SEPTEMBER 2011 - "Health and wellness concepts for the different stages of a consumer’s life" was the title of a presentation by Christina Ehrhardt, global research manager for Cognis Nutrition and Health (North America). This talk was given in Chicago at theFood Technology, Innovation and Safety Summit last May.

In this speech, Ehrhardt explained specific nutritional needs which differ throughout various life stages. The particular groups of interest included pregnant women, infants, children and pre-teens, Baby Boomers and seniors.  (*Part I of this article provided an overview of the presentation pertaining to pregnancy; infancy and childhood.) Please see www.nutrasolutions.com

Several nutrients are necessary for health and wellness in young adults. In this age group, omega-3 fatty acid supplementation is associated with an improvement of attentional and physiological functions, particularly those involving complex cortical processing (1). These results were reported in 33 healthy active subjects who received 2.8g/day of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 35 days. Mood profiles characterized by increased vigor and reduced anger, anxiety and depression were also improved after supplementing with omega-3 fatty acids.

Lutein has proven to be beneficial for eye health in young adults exposed to lengthy computer usage. After 12 weeks of 6mg or 12 mg/day, lutein supplementation improved visual acuity following long-term computer display light exposure in 37 healthy subjects (aged from 22-30 years) (2). Contrast sensitivity increased with supplementation, suggesting that a higher intake of lutein may have beneficial effects on visual performance.

Several nutrients have been found to be advantageous in maintaining healthy and radiant skin, not only for young adults, but for Baby Boomers and seniors, as well. Supplementation with beta-carotene or the consumption of a carotenoid-rich diet provides moderate protection from UV-induced erythema, which is skin redness (3). In a placebo-controlled, parallel study design, volunteers (n =12 in each group) received beta-carotene (24mg/d from an algal source); 24mg/d of a carotenoid mix consisting of the 3 main dietary carotenoids, beta-carotene, lutein and lycopene (8mg/d each) or placebo for 12 weeks. The intensity of erythema 24 hours after skin irradiation was diminished in both groups that received carotenoids and was significantly lower than baseline after 12 weeks of supplementation. The protective effects of carotenoids are ascribed to their antioxidant activities, including the scavenging of reactive oxygen.  

Adults

Ehrhardt cited recent data from the Centers for Disease Control for the period 1999-2009, which identified a decline in the number of smokers and an improvement in the percentage of men participating in moderate physical activity. However, incidences of obesity, high cholesterol, diabetes and hypertension increased over the decade. Additionally, the percentage of men who ate 5 or more servings of fruits and vegetable per day decreased slightly. Several bioactives are being assessed to reduce the risk of cardiovascular diseases and assist in weight reduction.

Tonalin®, a trademarked form of conjugated linoleic acid (CLA), has been studied in Baby Boomers for its ability to reduce fat, while increasing muscle mass (4). In a double-blind, placebo-controlled trial, 118 overweight subjects were randomized into two groups supplemented with either 3 x 4g/day CLA or placebo for 6 months. CLA significantly decreased body mass fat (BFM) at month 3 and6, when compared with placebo. The reduction in fat mass was located mostly in the legs, and in women with a BMI >30kg/m2. The waist-hip ratio decreased significantly and lean body mass (LBM) increased within the CLA group. All changes were independent of diet and physical exercise.

Similar results were noted over a longer term (one year) assessment of CLA (Tonalin®) in 180 healthy overweight humans consuming an ad libitum diet (5). BFM in the CLA group was lower and LBM greater than that in the placebo group. Again, these changes were not associated with diet or exercise.

Plant sterols show significant potential to improve heart health in adults. Korpela et al. studied the effects of 2g/day of plant sterol intake in 82 mildly or moderately hypercholesterolemic subjects compared to the same number who received a placebo (6). Products containing the sterols were consumed for 6 weeks after a 3-week run-in period. There was a 6.5% reduction in serum total cholesterol, and low-density lipoprotein (LDL) cholesterol was reduced by 10.4%. The high-density lipoprotein (HDL)/LDL cholesterol ratio increased by 16.1% in the sterol group.

