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Does Aging Cause Vitamin Deficiencies?

Written by Kathleen Doheny

Reviewed by Louise Chang, MD on November 30, 2012

Nov. 30, 2012 — At least half of adults age 65 and above take daily vitamins and other supplements, but only a fraction actually need them, says an Emory University expert.

The majority of older adults, he says, can improve their diet to get needed nutrients.

“A lot of money is wasted in providing unnecessary supplements to millions of people who don’t need them,” says Donald B. McCormick, PhD, an Emory professor emeritus of biochemistry and the graduate program in nutrition and health sciences at Emory.

He challenges what he says is a widely held belief that the older people get, the more vitamins and mineral supplements they need.

The scientific backup for that doesn’t exist, he says. “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 says. And in some cases, supplements may do harm, he says. Expense is another factor.

His report, which reviews numerous studies of vitamins and mineral supplements, is published in Advances in Nutrition.

Duffy MacKay, ND, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, an industry group representing dietary supplement makers, agrees that starting with a good diet is the best way to get needed nutrients.

But he says that is not always reality, especially for older adults who may have obstacles such as a reduced appetite.

Older-Adult Nutrient Needs

McCormick reviewed studies on dietary supplements in older adults published in the last 12 years.

He says that ”it is apparent that changes in requirements for the elderly do not suggest massive supplement use covering most micronutrients.” He says minor diet changes can fill needs for nutrients, ”with supplements included only where there is evidence of serious limitation of intake.”

He disagrees with a study suggesting that older adults should take two multivitamins a day. He found no evidence that older adults need more thiamin, riboflavin, or niacin than younger people. Some older adults may need more vitamin B6, B12, and folate, research suggests.

But vitamin C needs do not seem to change with age, he says, if an older adult does not smoke cigarettes.

McCormick also found no evidence that absorption or the body’s use of vitamin E changes as people get older. He says there is a decrease in the way the skin makes vitamin D. So for some older adults, supplemental vitamin D may be needed. In some research, taking 800 to 1,000 IUs of vitamin D a day helped women who were past menopause.

Copper requirements don’t seem to change with age, either, McCormick says.

Older adults often take in less chromium, but he says there is not evidence that there are any health consequences.

In his report, McCormick says supplements for cancer patients are not recommended. (His report was finalized before recent research linked the use of a daily multivitamin to decreased cancer risk modestly in male doctors age 50 and older.) “The jury is still out.” (SJF).

For older adults, McCormick has this advice: “If you are still eating fairly well, you are getting more micronutrients than you probably really need to function as well as you can.”

Boosting nutrients above what can be gotten from a well-balanced diet won’t necessarily lead to better health, he says.

At very high levels, some vitamins and minerals can be toxic, he says.

Perspectives: Vitamins, Supplements for Older Adults

”The adequate intake of vitamins in the elderly is a concern,” MacKay of the Council for Responsible Nutrition says.

In particular, he says, older adults may lack calcium, vitamin D, vitamin B12, potassium, and fiber.

Changing the diet can be difficult for older people, he says. Living on fixed incomes may make fresh produce too costly.

Some older adults don’t know how to cook. For others, ill-fitting dentures or a reduced appetite may make eating difficult.

“Where dietary changes are difficult, a dietary supplement can be a responsible, reasonable solution,” he says.

The Academy of Nutrition and Dietetics says older adults should pay special attention to their intake of calcium, vitamin D, vitamin B-12, potassium, and fiber.

Fortified milk and yogurt can boost calcium and vitamin D. Lean meat, fortified cereal, and some fish and seafood have vitamin B12. Fruits and vegetables have potassium and fiber.

“It’s always best to obtain your nutrients from food,” says Andrea Giancoli, RD, MPH, a spokeswoman for The Academy of Nutrition and Dietetics. She reviewed the report for WebMD.

When she counsels older adults, Giancoli first figures out what nutrients are lacking in the diet. Often, it’s vitamin D, calcium, and vitamin B12.

“I try to fix it with food,” she says. For instance, she suggests someone with calcium deficits increase their dairy products.

“I don’t think we should be recommending supplements blindly without assessing their food intake,” she says.

