Taking a daily multivitamin or trace mineral formula that includes zinc, selenium, and vitamin E may help prevent infection and reduce the need for antibiotics in elderly people, according to a new review article in Clinical Infectious Diseases.1
Poor nutritional status is common in elderly individuals, because of factors such as tooth loss, difficulty shopping for fresh foods, reduced efficiency of digestion and absorption, and drug-induced nutritional deficiencies. Malnutrition can impair the functioning of the immune system, leading to an increased risk of developing infections.
The author of this new report discusses the evidence that taking a daily multivitamin may improve nutritional status, increase specific cells that play a role in the immune system (T cells and natural killer cells), reduce the number of days of infection, and decrease the need for antibiotics in elderly people. While no specific intake amount is mentioned, healthcare professionals often advise supplementing with a daily multivitamin that meets at least 100% of the recommended dietary allowance (RDA).
A review of four clinical trials on trace mineral formulas indicates that trace minerals, rather than vitamins, may be the key constituents for preventing infections in older adults. It appears that daily formulas that contain at least 20 mg of elemental zinc plus at least 100 mcg of selenium may enhance white blood cell function and reduce the incidence of lung and bladder infections.
The author states that taking a daily supplement of 200 IU of vitamin E may help boost the immune system in the elderly, although the mechanism of action is unknown. He cautions to be careful about potential drug-nutrient interactions and to make your health care provider aware of any supplements being taken in addition to prescription medications.
While taking a supplemental multivitamin, trace mineral formula, or vitamin E may be appropriate for many older adults, the author recognizes that there are specific situations where other supplements may be beneficial. Taking either a daily protein/calorie supplement or approximately 220 mg of zinc sulfate (about 50 mg of elemental zinc) may help prevent pressure ulcers. Daily consumption of 300 ml of cranberry juice may help lower the incidence of urinary tract infections and reduce the need for antibiotics. Other specific nutritional therapies that are not mentioned in the article may be warranted for other diseases that afflict the elderly. These include vitamin B12 for megaloblastic anemia, coenzyme Q10 (CoQ10) for heart failure, or chromium for type 2 diabetes, to name a few.2 3 4 5
The focus of these nutritional guidelines is geared toward those older than 65 years of age, who are most likely to be susceptible to infection. However, there may be some benefit to younger adults following these guidelines as well, in order to possibly prevent nutritional deficiencies later in life. It is not clear whether taking a daily multivitamin, trace minerals, or vitamin E will prevent infections later in life, but given the safety and relatively low cost of these products, it seem reasonable to consider using these supplements as "nutritional insurance."
References:
1. High KP. Nutritional strategies to boost immunity and prevent infection in elderly individuals. Clin Infect Dis 2001;33:1892-900.
2. Morisco C, Trimarco B, Condorelli M. Effect of coenzyme Q10 in patients with congestive heart failure; a long-term, multicenter randomized study. Clin Investig 1993;71(8 Suppl):134S-6S.
3. Baggio E, Gandini R, Plancher AC, et al. Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. Mol Aspects Med 1994;15 Suppl:S287-S94.
4. Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin and lipid variables. Metabolism 1983;32:894-9.
5. Glinsmann WH, Mertz W. Effect of trivalent chromium on glucose tolerance. Metabolism 1966;15:510-20.