Plant sterol esters (PSE) in capsule form (1.3g of PSE/day) have been studied in free-living hypercholesterolemic subjects during a 4-week intervention period (7). Sixteen subjects participated in a double-blind, placebo-controlled, sequential study. In comparison to placebo, LDL-cholesterol was significantly reduced by 7% and 4% at both week 3 and week 4; HDL at week 3 of the PSE treatment was significantly increased by 9%, but not at week 4 (4%). Total cholesterol (TC) was not significantly different from placebo throughout the period, TC/HDL and LDL/HDL were significantly reduced by (8%, 8%, 6%, 10%, respectively) at both week 3 and week 4. To achieve better lipid-lowering results, higher plant sterol dosages and combination with diets low in saturated fat and cholesterol should be pursued.

The lipid-lowering effects of phytosterols may be enhanced with omega-3 long-chain polyunsaturated fatty acids (LCPUFA). A 3-week randomized, double-blind, placebo-controlled, study was conducted in 60 hyperlipidemic individuals who received 1.4g/day omega-3 LCPUFA capsules with or without 2g phytosterols per day, while maintaining their habitual diet (8). The combination of phytosterols and omega-3 LCPUFA reduced plasma total cholesterol by 13.3%; LDL-C concentrations decreased 12.5% and HDL-C levels increased by 8.6%. Plasma triglyceride concentration was lowered by omega-3 LCPUFA (22.3%) alone and in combination with phytosterols (25.9%).

Seniors

The role of nutritional supplementation in healthy aging has been extensively studied with strong health benefits supported for lutein and several vitamins, according to Ehrhardt. Lutein has been assessed for its effects on age-related macular degeneration (AMD), the leading cause of irreversible blindness in Western countries (9). Lutein and zeaxanthin exist in high concentrations in the macula of the eye and are hypothesised to play a protective role. Of 9 controlled trials of supplementation with carotenoids and other antioxidants, 3 suggested that various combinations of antioxidants and carotenoids were protective against AMD (9).

Ehrhardt described the effects of key vitamins for health and wellness, especially in the elderly population. According to the National Institutes of Health, atrophic gastritis, a condition affecting 10-30% of older adults, results in a decreased absorption of vitamin B12 (10). This is characterized by a reduction of hydrochloric acid in the stomach. Vitamin B12 deficiency causes tiredness, weakness, constipation, loss of appetite, weight loss and anemia. Nerve problems, such as numbness and tingling in the hands and feet, can also occur.  A potential connection between vitamin B12 deficiency and dementia and cognitive decline has also been reported (11).

Folateis a water-solubleB vitaminthat occurs naturally in food. Folic acidis the syntheticform of folate that is found in supplementsand added to fortifiedfoods. Folate helps produce and maintain new cellsand is required for normal red blood cell synthesis and to prevent anemia. Folate is also essential for the metabolismof homocysteineand helps maintain normal levels of this amino acid (12).

In adults, signsof folate deficiency include diarrhea, loss of appetite, and weight loss, as well as weakness, headaches, heart palpitations, irritability, forgetfulness, and behavioral disorders. An elevated level of homocysteine in the blood, a risk factorfor cardiovascular disease, also can result from folate deficiency (13). Elevated homocysteine levels may impair endothelial vasomotorfunction, which determines blood flows through vessels. High levels of homocysteine can damage coronary arteries and increase the risk of thrombosis (blood clotting), which may lead to a heart attack.

A deficiency of folate, vitamin B12 or vitamin B6 may increase blood levels of homocysteine, and folate supplementation has been shown to decrease homocysteine levels and to improve endothelial function. Low dietary folate intake is associated with an increased risk of coronary events (14). Older adults are encouraged to consume folic acid-fortified foods and supplements as a strategy for reducing homocysteine concentrations and the risk of cardiovascular disease (15).

Vitamin D is necessary for maintaining many aspects of health during aging and is best recognized for its role in maintaining strong bones through enhancing calcium absorption. The National Health and Nutrition Examination Survey (NHANES), 2005–2006, estimated vitamin D intakes from both food and dietary supplements and found that the use of dietary supplements was a very important source among older women. However, seniors were still not consuming enough vitamin D. For women aged 51–70 years, mean intake of vitamin D from foods alone was 156 IU/day and 404 IU/day with supplements. For women >70 years, the corresponding intake levels were 180 IU/day to 400 IU/day (16). The recommended dietary levels for these age groups are 600 IU and 800 IU, respectively (17).