Bottom Line:

“Supplements are a multi-billion-dollar industry, and a lot of that is marketing. But the argument that supplments are useless and everybody should stop wasting their money is also overblown: There are gaps left by the typical American diet, and those gaps can be plugged with the judicious use of supplements. But if your diet is good, the supplements you take should be minimal.”

Source: Mark Bittman and David L. Katz, MD. How to Eat: All your food and diet questions answered. 2020

From SJF: Supplements should not be taken in what is found in many popular products and dosages called megadoses, Some supplements can be toxic, i.e.amounts in huge percentages over the RDA. These values can be found in any nutrition textbook as Tolerable Upper Intake Levels (UL) for Vitamins and Tolerable Uppper Intake Levels (UL) for Minerals and reading supplement labels can provide megadose amounts if present in the product. Consult your doctor who may have prescribed these doses for a medical problem.

SOURCES:

Donald B. McCormick, PhD, professor emeritus of biochemistry and graduate program in nutrition and health sciences, Emory University, Atlanta.

Duffy MacKay, ND, vice president of scientific and regulatory affairs, The Council for Responsible Nutrition.

Andrea Giancoli, MPH, RD, spokesperson, The Academy of Nutrition and Dietetics.

McCormick D. Advances in Nutrition, November 2012.

Restricted eating and gene expression

The authors of a study found that 70 percent of mouse genes respond to time-restricted eating.

Satchidananda Panda, PhD – Salk Institute for Biological Studies

“By changing the timing of food, we were able to change the gene expression not just in the gut or in the liver, but also in thousands of genes in the brain,” the authors say.

Nearly 40 percent of genes in the adrenal gland, hypothalamus, and pancreas were affected by time-restricted eating. These organs are important for hormonal regulation. Hormones coordinate functions in different parts of the body and brain, and hormonal imbalance is implicated in many diseases from diabetes to stress disorders. The results offer guidance to how time-restricted eating may help manage these diseases.

Interestingly, not all sections of the digestive tract were affected equally. While genes involved in the upper two portions of the small intestine — the duodenum and jejunum — were activated by time-restricted eating, the ileum, at the lower end of the small intestine, was not. This finding could open a new line of research to study how jobs with shiftwork, which disrupts our 24-hour biological clock (called the circadian rhythm) impact digestive diseases and cancers. Previous research by Panda’s team showed that time-restricted eating improved the health of firefighters, who are typically shift workers.

The researchers also found that time-restricted eating aligned the circadian rhythms of multiple organs of the body.

“Circadian rhythms are everywhere in every cell,” says Panda. “We found that time-restricted eating synchronized the circadian rhythms to have two major waves: one during fasting, and another just after eating. We suspect this allows the body to coordinate different processes.”

Next, Panda’s team will take a closer look at the effects of time-restricted eating on specific conditions or systems implicated in the study, such as atherosclerosis, which is a hardening of the arteries that is often a precursor to heart disease and stroke, as well as chronic kidney disease.

Other authors include Shaunak Deota, Terry Lin, April Williams, Hiep Le, Hugo Calligaro, Ramesh Ramasamy, and Ling Huang of Salk; and Amandine Chaix of the University of Utah.

The research was supported by the National Institutes of Health (grants CA258221, DK115214, CA014195, and AG065993) and the Wu-Tsai Human Performance Alliance.

Organic – Fact or Fad?

U.S. government cracks down on scammy organic labels

Erica Pandey

Illustration of an apple wearing a joke Groucho Mark glasses
Illustration: Sarah Grillo/Axios

“The government has new rules to determine what’s really organic and what’s a sham.

Why it matters: The term “organic” has been stretched over the years as these foods become increasingly popular — and pricey. Products labeled organic that don’t meet government standards are hitting store shelves.

Case in point: The Justice Department recently charged several individuals in a multimillion-dollar scheme to sell ordinary soybeans from Eastern Europe as organic in the U.S.

  • Organic soybeans cost up to 50% more than their nonorganic counterparts.

Driving the news: The Department of Agriculture is cracking down on fakes with its biggest-ever overhaul of organic guidelines, released Thursday.

  • The changes include requiring those in the middle — such as traders and brokers — to be certified alongside the food producers themselves, per the Washington Post. There will also be more inspections and required certification for imports.

