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The effect of dietary supplementation with vitamins A, C and E on cell-mediated immune function in elderly long-stay patients: a randomized controlled trial.

Thirty elderly long-stay patients were randomly allocated to receive either placebo or dietary supplementation with vitamins A, C and E for 28 days. Nutritional status and cell-mediated immune function were assessed before and after the period of supplementation. Following vitamin supplementation, cell-mediated immune function improved as indicated by a significant increase in the absolute number of T cells (p less than 0.05), T4 subsets (p less than 0.05), T4 to T8 ratio (p less than 0.01) and the proliferation of lymphocytes in response to phytohaemagglutinin (p less than 0.01). In contrast, no significant changes were noted in the immune function of the placebo group. We conclude that supplementation with the dietary antioxidants vitamins A, C and E can improve aspects of cell-mediated immune function in elderly long-stay patients.

Aged↗

Vitamin C and osteoporosis in old age.

In a study of 80 reasonably healthy geriatric day hospital attenders, a progressive decline with age in bone mass and ascorbic acid level was noted; however, they were not simultaneous in each individual and there was no statistically significant correlation. Ascorbic acid depletion is not a cause of osteoporosis in old age.

Aged↗

Nutritional status of long-stay geriatric in-patients: effects of a food supplement (Complan).

In a detailed nutritional study of 50 long-stay elderly patients, intakes of vitamins C and D and nicotinic acid were found to be sub-optimal compared to D.H.S.S. recommendations. Whole-food supplementation did not increase calorie, fat or carbohydrate intake, although it did increase protein, vitamins and minerals. However, it did not correct the intake of vitamins C and D and of nicotinic acid to those recommended by D.H.S.S. Supplementation affected neither serum albumin nor transferrin. No positive correlation could be established between physical disabilities and total dietary intake among these patients. However, the appearance of the skin improved and skin thickness increased in the supplemented patients and the blood urea diminished in them also.

Aged↗

Nutritional status measures as predictors of nutritional risk in preschool children.

Data from 19 dietary and biochemical indices of nutritional status for 419 participants in the Preschool Nutrition Survey were analyzed to determined the smallest number of variables that could be used to identify all children with any of measure below a criterion of adequacy. Serum transferrin iron and dietary iron intake identified 74% of those at nutritional risk. Additional information on dietary calories, calcium, ascorbic acid, thiamin, and vitamin A identified all subjects at risk.

Ascorbic Acid Deficiency↗

Hospital malnutrition. A prospective evaluation of general medical patients during the course of hospitalization.

Nutrition status was evaluated in 134 consecutive admissions to a general medical service and throughout hospitalization among patients hospitalized 2 weeks or longer. Likelihood of malnutrition was determined using eight nutrition-related parameters: serum folate and vitamin C, triceps skinfold, weight/height, arm muscle circumference, lymphocyte count, serum albumin, and hematocrit. On admission 48% of patients had a high likelihood of malnutrition, which correlated with a longer hospital stay (20 versus 12 days for patients with a low likelihood of malnutrition) and an increased mortality rate (13 versus 4%). Likelihood of malnutrition increased with hospitalization in 69% of patients with paired determinations. Compared to admission, at final follow-up a greater proportion of patients fell into the depleted range of values for folate, triceps skinfold, weight/height, arm muscle circumference, lymphocyte count, and hematocrit. These parameters worsened in over 75% of patients admitted with normal values. Hematocrit fell in all patients with normal admission levels. These findings demonstrate and association between nutrition status and hospital course and a worsening trend during hospitalization.

Anthropometry↗

Ascorbic acid-selenite interactions in humans studied with an oral dose of 74SeO3(2-).

The interaction between dietary ascorbic acid at extremes of ascorbic acid intake and selenium in young adult male humans was investigated with a stable-isotope approach using 74Se-selenite. Measurements were made of 74Se in plasma, urine, and feces with neutron-activation analysis after oral administration of 74SeO3(2-). Urine excretion and total body retention of isotope and the selenite-exchangeable metabolic pool (Se-EMP) were calculated. Limiting dietary ascorbic acid to about 20 mg/d appeared to reduce the time-related retention of absorbed selenite and the size of Se-EMP. Compared with a diet providing 1 g ascorbic acid/d the low ascorbic acid intake was associated with a lower fractional absorption of the isotope, a reduced retention of the label, and a smaller Se-EMP. These data and those previously obtained in subjects with more usual ascorbic acid intakes point to a possible important role for ascorbic acid in the maintenance of Se homeostasis.

Absorption↗

Ascorbic acid and erythorbic acid metabolism in nonpregnant women.

Ascorbic acid (AA) metabolism and requirements were studied in 11 adult nonpregnant women maintained in a metabolic unit and fed a formula diet devoid of AA for 54 d. After depletion for 24 d, the subjects received increasing supplements of AA in the presence or absence of 600 mg/d of erythorbic acid (EA). Various analytical procedures were used to measure AA concentrations in blood components. The depletion period resulted in a marked decrease in AA in all blood indices. During the study scorbutic signs developed in some of the subjects. AA supplements of 30 mg/d for 10 d failed to increase plasma ascorbate concentrations; 60 mg/d for 10 d produced a small increase; 90 mg/d resulted in a mean AA concentration of 29 mumol/L. EA did not present any adverse effects, but rather had a small sparing effect. Vitamin C requirements for adult nonsmoking, nonpregnant women would be marginally met by an intake of 60 mg/d of AA whereas 90 mg/d would provide an allowance for body storage.

Adult↗

Ascorbic acid requirements for smokers: analysis of a population survey.

The recommended dietary allowance (RDA) of ascorbic acid for smokers was recently increased from 60 to 100 mg. To determine whether this new RDA for smokers is sufficient to reduce the risk of low serum ascorbic acid (AA) concentrations (LoC) to the same concentration as nonsmokers, we analyzed the dietary intakes and serum concentrations of AA in 11,582 adult respondents in the National Health and Nutrition Examination Survey (1976-1980). Serum AA concentrations and the risk of LoC (serum ascorbic acid levels less than 23 mumol/L) for smokers consuming different amounts of AA were compared with those for nonsmokers whose AA intake exceeded the RDA (60 mg). Serum AA concentrations were reduced, and risk of LoC increased, in smokers maintaining AA intakes greater than 60, 100, and 150 mg. Only smokers consuming greater than 200 mg AA/d had serum ascorbate concentrations and risk of LoC equivalent to nonsmokers meeting the RDA.

Adult↗