Page 128 - Petelin, Ana. 2021. Ed. Zdravje starostnikov / Health of the Elderly. Proceedings. Koper: University of Primorska Press.
P. 128
avje starostnikov | health of the elderly 126 tribution and marketing is performed by the Health Inspectorate of the RS
(Ministrstvo za zdravje, 2014). Safety and efficacy of DS in the EU are evalu-
ated by the European Food Safety Authority (EFSA), an entity set up in Janu-
ary 2002 as an independent source of scientific advice that produces opinions
which then are used by the European Commission to adopt legislation. In Slo-
venia, National Institute for Public Health (Nacionalni inštitut za javno zdra-
vje) has joined European linkage called Nutrivigilance, which is intended to
identify the possible risks related to DS consumption and prevention of them.
The main purpose of nutrivigilance is to ensure the information flow between
the consumers, food business operators and regulatory institutions. It includes
raising awareness and reporting of possible adverse events (Nacionalni inštitut
za javno zdravje, n.d.). Nonetheless, legislation around DS is much more loose
compared to drugs and regulation of quality and safety is mostly post-market,
whereas efficacy of DS is not being verified (Harris et al., 2017).
Benefits from taking DS
Nutrient deficiencies and malnutrition among the older adult population are
a concern and may be reduced by supplementation (Gariballa, 2000). DS can
play a role in optimizing nutrient levels among older adults who have poor nu-
trient intake due to decreased appetite, dental issues, etc., are at risk of mal-
nutrition, or experience nutrient depletions from medications. Approximately
34% of individuals over the age of 65 are nutritionally deficient in protein, cal-
ories, and multiple micronutrients. Specific micronutrients of concern include
those that are consistently found to be deficient in the diet and/or nutrients for
which the digestion, absorption, or metabolism declines with age (such as vita-
mins A, C, D, B6, B12, and folate plus calcium, zinc, and magnesium). Supple-
mentation may also be beneficial among older adults prescribed medications
that reduce or interfere with the absorption of nutrients, such as statins, antac-
ids, antidepressants, antibiotics, oral hypoglycemic medications. Proton pump
inhibitors have been associated with nutrient deficiencies such as vitamin B12,
vitamin C, calcium, iron, and magnesium and metformin has been shown to
cause vitamin B12 and folate malabsorption, specifically when used at higher
doses and for extended periods of time (Harris et al., 2017).
In general, various DS are used by older people mainly in the expecta-
tion of reducing the risk of developing cancer, cardiovascular diseases, cogni-
tive impairment, or skeletal muscle loss (Walrand, 2018). The most common
DS taken among elderly, can be grouped according to their chemical nature as
follows: vitamin and mineral supplements, omega-3 polyunsaturated fatty ac-
ids (PUFAs) supplements, protein supplements and plant-based supplements.
Many clinical studies aimed to investigate positive effects of the admin-
istration of antioxidant vitamins and their possibility to decrease cell oxidative
damage, thereby decreasing the incidence of degenerative diseases and cancer
(Walrand, 2018). In a longitudinal population-based study high vitamin E in-
take was associated with better cognitive performance during aging (Morris et
(Ministrstvo za zdravje, 2014). Safety and efficacy of DS in the EU are evalu-
ated by the European Food Safety Authority (EFSA), an entity set up in Janu-
ary 2002 as an independent source of scientific advice that produces opinions
which then are used by the European Commission to adopt legislation. In Slo-
venia, National Institute for Public Health (Nacionalni inštitut za javno zdra-
vje) has joined European linkage called Nutrivigilance, which is intended to
identify the possible risks related to DS consumption and prevention of them.
The main purpose of nutrivigilance is to ensure the information flow between
the consumers, food business operators and regulatory institutions. It includes
raising awareness and reporting of possible adverse events (Nacionalni inštitut
za javno zdravje, n.d.). Nonetheless, legislation around DS is much more loose
compared to drugs and regulation of quality and safety is mostly post-market,
whereas efficacy of DS is not being verified (Harris et al., 2017).
Benefits from taking DS
Nutrient deficiencies and malnutrition among the older adult population are
a concern and may be reduced by supplementation (Gariballa, 2000). DS can
play a role in optimizing nutrient levels among older adults who have poor nu-
trient intake due to decreased appetite, dental issues, etc., are at risk of mal-
nutrition, or experience nutrient depletions from medications. Approximately
34% of individuals over the age of 65 are nutritionally deficient in protein, cal-
ories, and multiple micronutrients. Specific micronutrients of concern include
those that are consistently found to be deficient in the diet and/or nutrients for
which the digestion, absorption, or metabolism declines with age (such as vita-
mins A, C, D, B6, B12, and folate plus calcium, zinc, and magnesium). Supple-
mentation may also be beneficial among older adults prescribed medications
that reduce or interfere with the absorption of nutrients, such as statins, antac-
ids, antidepressants, antibiotics, oral hypoglycemic medications. Proton pump
inhibitors have been associated with nutrient deficiencies such as vitamin B12,
vitamin C, calcium, iron, and magnesium and metformin has been shown to
cause vitamin B12 and folate malabsorption, specifically when used at higher
doses and for extended periods of time (Harris et al., 2017).
In general, various DS are used by older people mainly in the expecta-
tion of reducing the risk of developing cancer, cardiovascular diseases, cogni-
tive impairment, or skeletal muscle loss (Walrand, 2018). The most common
DS taken among elderly, can be grouped according to their chemical nature as
follows: vitamin and mineral supplements, omega-3 polyunsaturated fatty ac-
ids (PUFAs) supplements, protein supplements and plant-based supplements.
Many clinical studies aimed to investigate positive effects of the admin-
istration of antioxidant vitamins and their possibility to decrease cell oxidative
damage, thereby decreasing the incidence of degenerative diseases and cancer
(Walrand, 2018). In a longitudinal population-based study high vitamin E in-
take was associated with better cognitive performance during aging (Morris et