The big picture: U.S. organic food sales hit $57.5 billion in 2021 — more than double what they were about a decade ago, per Food Dive.

Reality check: “Though some consumers view ‘organic’ as a synonym for ‘healthy,’ the science on whether organic food is healthier is mixed,” the Washington Post’s Laura Reiley writes.

Diet and Lifestyle

Healthy Eating Linked to Lower Risk of Total Mortality

— Lower risks of death due to cardiovascular disease, cancer, respiratory disease noted

by Kristen Monaco, Staff Writer, MedPage Today January 9, 2023

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A photo of a couple serving dinner in their kitchen.

Adhering to healthy eating patterns was associated with lower risk of total and cause-specific mortality, a prospective cohort study with up to 36 years of follow-up showed.

Among 75,230 women from the Nurses’ Health Study and 44,085 men from the Health Professionals Follow-up Study, those who scored in the highest quintile for healthy eating patterns recommended by the Dietary Guidelines for Americans (DGAs) had a 14% to 20% lower risk of total mortality versus those in the lowest quintile, reported Frank Hu, MD, PhD, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues in JAMA Internal Medicineopens in a new tab or window.

The pooled multivariable-adjusted hazard ratios of total mortality with four healthy eating patterns were (P<0.001 for trend for all):

  • Healthy Eating Index 2015 (HEI-2015): HR 0.81 (95% CI 0.79-0.84)
  • Alternate Mediterranean Diet (AMED): HR 0.82 (95% CI 0.79-0.84)
  • Healthful Plant-Based Diet Index (HPDI): HR 0.86 (95% CI 0.83-0.89)
  • Alternate Healthy Eating Index (AHEI): HR 0.80 (95% CI 0.77-0.82)

This lower risk was consistent across all racial and ethnic groups.

“This is one of the largest and longest-running studies that examine the associations of dietary scores for four healthy eating patterns recommended by the DGAs with the risk of total and cause-specific mortality in large cohort studies,” Hu told MedPage Today.

“Every 5 years, the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) release an updated version of the Dietary Guidelines for Americans,” he explained. “It is important to evaluate adherence to DGA-recommended eating patterns and health outcomes, especially mortality, so that timely updating of DGAs can be made.”

Hu noted that these findings will be valuable for the 2025-2030 Dietary Guidelines Advisory Committee, which is being created by the USDA and HHS to evaluate the current evidence on different eating patterns and health outcomes.

Beyond total mortality, healthier diets were also significantly linked to lower risk of cause-specific mortality.

Across the four different dietary patterns, people in the highest quintile saw a 6% to 13% lower risk of death from cardiovascular disease versus those in the lowest quintile. Likewise, those in the highest quintile saw a 6% to 15% lower risk of death due to heart disease, a 7% to 18% lower risk of cancer-related death, and a 35% to 46% lower risk of respiratory disease-related death.

In addition, those with the highest scores on the AMED and AHEI also saw a modestly lower risk of death due to neurodegenerative disease (HR 0.94, 95% CI 0.90-0.99 and HR 0.93, 95% CI 0.87-0.99, respectively).

“Although previous studies have found an inverse association between healthy eating patterns and mortality, our study provides evidence that healthy eating patterns reduce the risk of cause-specific mortality including cardiovascular disease, cancer, respiratory, and neurodegenerative mortality,” said Hu. “The findings on respiratory and neurodegenerative mortality are novel.”

However, eating a healthy diet according to any of the four patterns did not appear to be protective against stroke-related deaths.

Hu said clinicians can recommend a “variety of healthy dietary patterns” to patients in order to reduce their risk for chronic diseases and premature death.

“These patterns such as the Mediterranean diet, DASH diet, vegetarian diet, or other versions of healthy diets can be adapted to meet individual health needs, food preferences, and cultural traditions,” he noted. “These healthy dietary patterns typically include high amounts of plant foods such as fruits, vegetables, whole grains, nuts, and legumes, and lower amounts of refined grains, added sugars, sodium, and red and processed meats.”

“It is also important to balance caloric intake with physical activity to maintain a healthy weight,” he added.

