Older age associated with poor nutritional status
An article published on October 27, 2005 in the online publication Nutrition Journal reported a decline in nutritional status among subjects aged 75 and older. The finding may explain in part the poor clinical outcome in older patients.
Sarah Forster and Salah Gariballah of the Sheffield Institute for Studies on Ageing at the University of Sheffield in England analyzed data from 445 hospitalized patients who took part in a randomized trial of nutritional supplementation. While adjusting for disability, chronic illness, smoking and other factors, they found that body mass index, hemoglobin (an indicator of iron status), serum albumin (an indicator of protein status), and plasma vitamin C levels were all significantly lower in men and women age seventy-five and older than in younger patients. Vitamin B2, vitamin D, folate and B12 levels were also lower among older patients but the researchers did not determine the differences to be statistically significant. Additionally, there was a significant independent association discovered between current and former smokers and poor nutritional status.
In their introduction to the article, the authors observed that good nutrition may offer significant contributions to the health of older individuals and to their ability to recover from illness. Poor appetite, digestion and metabolism may lead to reductions in macro and micronutrients. However, they conclude that it is "not clear whether nutritional deficiencies in individuals aged 75 years and older reflect poor nutrient intake, increased demand for nutrients, or simply represent underlying co-morbidities. Although this study was not designed to answer these questions, targeting this cohort with nutritional supplementation may help to overcome the potentially detrimental effects of nutritional deficits in this population."
Congestive heart failure (CHF) seems to be the exception when it comes to our national battle against heart disease. While other forms of heart disease, including coronary artery disease (CAD), are becoming less common, the rates of CHF continue to rise. The rate of hospitalization for CHF increased 3- to 4-fold between 1971 and 1999 (American Heart Association 2004; McCullough PA et al 2002). It is the leading cause of hospitalization among people over the age of 65, accounting for about 20 percent of the hospital admissions in this group (Jessup M et al 2003).
CHF occurs when the heart cannot pump efficiently enough to supply the body with freshly oxygenated blood. It affects about 5 million people in the United States . Within 5 years, medical experts predict that about half of these patients will have died of their conditions (American Heart Association 2004). Hoping to prolong survival, patients with CHF are typically treated with an array of powerful medications that have been shown to increase survival, often at a high cost.
The increase in CHF is partly because of a graying population and our success in treating other forms of heart disease. In many instances, cases of CAD and high blood pressure that would have once resulted in fatal heart attacks are successfully managed, only to have the patient later develop CHF.
Vitamins and dietary supplements have also been shown to ease the symptoms of CHF—often without the debilitating side effects of more powerful pharmaceuticals (Witte KK et al 2005). Coenzyme Q10 (coQ10) has been widely studied in CHF and found to increase heart function, while L-carnitine and taurine have been shown to improve cardiac function and lessen the heart's workload (Fugh-Berman A 2000; Schaffer SW et al 2000). Other dietary supplements and nutrients, including minerals (such as magnesium and potassium), antioxidants (such as alpha-lipoic acid and vitamins C and E), and herbs (such as hawthorn) may help ease symptoms of CHF.
A study published in the January 17, 2006, issue of the Journal of the American College of Cardiology reported that approximately one out of three patients hospitalized with heart failure have deficient levels of thiamin, also known as vitamin B1. According to the authors of the report, a deficiency of thiamin manifests as heart failure symptoms and may worsen pre-existing disease. The study is the largest to date of thiamin deficiency among individuals hospitalized with heart failure.
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