Question 1 - Jenn
With the growing prevalence of the elderly population, nutrition recommendations for this age group are likely to become a high priority. With your knowledge of the micronutrients and their health implications, do you believe that increasing the RDAs for Vitamins B-12, A, and/or C could benefit the elderly female population – Why or why not?
posted by Unknown @ 7:55 AM
12 comments
12 Comments:
I think increasing the RDAs for those vitamins could be more beneficial than harmful, especially with water-soluble vitamins C and B-12. Since many individuals over the age of 50 lose or have a decreased ability to absorb vitamin B-12, it would be beneficial to increase the RDA so that the actual absorbed amount would be higher for the elderly. However, if the individual does have an impaired ability to absorb B-12, I wonder if increasing the RDAs would affect their B-12 status. Additionally, B-12 is needed to help maintain the central nervous system, in which a deficiency can lead to loss of balance and numbness, this may trickle down to fall prevention if B-12 status is adequate. Vitamin C could greatly benefit the elderly by acting as an antioxidant as well as vitamin A. Additionally, an adequate amount may lead to improved repairing of tissues, which is a problem we see among the elderly after injuries. Increasing RDA for vitamin A may help reduce the risk of developing eye problems for the elderly, or at least delay the deterioration of eye health, as long as the levels is not toxic. Essentially, I believe increasing the RDAs for these three vitamins could be beneficial for the elderly who have decreased absorption abilities. However, I do not see increasing RDAs translating directly to increased intake since most people do not follow the RDAs. Additionally, the elderly have smaller appetites, so it would be difficult for them to receive even higher amounts of vitamins through food.
I agree with Vivian's comment that increasing the RDAs for vitamins C and B-12 would be more beneficial than it would be harmful. Especially in elderly female patients' with compromised health, Vitamin A, C and B-12 could prove to be beneficial. Many elderly patients who are less active may have more skin break down which vitamin C and possibly A, if they are deficient, could improve their skin integrity. Again, as vivian said, vitamin C and B12 are water soluble, making them less harmful to increase the RDA, so for those two I think it could benefit the elderly female population to increase their suggested daily intake amount. Vitamin A, however, I think it is unnecessary to increase the RDA. If an elderly female is deficient, supplementing A may help with their healing process, but seems unnecessary and possibly dangerous otherwise. Lastly, I agree with Vivian that simply increasing the RDAs will not necessarily be reflected in the way an elderly patient would eat, because majority of patients are unaware that RDAs even exist, let alone try to follow the recommendations. With a lot of elderly patients with compromised health, getting them to eat is a big enough challenge, let alone getting them all of the nutrients they need.
I do think more research should be done on elderly nutritional requirements. The ability of the body to breakdown and use dietary protein diminishes with age, why would absorption of vitamins and minerals not also change? As you get older, (to keep it simple) things start to wear out and not work as well. So yes, the elderly may need more of some nutrients; I do think the issue deserves more attention. Yet, while the efficiency of absorption of some nutrients may decrease (necessitating more in the diet) others may increase in efficiency if, for example, peristalsis is slower, leaving more time for absorption. I would not charge so quickly into raising levels by any significant amount. I think micronutrient recommendations should be further assessed on an individual basis with particular attention to pathway of excretion. Though genetics certainly sets the stage, maybe these women were disease free and fully functional in their elderly years because of their lifestyles and nutrient intake in their earlier years.
I don't think raising the target nutrient values of the specified nutrients for certain population groups (elderly women) would be harmful....but honestly I am not sure how much good it would do either. I think realistically the amount of time and money spent on research to determine the exact details of the proposed new nutrient values would be better spent on a different nutrition related topic. I think that as nutrition experts it is our job to be able to compare our client's dietary intake to the current standards of reference and assess the gaps and make suggestions for improvement. I think the current status of most americans would leave them with some sort of room for significant nutritional improvement...I don't know if focusing on bumping up the RDAs of a few individual nutrients would be worth it when it is likely there is already things we could focus on with our clients to increase their overall dietary well-being.
I agree with Gina that more research definitely needs to be conducted before we start raising the RDA levels. There is already some research conducted and showing that certain micronutrients are not absorbed as well as we age. If further research is conducted, I think we need to examine the effects and benefits, if any, of raising these RDAs. If there are no benefits to increasing the RDAs, then essentially there is no point in making healthcare more expensive and providing more supplements that do not make a difference in an individual's health. Therefore, we need to assess! And as Gina mentioned, maybe we just need closer attention to elderly individuals in assessing their individual needs. Perhaps one elderly woman has a greater need for Vitamin C but not Vitamin A and it could be vice versa for another individual of the same age and gender.