Among the women included in the analysis, mean baseline age was 50.2 and 98% were white; for men, mean age was 53.3 and 91% were white. In total, 31,263 women and 22,900 men died during follow-up. The leading cause of death was cancer, followed by cardiovascular disease, heart disease, neurodegenerative disease, respiratory disease, and stroke.

Dietary data were taken from semiquantitative food frequency questionnaires including more than 130 items, which were completed every 2 to 4 years.

  • author['full_name'] Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

The study was supported by a grant from the National Heart, Lung, and Blood Institute.

Hu reported no disclosures. Other co-authors reported relationships with Kubara Honke, Grants-in-Aid for Scientific Research, the G-7 Scholarship Foundation, the Japan Diabetes Society, the LOTTE Foundation, Layer IV, the U.S. Department of Agriculture, the U.S. Highbush Blueberry Council, the National Institutes of Health, Mars Edge, and the National Heart, Lung, and Blood Institute.

Primary Source

JAMA Internal Medicine

Source Reference: opens in a new tab or windowShan Z, et al “Healthy eating patterns and risk of total and cause-specific mortality” JAMA Intern Med 2023; DOI: 10.1001/jamainternmed.2022.6117.

Vitamin D and Mortality – In the News

Improving vitamin D levels in Older Age is Linked to Lower risk of all-cause Mortality

Sources: BMC Geriatr 22, 245 (2022)
LIfe Extension, Feb. 2023

Judith E. Brown. Nutrition Now, 7th Edition

The participants in this study included 1,362 individuals in the Chinese Longitudinal and Health Longitudinal Survey, aged 60 to 113 whose serum vitamin D levels were measured in 2012 and 2014. Mortality data were collected in 2018.

Deficient vitamin D levels were detected in 67.5% of the participants in 2012 and 68.4% in 2014.

During follow-up, 420 deaths occurred. Individuals who were deficient in vitamin D in 2012 and 2014 had more than twice the mortality risk than those who maintained higher levels.

Among participants who maintained sufficient vitamin D were deficient in 2012 and not deficient in 2014, the risk of dying was 30% and 53% lower, respectively, compared to participants who were deficient at both points in time.

This highlights the need to address vitamin D deficiency in older individuals to support longevity and healthy aging.

Editor’s Note: The greatest benefit associated with improved vitamin D status was found among women and those people who were 80 years of age or older.

What are the primary functions of vitamin D? This fat-soluble vitamin is needed for absorption of calcium and phosphorus needed for bone formation and muscle activity. It inhibits inflammation and is involved in insulin secretion and blood glucose level maintenance. It can be toxic with the long term use of 10,000 IU daily. The RDA is 600 IU for adult women and men; the Upper Tolerable Intake (UL) is 4,000 IU.s or 100 ug.

This highlights the need to address vitamin D deficiency in older individuals. Based on the evidence for bone benefits, however, a nutrition panel recently increased the RDA for vitamin D to 600 IU for people up to age 70 and to 800 IU for those over 70. That’s a fairly sizable boost over the previous recommendations of 200 IU per day through age 50, 400 IU for ages 51 to 70, and 600 IU for ages over 70. They also raised the safe upper limit of daily intake for most age groups from 2,000 to 4,000 IU. to support longevity and healthy aging. 1 microgram vitamin D = 40 IU as both terms are used on supplement labels. It is primarily found only in vitamin D-fortified milk, cereals, and other foods such as fish.

The best way to measure effects of supplemental intake or vitamin D status is by a blood test. Vitamin D3 is the most active form and is made from a form of cholesterol in the skin cells upon exposure to ultraviolet rays from the sun. See your doctor for guidance.

The Blue Zone Way to Healthy Diets

Micronutrient Needs of Older Adults

Source: Smolin and Grosvenor. Nutrition: Science and Applications, Third Addition

Changes in digestion, absorption, and metabolism affect micronutrient status and may contribute to the development of some of the disorders that are common in older adults.    

This may be a concern especially for the B vitamins, and vitamin D, iron, and zinc.

