diet, and other factors. Older adults may require supplements like vitamin D and B12 as their bodies become less efficient at absorbing and converting nutrients.
However, sometimes, health-focused patients unknowingly overdose on specific micronutrients when taking other supplements in addition to a multivitamin. Clinicians can refer these patients to a registered dietitian-nutritionist to review their supplement intake if this is a concern.
Patients who take prescription medication must be counseled on potential supplement interactions. Blood tests to check for deficiencies are necessary before recommending vitamin or mineral supplements. This allows you to monitor changes over time to ensure effective dosing and response.
Additionally, contaminants are present in some supplements, given the lack of quality regulation in the industry. Advising patients to look for the United States Pharmacopeia (USP) verified mark on supplement bottles helps find products that contain what’s actually listed on the label.
What this means for you
Over-supplementing doesn’t only waste patients' money, it can also cost them their health. Correct supplementation of some vitamins and minerals can contribute to healthy aging and longevity. Patients may not think supplement use is important to discuss at office visits, so it never hurts to ask. Encouraging patients to choose verified brands and steer clear of gimmicks can help protect them from harm.