December 17, 2012

Supplements – Does the Elderly Need Them?

This debate has been around for some time and just does not go away. Do elderly people need to take supplements? Some “experts” say no, other “experts” say yes. Many of these “experts” are assuming that the elderly have unlimited funds, can prepare meals that are nutritionally complete, and reside in areas that are safe and easy to move around within. Most of the “experts” have never had to spend a day in the shoes of some of the elderly.

I wish some of these “experts” would have to do a field study of the elderly and really get out and spend a few weeks seeing how they live, how safe it is for them to even walk around the neighborhood they live in, and how little money has to last for a month for food, shelter, and medications. This says nothing about transportation and some of the other necessities of life. Most of these elderly have no money left for supplements.

To ridicule the elderly like Donald B. McCormick, PhD, an Emory professor emeritus of biochemistry and the graduate program in nutrition and health sciences at Emory, takes ridicule to new levels. He says, “A lot of money is wasted in providing unnecessary supplements to millions of people who don't need them.” It is one thing to sit in the towers of academia and make statements like this, but I would have to ask if he has even seen where some of the elderly live. Then he continues, “We know too little to suggest there is a greater need in the elderly for most of these vitamins and minerals. A supplement does not cure the aging process.”

He thinks that the elderly believe they need vitamins and mineral supplements to blunt the aging process and the older they get the more supplements they need. He seems determined to take these supplements away from the elderly. One statement that McCormick makes I have to agree with and it is this - “At very high levels, some vitamins and minerals can be toxic.” This is especially true for many of the fat-soluble vitamins and minerals that the body can't readily flush.

Yes, McCormick does soften his rhetoric further into the article. He almost allows for obtaining most of them from foods, but with dietary changes. While I agree that it is best to obtain your nutrients from food, not all the elderly do well at cooking and balancing their nutritional needs. Not everyone can make use of nutrition experts and others capable of helping them.

Andrea Giancoli, RD, MPH, a spokeswoman for The Academy of Nutrition and Dietetics does carefully say that when counseling older adults, it is first necessary to determine what nutrients are lacking in the diet. I can believe it when she says it is often vitamin D, calcium, and vitamin B12. She does say she tries to fix it with food. I will give her positive marks for saying, “I don't think we should be recommending supplements blindly without assessing their food intake.”
Does the elderly need supplements? This debate will continue and probably never be resolved. I do think many of the elderly need some of the supplements because they do not eat a large variety of foods and are often short of some nutrients. Having seen some of my friends have anemia and be short of Vitamin D and Vitamin B12, I know what can happen. Another area of concern is those supplements that may cause extreme and even deadly side effects when taken with some prescriptions. Therefore, I have to urge caution for any supplements and urge all patients to make sure their physician knows what supplements are being taken.

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