B vitamins 

The only B vitamins for which recommendations differ between older adults and younger adults are vitamins B6 and B12. The  RDA for B6 is greater to maintain levels while the RDA for vitamin B12 is not increased, but is a nutrient of concern because of both reduced absorption and low dietary intakes among some groups like vegans. Also as we age, many people develop a condition called atrophic gastritis from a lack of acid in the stomach necessary for the absorption of vitamin B12. Eating fortified foods or taking a supplement under the guidance of a physician are the best way to counter this situation. 

Folate is another B vitamin of concern. Low folate along with inadequate levels of B6 and B12 may result in an elevated homocysteine level which increases the risks of cardiovascular disease. The fortification in grain products began in 1998 has increased the intake of this vitamin, however, when folate is consumed in excess, it can mask signs of a vitamin B12 deficiency and go untreated. Again, consuming any vitamin is unnecessary in excess and should be supervised by your primary care doctor or a trained dietitian.

 Vitamin D 

Vitamin D is necessary for adequate absorption of calcium which is also a concern in elderly people.  Intake is often low and synthesis  in the skin is reduced due to limited exposure of sunlight and because the capacity to synthesize vitamin D in the skin decreases with age. 

Iron 

The iron needs in women decline sharply at menopause when blood loss has ceased.The iron needs of men do not change., Nonetheless, iron-deficiency anemia is common in the elderly often due to chronic blood loss from disease and medications and poor absorption due to low stomach acid and antacid use. 

Zinc 

The RDA for zinc has not changed in older adults, but low energy intakes as well as absorption, stress,  trauma, muscle wasting  and OTC medications can all contribute  to poor zinc status. The consequences can  contribute to malnutrition by reducing food intake, Reduction in immune function and wound healing increases the risk of infection, which can also impair  nutritional status.

Food Guidelines: The Blue Zones Way

All About Vitamin B12

Disclaimer

This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your health care providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

What is vitamin B12 and what does it do?

Vitamin B12 is a nutrient that helps keep your body’s blood and nerve cells healthy and helps make DNA, the genetic material in all of your cells. Vitamin B12 also helps prevent megaloblastic anemia, a blood condition that makes people tired and weak.

How much vitamin B12 do I need?

The amount of vitamin B12 you need each day depends on your age. Average daily recommended amounts for different ages are listed below in micrograms (mcg):

Life StageRecommended Amount
Birth to 6 months0.4 mcg
Infants 7–12 months0.5 mcg
Children 1–3 years0.9 mcg
Children 4–8 years1.2 mcg
Children 9–13 years1.8 mcg
Teens 14–18 years2.4 mcg
Adults2.4 mcg
Pregnant teens and women2.6 mcg
Breastfeeding teens and women2.8 mcg

What foods provide vitamin B12?

Vitamin B12 is found naturally in a wide variety of animal foods, and manufacturers add it to some fortified foods. Plant foods have no vitamin B12 unless they are fortified. You can get recommended amounts of vitamin B12 by eating a variety of foods including the following:

  • Fish, meat, poultry, eggs, milk, and other dairy products contain vitamin B12.
  • Clams and beef liver are some of the best source of vitamin B12.
  • Some breakfast cereals, nutritional yeasts, and other food products are fortified with vitamin B12.

To find out if a food has added vitamin B12, check the Nutrition Facts label. Manufacturers are not required to list vitamin B12 on the label if a food naturally contains this vitamin.

What kinds of vitamin B12 dietary supplements are available?

Vitamin B12 is available in multivitamin/multimineral supplements, in B-complex supplements, and in supplements containing only vitamin B12. It is usually in a form called cyanocobalamin. Other common forms are adenosylcobalamin, methylcobalamin, and hydroxycobalamin. Vitamin B12 is also available in a form that’s dissolved under your tongue (called sublingual vitamin B12). Research has not shown that any form of supplemental vitamin B12 is better than the others.

The amount of vitamin B12 in supplements varies widely. Some provide doses of vitamin B12 that are much higher than recommended amounts, such as 500 mcg or 1,000 mcg, but your body absorbs only a small percentage of it. These doses are considered safe. Check the Supplement Facts label to see how much vitamin B12 a supplement contains.

A prescription form of vitamin B12 can be given as a shot. This is usually used to treat vitamin B12 deficiency. Vitamin B12 is also available by prescription as a nasal gel that’s sprayed into the nose.

