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Vitamin supplementation in the elderly: a critical evaluation.

Routine vitamin supplementation for the elderly has been advocated by many. Specific vitamin deficiencies are rare in free-living elderly, but are not uncommonly encountered in hospitalized and institutionalized patients. Deficiency may result from interactions with medications or overall poor dietary intake. Low blood or plasma vitamin concentration is not necessarily indicative of a deficient state. Specific vitamin supplements are useful in the treatment and prevention of a deficient state. However, there is little, if any benefit from supplementation for reasons other than replacement therapy. The incidence and clinical symptoms of thiamine (vitamin B1), riboflavin (B2), pyridoxine (vitamin B6), vitamin B12, C, D, folate, niacin, vitamin A, E, beta carotene, and K deficiency and their treatment and prevention in the elderly are discussed.

Aged↗

Vitamin A, E and C nutriture of elderly people in North Italy.

The vitamin A, E and C nutritional status of 313 non institutionalized elderly people living in a small town and in an agricultural village of North Italy has been evaluated. From results obtained it is possible to say that all the population tested is at low risk for vitamin A deficiency, while 10-20% of people over 70 living in the small town have low levels of vitamin E. On the contrary, the nutritional status of ascorbic acid, where the levels are inadequate in more than 50% of the population, is worrying.

Aged↗

Impairment of ascorbic acid synthesis in liver extracts of magnesium-deficient rats.

The effect of feeding a magnesium (Mg)-deficient diet for 9-34 days to weanling and young male rats on urinary and tissue ascorbate levels were studied. The concentrations of ascorbic acid in the liver and kidney were significantly reduced in the rats receiving a Mg-deficient diet as compared to those receiving a Mg-supplemented diet. The response to trichloro-2-methyl-2-propanol stimulation of urinary ascorbic acid was found to be considerably suppressed by dietary deficiency of Mg, suggesting that the decrease was not due to feed intake. In in vitro studies, the enzymatic synthesis of the vitamin from glucuronolactone or gulonolactone by liver extracts from Mg-deficient rats was significantly decreased as compared with Mg-supplemented rats. These results suggest that Mg-deficient rats have a reduced capacity to synthesize ascorbate which in turn produces a decrease in ascorbic acid concentrations in the liver.

Animals↗

Nutrition in cryptogenic cirrhosis and chronic aggressive hepatitis.

The nutritional status of 80 patients with non-alcoholic chronic liver disease was assessed by determination of various nutritional parameters in body fluids. With the exception of vitamin C there was a higher incidence (40%) of fat soluble vitamin deficiency (vitamins A, E, and carotene) than of the water soluble vitamins. Less than 10% of patients showed evidence of vitamin B12, nicotinic acid, thiamin, or riboflavin deficiency, and 17% had evidence of folic acid deficiency. The presence of deficiency was not related to age of the patient or fat absorption, and an inadequate dietary intake was not a major cause of deficiency. The incidence of nutritional deficiency is less frequent in non-alcoholic as compared with alcoholic liver disease.

Adult↗

Physical and psychological complications after intestinal bypass for obesity.

Cognitive changes, depression, arthralgia and dermatitis developed in a 33-year-old woman 5 years after a jejunoileal shunt for massive obesity, The dermatitis and low serum carotene and vitamin C values suggested vitamin deficiencies, The serum magnesium concentration also was low. Vitamin and mineral replacement led to amelioration of the physical and psychological symptoms; the improvement has been maintained at 18-month follow-up. The favourable changes were documented with the Wechsler Adult Intelligence Scale, the Minnesota Multiphasic Personality Inventory and test performance ratings. It is concluded that the surgical procedure caused vitamin and magnesium deficiencies and that these resulted in the patient's symptoms.

Adult↗

[Iron stores status at early pregnancy].

Iron deficiency is the most common cause of nutritional anemia. During pregnancy there is a high risk of developing it, due to the increase of iron requirements for fetal and maternal tissues growth. The objective of this study was to determine the iron nutritional status in early pregnancy and to determine its relationship with the dietary intake. The study applied a cross-sectional and descriptive design in 419 pregnant women (13-41 y) from Valencia, Carabobo, Venezuela. Serum ferritin was determined by enzimoinmunoassay and hemoglobin by a semi-automated method. Dietary iron intake was assessed through two non-consecutive 24 hours recalls. Statistical analysis included basic descriptives, Fisher exact test, Chi-square, and Mann-Whitney tests; with a statistical significance of p < 0.05. The iron deficiency and anemia prevalence were 16.2% and 14.4%, respectively; corresponding 36.6% to ferropenic anemia. 10.4%, 29.0% and 24.2% of the women had deficient intake for iron, vitamin C and A, respectively. There were no significant differences by age. A nutritional risk was observed regarding the iron status, demonstrated by the percentage of ferropenic anemia and because the main dietary contribution came from non-heme iron, which has low bioavailability. Additionally, there was an important percentage of inadequate vitamin C and A intakes; hence, their contribution to iron absorption was limited.

Adolescent↗

Scurvy in infantile tremor syndrome.

Infantile Tremor Syndrome is a distinct clinical entity most commonly seen in Indian Subcontinent. Syndrome consists of tremors, mental and developmental retardation, abnormal skin pigmentation and anemia in children between 6 months to 2 years. The etiology is still elusive. Amongst various theories, nutritional theory is the most accepted. So far there are no cases reported of vitamin C deficiency in ITS. In this article, three cases of ITS associated with vitamin C deficiency are reported.

Age Factors↗