Additionally, like Des had said, perhaps we need to put research funding into other nutrition topics instead of looking again and again at details of nutrient values. Perhaps we should examine how to increase intake or absorption of these micronutrients for certain populations, especially the elderly. The elderly have so much trouble getting in extra nutrients and calories with their decreased food intake in many cases. I think it's more important to examine how to get more of these nutrients to the elderly through food than figuring out if they need more nutrients or not based on the RDAs (which few meet anyway).
Des makes an excellent point about stressing education and just getting people to meet the guidelines that are already in place. It's great to know the intricate details of precise nutrition, but as many mentioned before, most people don't even know what the RDAs are, much less really want to put that much effort into dissecting the nutrient content of their food. I still feel teaching recognition of meal patterns (I feel like I say this every month) like plenty of fruits and vegetables, less processed items, and lean meats, etc. would be much more practical for improving the health of our elderly population. Splitting hairs over micrograms of a nutrient which are supposedly optimal for health doesn't seem practical, when as Vivian mentioned, getting elderly individuals to simply eat enough nutrient dense foods is a challenge in itself. It is a very forward looking concept, however, there are issues right in front of us that need to be managed before we talk about raising a bar that typically isn't being met to begin with. Studies on the bioavailability and absorption capability changes in the elderly population seem a more likely way to distinguish what can be solved with dietary improvement and what needs supplementation or injection (i.e.B12). This would be relevant to all countries (considering the other questions this month) as an alert to what nutrients should be of concern, why they should be of concern, and what we can do about it in the elderly population.
I think that we are all critically evaluating this article's conclusions and certainly exposing limitations and recommendations for future practice and research. I love how we are able to brainstorm ideas for future studies based on the needs we see in dietetics practice and our current recommendations. The elderly population certainly poses interesting variables to intake levels and absorption, which I think we can all agree will be increasing topics of concern as the elderly population continues to grow in number.
Gina makes a great point about how the elderly have decreased absorption that would probably effect their vitamin and mineral absorption too. I do think that the elderly do need more nutrients, and I am not overly concerned about them facing toxicity levels. I think that it would be impossible to try to decide specifics on the vitamin and mineral requirements because it will vary from individual to individual. Like Viv had mentioned, I am not concerned with increasing the RDA for water soluble vitamins such as B-12 and C. I think we need additional research for this population. As the elderly population grows, it will become more important to be familiar with the nutrition concerns of this population.
I do not believe increasing the RDAs of vitamin B-12, A, and C, would be incredibly beneficial. Dietitians would most often be the healthcare professionals evaluating an elderly woman's micronutrient intake. In a situation of a client not getting enough micronutrients I would hypothesize that a RD would recommend increasing certain foods or supplementing with a vitamin. I would expect the recommendations given would exceed the RDA, so going through the process to raise the RDA might not be beneficial. In the situation of a client getting adequate micronutrients I believe a RD would still promote more nutritious food options, which again would exceed the RDA and not support raising the RDA.
I agree with what Gina mentioned- that focussing on education and increasing micronutrient intake in that fashion could be more appropriate.
I think that increasing the RDAs of vitamin B-12, A, and C would be somewhat beneficial because although the elderly population might not increase their consumption of these vitamins to the RDA values, it may increase overall consumption of these vitamins then current consumption averages. I think a better use of time and money would be spent on educating the elderly population on the importance of adequate consumption of vitamins such as B-12, A, and C. I agree with Des that the money that would be put into research of increasing the RDAs is much too great to deem appropriate. I also think Abby made a great point that as the elderly population grows proper RDA recommendations for this population will become even more important.
As is the general consensus of the responses of this post, I do believe that increasing the RDAs may be of some benefit. Vivian makes a good point about how people over the age of 50 years lose or have a decrease in ability to absorb vitamin B12. However, the one thing that comes to mind for me is whether this will actually benefit people. If we increase the RDA, does that mean that people will actually increase their intake? I think moreso what is needed is some kind of promotion of important micronutrients. I don't think people fully understand the imporyance of micronutrients and the role they play in the human body. Also, as Sophie mentions, RDs may actually exceed recommendations in their practice.
I feel that there definitely is a need for increased vitamin intake with respect to the aging process as Gina and others have pointed out and I do not see any harm with raising the RDAs for any of the vitamins including fat soluble Vitamin A. With that being said, I don't really see any benefit of making such slight changes to the RDAs; there certainly needs to be more research performed as well that takes into consideration biochemical values as well. Even if we are to increase the RDAs is this going to increase the level of consumption for these vitamins?? I definitely agree with what Carly has mentioned that there needs to be more efforts spent towards educating the elderly population (as well as their families) on the importance of a healthy diet and including all of the essential food groups. My guess is that many elderly folks are not even aware of what the MyPlate is considering it has changed so much for them. I think that this is the best place to start before increasing RDAs.
Post a Comment
<< Home