Am I getting enough vitamin B12?

Most people in the United States get enough vitamin B12 from the foods they eat. But some people have trouble absorbing vitamin B12 from food. The body absorbs vitamin B12 from food in a two-step process. First, hydrochloric acid in the stomach separates vitamin B12 from the protein that it’s attached to. Second, the freed vitamin B12 then combines with a protein made by the stomach, called intrinsic factor, and the body absorbs them together.

Vitamin B12 in dietary supplements isn’t attached to protein and doesn’t require the first step. However, B12 in supplements does need to combine with intrinsic factor to be absorbed.

People with pernicious anemia, an autoimmune disease, can’t make intrinsic factor. As a result, they have trouble absorbing vitamin B12 from foods and dietary supplements.

Vitamin B12 deficiency affects between 3% and 43% of older adults. Your doctor can test your vitamin B12 level to see if you have a deficiency.

Certain groups of people may not get enough vitamin B12 or have trouble absorbing it:

  • Many older adults don’t have enough hydrochloric acid in their stomach to absorb the vitamin B12 that’s naturally present in food. People over 50 should get most of their vitamin B12 from fortified foods or dietary supplements because, in most cases, their bodies can absorb vitamin B12 from these sources.
  • People with an autoimmune disease called atrophic gastritis might not absorb enough vitamin B12 because they make too little hydrochloric acid and intrinsic factor in their stomach.
  • People with pernicious anemia do not make the intrinsic factor needed to absorb vitamin B12. As a result, they have trouble absorbing vitamin B12 from foods and dietary supplements. Doctors usually treat pernicious anemia with vitamin B12 shots, although very high doses of vitamin B12 given by mouth might also be effective.
  • People who have had some types of stomach or intestinal surgery (for example, to lose weight or to remove part or all of the stomach) might not make enough hydrochloric acid and intrinsic factor to absorb vitamin B12.
  • People with disorders of the stomach and small intestine, such as celiac disease or Crohn’s disease, might not absorb enough vitamin B12.
  • People who eat little or no animal foods, such as vegetarians and vegans, might not get enough vitamin B12 from their diets. Only animal foods have vitamin B12 naturally. When pregnant women and women who breastfeed their babies are strict vegetarians or vegans, their babies might also not get enough vitamin B12.

What happens if I don’t get enough vitamin B12?

Your body stores 1,000 to 2,000 times as much vitamin B12 as you’d typically eat in a day, so the symptoms of vitamin B12 deficiency can take several years to appear.

If you have a vitamin B12 deficiency, you may feel tired or weak. These are symptoms of megaloblastic anemia, which is a hallmark of vitamin B12 deficiency. You might also have pale skin, heart palpitations, loss of appetite, weight loss, and infertility. Your hands and feet might become numb or tingly, a sign of nerve problems. Other symptoms of vitamin B12 deficiency include problems with balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue.

Vitamin B12 deficiency can damage the nervous system even in people who don’t have megaloblastic anemia, so it’s important to treat a deficiency as soon as possible.

What are some effects of vitamin B12 on health?

Scientists are studying vitamin B12 to understand how it affects health. Here are several examples of what this research has shown.

Heart disease and stroke
Vitamin B12 supplements (along with other B vitamins) reduce blood levels of homocysteine, a compound linked to an increased risk of having a heart attack or stroke But despite reducing homocysteine, research shows that these vitamins don’t reduce the risk of developing cardiovascular disease or stroke.

Dementia and cognitive function
Most studies show that low blood levels of vitamin B12 don’t affect the risk of cognitive decline in older people, regardless of whether they have dementia or Alzheimer’s disease. More clinical trials are needed to better understand the effects of vitamin B12 supplementation on cognitive function in older adults.

Energy and Endurance
Manufacturers often promote vitamin B12 supplements for energy, athletic performance, and endurance. But vitamin B12 doesn’t provide these benefits in people who get enough B12 from their diet.

Can vitamin B12 be harmful?

Vitamin B12 has not been shown to cause any harm, even at high doses.

Does vitamin B12 interact with medications or other dietary supplements?

Yes. Vitamin B12 supplements can interact or interfere with some medicines that you take. Here are several examples.