Older adults are at increased risk of developing vitamin D insufficiency because their skin is not efficient at synthesizing vitamin D when exposed to sunlight, and their kidneys are less able to convert vitamin D to its active form. This may lead to the development of soft, thin and brittle bones (osteomalacia). Vitamin D is also being studied for its possible beneficial effects in diabetes, hypertension, autoimmune disorders and cancer (18).

Nutrition research supports the necessity of particular omega-3 fatty acids, lutein, CLA, plant sterols, vitamin D, and B vitamins to maintain health and reduce disease in early adulthood, for Baby Boomers and seniors. Work is ongoing to better understand the optimal requirements of these micronutrients for all life stages, although it is clear that important roles in overall health and development have been established.  NS

References:

1.         Fontani, G, Corradeschi, F,  Felici, A. et al. 2005. Cognitive and physiological effects of omega-3

polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 35(11):691–699.

2.         Ma, L, Lin, X-M, Zou, Z-Z, et al. 2009. 12-week lutein supplementation improves visual function in Chinese people with long-term computer display light exposure. 102: 186–190.

3.        Heinrich, I, Gartner, C,  Wiebusch, M, et al. 2003.  Supplementation with beta-carotene or a similar amount of mixed carotenoids protects humans from UV-induced erythema. J. Nutr. 133: 98–101.

4.         Gaullier,JM, Halse, J, Høivik, HO, et al. 2007. Six months supplementation with conjugated linoleic acid induces regional-specific fat mass decreases in overweight and obese. Br J Nutr. 97(3):550-60.

5.         Gaullier,JM, Halse, J, Høye, K, et al. 2004. Conjugated linoleic acid supplementation for 1 y reduces body fat mass in healthy overweight humans. Am J Clin Nutr.79(6):1118-25.

6.             Korpela,R, Tuomilehto, J, Högström, P, et al. 2006. Safety aspects and cholesterol-lowering efficacy of low fat dairy products containing plant sterols.Eur J Clin Nutr. 60(5):633-42.

7.         Acuff, RV, Cai, DJ, Dong, ZP, Bell, D. 2007.  The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis. 6:11.

8.         Micallef, MA and Garg, ML. 2008.  The lipid-lowering effects of phytosterols and (n-3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women. J. Nutr. 138:1086–1090.

9.         Guymer, RH and Chong, EW. 2006. Modifiable risk factors for age-related macular degeneration Med. J Aust. 184:455–458.

10.        National Institutes of Health. 2011. Vitamin B12 Fact Sheet. Available at: http://ods.od.nih.gov/factsheets/VitaminB12-QuickFacts/(accessed August 10, 2011)

11.        Carmel, R. Prevalence of undiagnosed pernicious anemia in the elderly. 1996. Arch Intern Med. 156:1097-100.

12.        Zittoun,  J. 1993. Anemias due to disorder of folate, vitamin B12 and transcobalamin metabolism. Rev Prat. 43:1358-63.

13.        Haslam, N and Probert , CS. 1998. An audit of the investigation and treatment of folic acid deficiency. J R Soc Med. 91:72-3.

14.        Doshi, SN, McDowell , IF, Moat, SJ, et al. 2002. Folic acid improves endothelial function in coronary artery disease via mechanisms largely independent of homocysteine. Circ. 105:22-6.

15.        Schnyder, G., Roffi M, Pin R, et al. 2001. Decreased rate of coronary restenosis after lowering of plasma homocystein levels. N Eng J Med. 345:1593-60.

16.        Bailey, RL, Dodd, KW, Goldman, JA, et al. 2010. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr. 140:817-822.

17.        Institute of Medicine, Food and Nutrition Board. 2010. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press.

18.        Chung, M, Balk, EM, Brendel, M, et al. 2009. Vitamin D and calcium: a systematic review of health outcomes. Evidence Report/Technology Assessment No. 183 prepared by the Tufts Evidence-based Practice Center under Contract No. 290-2007-10055-I. AHRQ Publication No. 09-E015. Rockville, MD: Agency for Healthcare Research and Quality.

(*The first part of this article titled, “Nutrition for the Health and Wellness Lifecycle (Part I)*: Nutrient Needs for Pregnancy Through Teen Years,  provided an overview of this presentation pertaining to pregnancy; infancy and childhood; see www.nutrasolutions.com