Plain language summary
Increasing life-expectancy and consequently the incidence of age-related diseases is one main challenge for health systems. Elderly people are often at risk for inadequate nutrient supply due to physiological, metabolic, and age-associated factors affecting nutrient and fluid intake. The main aim of this study was to evaluate the plasma status of ten fat soluble micronutrients in a cohort of institutionalized elderly. A secondary aim was to investigate the effect of six months of either strength training, strength training and a protein-vitamin supplement, or a cognitive intervention on their plasma status. The study is a secondary analysis of the ‘Vienna Active Ageing Study’. One hundred and seventeen institutionalized elderly women and men (aged 65–98 years) were recruited. The participants were randomly assigned into three intervention groups—cognitive training, resistance training (RT), RT + supplement, and stratified for gender in a randomised, controlled, observer-blind design. Results show a diverse plasma status of fat soluble micronutrients in old institutionalised elderly; appropriate for retinol, improvable for alpha-tocopherol, and not satisfying for beta-carotene. Furthermore, the effect of six months training intervention with or without protein-vitamin supplementation improved physical function, but it was very moderate on the status of fat soluble micronutrients. Authors conclude that their findings encourage a stronger focus on the supply of nutrient dense plant food in this age group in order to obtain sufficient micronutrient levels or, if not otherwise possible such as for vitamin D, to use specific supplements.
Abstract
BACKGROUND Institutionalized elderly are at higher risk for micronutrient deficiency. In particular, fat soluble micronutrients, which additionally have antioxidative function, are of interest. The purpose of this secondary investigation of the Vienna Active Ageing Study was to assess and evaluate the plasma status of retinol, alpha- and gamma-tocopherol, alpha- and beta-carotene, lutein, zeaxanthin, beta-cryptoxanthin, and lycopene, as well as vitamin D (25(OH)D) in a cohort of institutionalized elderly. We further determined the effect of six months strength training with or without supplementing (antioxidant) vitamins and protein on the plasma status of these ten micronutrients. METHODS Three groups (n = 117, age = 83.1 ± 6.1 years)-resistance training (RT), RT combined with protein and vitamin supplementation (RTS), or cognitive training (CT)-performed two guided training sessions per week for six months. Micronutrients were measured with High Performance Liquid Chromatography (HPLC) at baseline and after 6 months of intervention. Physical fitness was assessed by the 6-min-walking, the 30-s chair rise, isokinetic dynamometry, and the handgrip strength tests. RESULTS At baseline, the plasma status of retinol was satisfactory, for alpha-tocopherol, beta-carotene, and 25(OH)D, the percentage of individuals with an insufficient status was 33%, 73% and 61%/81% (when using 50 nmol/L or 75 nmol/L as threshold levels for 25(OH)D), respectively. Plasma analyses were supported by intake data. Six months of elastic band resistance training with or without protein-vitamin supplementation had no biological impact on the status of fat soluble micronutrients. Even for vitamin D, which was part of the nutritional supplement (additional 20 µg/d), the plasma status did not increase significantly, however it contributed to a lower percentage of elderly below the threshold levels of 50/75 nmol/L (49%/74%). CONCLUSIONS The findings of the study lead to the strong recommendation for regular physical activity and increased consumption of plant-based foods in institutionalized elderly. When supported by blood analysis, supplementing micronutrients in a moderate range should also be considered.
Methodological quality
Jadad score
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3
Allocation concealment
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Yes