Gastric acid inhibitors
People take gastric acid inhibitors to treat certain digestion problems, such as gastroesophageal reflux disease and peptic ulcer disease. These drugs can interfere with vitamin B12 absorption from food by slowing the release of hydrochloric acid into the stomach, leading to vitamin B12 deficiency. Gastric acid inhibitors include omeprazole (Prilosec®), lansoprazole (Prevacid®), cimetidine (Tagamet®), and ranitidine (Zantac®).

Vitamin B12 and healthful eating

People should get most of their nutrients from food and beverages, according to the federal government’s Dietary Guidelines for Americans. Foods contain vitamins, minerals, dietary fiber, and other components that benefit health. In some cases, fortified foods and dietary supplements are useful when it is not possible to meet needs for one or more nutrients (for example, during specific life stages such as pregnancy).

Protection against memory loss?

Source: Medical News Today.

By Katharine Lang, Dec. 13, 2022.

Fact Checked by Hannah Flynn

A healthy diet and lifestyle

“Keeping physically healthy can help protect against memory loss and dementia. The NIATrusted Source recommends regular aerobic exercise, and a healthy diet with plenty of fresh fruit and vegetables.

In addition, getting the right amount of sleep, socializing, minimizing stress, and keeping health conditions such as high blood pressure and diabetes under control will help reduce the risk of cognitive decline.

Dr. MacSweeney reiterated this advice:

“It has been shown that as a population we can reduce risk of cognitive impairment due to Alzheimer’s by adhering to healthy lifestyle habits including exercise, diet (Mediterranean diet high in fish oils) and keep[ing] sugar intake low — the brain hates sugar. High levels of mental and social activity. The brain needs to be exercised just like our bodies to stay in good condition. Avoid excess alcohol and smoking.”

A new studyTrusted Source has also highlighted the importance of vitamin D in preserving cognitive function. In this study of postmortem brains, the brains of people with higher cognitive function before death contained higher levels of vitamin D.

The researchers found that although the higher levels of vitamin D were associated with up to 33% lower odds of dementia symptoms, they were not associated with any decrease in post-mortem dementia neuropathologyTrusted Source.

Therefore, they could not suggest a mechanism for the potentially protective effect of vitamin D, or show a causative link.

They advised that ensuring you get sufficient vitamin D from sunlight and from foods such as oily fish might be beneficial. However, they warned against taking high doses of the vitamin to try and prevent dementia, as this can cause other health problems.

Exercise the brain

“Engaging in cognitively stimulating activities is also beneficial. We also know that depression and anxiety can negatively impact cognition, so it is important to treat those conditions if present. Maintaining social connections, engaging in meaningful activities, and exercising also help mood, which in turn, can impact cognition. It is not only your body that benefits from exercise, keeping the brain exercised can help preserve your mental abilities well into older age.”

– Dr. Miriam Weber

Although keeping active and engaged as you age may not prevent dementia, mentally stimulating activities, such as volunteering, reading, playing games, or learning new skills could help lower the riskTrusted Source.

Doing word games, such as crosswords, has long been advocated in the popular press as a means of keeping yourself sharp, but until recently, there has been little evidenceTrusted Source in peer-reviewed journals.

Now, a new study published in NEJM Evidence has demonstrated their efficacy in a small group of people with MCI.

The participants, who had an average age of 71, and some degree of mild cognitive impairment, did either intensive crossword puzzle training or intensive cognitive games training on a computer for 12 weeks. They continued with booster sessions to 78 weeks.

At 78 weeks, crossword puzzles had improved both a primary cognitive outcome measure (ADAS-Cog) and a measure of daily functioning more than cognitive games. More strikingly, brain shrinkage — measured using MRITrusted Source — was less in those who did the crossword training.”

Can memory loss be reversed?

“So, you can reduce your risk of memory issues, but once the memory starts to fail, can the problem be reversed?”So, you can reduce your risk of memory issues, but once the memory starts to fail, can the problem be reversed?

There is some evidence that it may be possible. In a mouse study,Trusted Source researchers managed to reverse memory loss using chondroitin-6-sulphate, a substance that has also been shown to increase lifespan in the nematode worm Caenorhabditis elegans. It might have similar effects in people, but has yet to be tested.

In a more recent studyTrusted Source, researchers improved memory function in adults aged between 65 and 88 years using electrical stimulation via a wearable cap.

The researchers found that giving 20 minutes of electrical stimulation on 4 consecutive days led to an improvement in both working memoryTrusted Source and long-term memory for at least 1 month. They could focus the stimulation to affect different types of memory.

Dr. Robert Reinhart, of Boston University, corresponding author on the study, explained: “We developed two brain stimulation protocols — one for selectively improving short-term memory via low-frequency parietal stimulation, and another protocol for selectively improving long-term memory via high-frequency prefrontal stimulation.”

However, the improvement was only tested over one month, so the researchers call for further investigation into whether similar treatments might have a long-term benefit.”

The bottom line

“As we age, many of us will find we experience more frequent memory lapses, but unless these start to interfere with daily functioning, they are unlikely to be a sign of impending dementia.

To minimize the occurrence of memory issues, the advice is to keep active, eat well, look after your health, and stay engaged in lots of social and stimulating activities. And remember, like any part of the body, the brain will function better if it is exercised.

So keep up the daily word puzzle, and for even greater benefit tackle it with a friend. It could well be doing you more good than you realize.”

Fast Food and Dementia ?

 Is Eating Fast Food a Dementia Risk? 

The health risks of eating ultraprocessed foods —including sausages and burgers as well as pizza and ice cream — are well documented. They have been shown to raise the risk of obesity, diabetes, and cancer among other chronic ailments. (CNN.com). 

In a new study, researchers followed more than 10,000 Brazilians with an average age of 51 for more than 10 years. They found that people who consumed more than 20% of their daily calories from ultra processed foods had a 28% faster cognitive decline compared with those whose intake was less than 20%.  Unfortunately, that 20% is not a high threshold: just 400 calories out of the 2000 calorie diet. And most Americans are well over that, getting on average a whopping 58% of their calories from ultraprocessed foods.

 “The sample size is substantial and the followup extensive,” says Dr. David Katz, a nutrition specialist who was not involved in the study. While short of proof, this is robust enough that we should conclude ultraprocessed foods are probably bad for our brains,” 

Source: The Week. December 23, 2022, Volume 22, Issue 110.

Nutrigenomics

What is Epigenetics?

Epigenetics refers to the inheritable changes in your DNA that don’t change the actual DNA sequences. That means these changes are potentially reversible.

What is DNA Methylation?

Your DNA consists of four bases called cytosine, guanine, adenine, and thymine. A chemical unit called a methyl group (designated by CH3 or one carbon atom and three hydrogen atoms) can be added to cytosine.

When that happens, that area of the DNA is methylated. When you lose that methyl group, the area becomes demethylated.

DNA methylation often inhibits the expression of certain genes. For example the methylation process might stop a tumor-causing gene from “turning on”, preventing cancer.

Researchers are currently working to better understand the factors that affect DNA methylation. Based on some earlier findings, there is some evidence that diet plays a role. This opens up the potential to reduce genetic risk of developing certain conditions such as breast cancer or heart disease through simple lifestyle changes.

The patterns of DNA methylation change through out your life, from fetal development to end of life. Studies suggest thqt DNQ methylation slows down as we age. Genes that were once repressed by methylation start to become active and possibly result in a variety of diseases. Interestingly, another study found that participants”who consumed more alcohol were more likely to have decreased DNA methylation. In contrast, those who consume a lot of folate were more likely to have increased methylation.

“Can Diets Change Your DNA? The question is “are you really what you eat? The answer appears to be No. However, we have known for years that gene expression influences metabolism. A study published in Nature Microbiology in 2016 indicates that nutrition may play an important role in how some DNA sequences are expressed. The study that how genes behave is strongly influenced by the food we eat. Even so, we are still a long way from the kind of personalized medicine that will furnish nutritional therapies to treat a wide spectrum of conditions.” Stay tuned for the future. Source: You Are what Your Grandparents Ate. Judith Finlayson, 2019.

You may want to search my blog for a simple description of the association between nutrigenomics and diet with the Agouti yellow mouse.

CLICK HERE.