Study: High-Dose Vitamin D Won’t Prevent Seniors’ Falls

High doses of vitamin D may increase seniors’ risk of falls, rather than reduce it, according to a new study.

Preliminary studies suggested vitamin D may increase muscle strength and improve balance, so Johns Hopkins researchers investigated whether high doses of vitamin D might reduce the risk of falls in people aged 70 and older.

But the investigators found that large doses of vitamin D supplements were no better at preventing falls in this age group than a low dose.

“There’s no benefit of higher doses but several signals of potential harm,” study author Dr. Lawrence Appel said in a Hopkins news release.

“A lot of people think if a little bit is helpful, a lot will be better. But for some vitamins, high-dose supplements pose more risks than benefits. There’s a real possibility that higher doses of vitamin D increase the risk and severity of falls,” said Appel, a professor of medicine with joint appointments in epidemiology, international health and nursing.

Taking 1,000 or more international units per day (IU/day), equivalent to 25 micrograms/day of vitamin D, was no better than 200 IU/day at preventing falls, according to the study, which was funded by the U.S. National Institute on Aging.

The results were published Dec. 8 in the journal Annals of Internal Medicine.

The researchers also found that vitamin D supplement doses of 2,000 and 4,000 IU/day seemed to increase the risk and severity of falls compared with 1,000 IU/day, a relatively common dose for a pure vitamin D supplement.

Another finding was that serious falls and falls that required hospitalization occurred more often in older people who took 1,000 or more IU/day than in those who took 200 IU/day (about half the typical dose found in multivitamins).

Older folks should talk with their doctors about their fall risk and vitamin D levels in order to determine whether or not to continue taking vitamin D supplements, Appel recommended.

Source: HealthDay

Fish Oil and Vitamin D Supplements Not Effective for Preventing Atrial Fibrillation

Taking omega-3 fatty acids and vitamin D3 supplements does not neither increase nor decrease the risk of developing atrial fibrillation, according to late-breaking research presented today at the American Heart Association’s Scientific Sessions 2020. The virtual meeting is Friday, November 13 – Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.

Atrial fibrillation is a rapid, irregular heartbeat caused by chaotic electrical signals in the top chambers of the heart. Atrial fibrillation is the most common heart rhythm disturbance, and it can lead to blood clots, strokes, heart failure and other heart-related complications. Atrial fibrillation risk increases with age, high blood pressure and heavy drinking and can be common among multiple, biologically related family members.

Evidence from previous observational studies has been conflicting, suggesting both risks and potential health benefits of fish oil – a source of omega-3 fatty acids – and vitamin D for atrial fibrillation.

“Once established, atrial fibrillation is difficult to treat and results in symptoms that can impair patients’ quality of life,” said Christine M. Albert, M.D., M.P.H., founding chair of the department of cardiology in the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles and lead author of this study. “Current treatment options have limited long-term success and significant risks, and there is a pressing need for preventive strategies.”

The VITAL Rhythm Trial is the first, placebo-controlled, randomized clinical trial investigating preventive therapies for atrial fibrillation. This trial evaluated whether supplementation with vitamin D3 (2000 IU/day) and omega-3 fatty acids (EPA:DHA in 1.2:1 ratio; 840mg/day) can reduce the risk of developing atrial fibrillation compared to placebo.

The five-year study, from 2012 – 2017, included 25,119 adults, ages 50 and older who had no history of atrial fibrillation. About half of the participants were female, 21% were black, and the average age was 67. Atrial fibrillation diagnoses were established both by participant self-report and claims data from the Centers for Medicare and Medicaid Services. Electrocardiogram evidence and/or a physician’s report documenting a new diagnosis of atrial fibrillation were required for confirmation.

During the trial follow-up period, 900 participants developed atrial fibrillation, 3.6% of the study population. There were no statistically significant differences between the groups who were assigned to supplemental EPA/DHA and/or vitamin D3 compared to individuals who were assigned to the placebo.

Albert added, “With regards to clinical care, these results do not support using marine omega-3 fatty acids or vitamin D to prevent atrial fibrillation. However, the results do provide reassurance that these supplements do not increase the overall risk of atrial fibrillation and appear to be generally safe for patients who are taking these supplements for other reasons.”

Source: American Heart Association

Compared to Placebo, Vitamin D Has No Benefit for Asthma

Contrary to earlier results, vitamin D supplements do not prevent severe asthma attacks in at-risk children, according to the first placebo-controlled clinical trial to test this relationship.

These results were published today in JAMA.

Juan Celedon release “The reason that’s important is there are colleagues around this country and worldwide who are testing vitamin D levels for kids with asthma and giving them vitamin D,” said study lead author Juan C. Celedón, M.D., Dr.P.H., chief of pediatric pulmonary medicine at UPMC Children’s Hospital of Pittsburgh. “As a system, it costs a lot of money to run all these tests and give the supplements. We’ve shown no benefit for children with moderately low vitamin D levels.”

For three years, the Vitamin-D-Kids Asthma (VDKA) Study followed nearly 200 children ages 6 to 16 across seven different U.S. hospital systems. All had at least one asthma attack during the year before the study began.

Half of the participants were randomized to receive 4,000 IU of vitamin D per day, and the other half got placebo pills. No one involved in the study knew which type of pill each participant was getting.

All of the children had vitamin D levels low enough that supplements should have an effect — if vitamin D truly is beneficial for reducing severe asthma attacks — but the study excluded children with severe vitamin D deficiency because it would be unethical to withhold it in those cases.

Compared to placebo, vitamin D did not reduce the number of asthma attacks participants experienced or their reliance on inhaled steroids.

That’s different from what was seen in the past with observational studies in Costa Rica, the U.S. and Canada, and Puerto Rico, where children with naturally low vitamin D levels seemed to have worse asthma.

“With observational studies, you never know — is vitamin D causing asthma to be worse or do kids with worse asthma end up having lower vitamin D?” said Celedón, who also holds the Niels K. Jerne chair of Pediatrics at the University of Pittsburgh School of Medicine.

Even with the rigor of the present study’s design, Celedón acknowledges that he can’t draw conclusions about whether very low vitamin D levels contribute to asthma attacks, but he argues that those children would be supplemented either way because of known effects on bone health.

Source: UPMC

Global Gut Health Experts Guide Growth of Synbiotics

Lauren Quinn wrote . . . . . . . . .

Chances are you’ve heard of or even taken probiotics: supplements delivering “good microbes” to the gut, providing a wide range of health benefits. If you’re really up on your gut health, you may also be aware of prebiotics: supplements designed to fuel the good microbes already living in our guts.

The next wave of gut-health supplements, known as synbiotics, essentially combine pre- and probiotics. To keep research and development efforts on the right track, an international panel of experts – including two from the University of Illinois – recently redefined the term and developed guidelines on the scientific investigation of the supplements.

The consensus report, published in Nature Reviews: Gastroenterology & Hepatology, is expected to serve as the definitive reference in the development of new synbiotic products.

“Synbiotics are starting to gain traction in the marketplace, but there’s a lot of confusion around the term, even among scientists,” says Kelly Swanson, consensus panel chair and professor in the Department of Animal Sciences at Illinois. “The panel’s main goal was to clarify what synbiotics are and provide guidance for future research and innovation.”

The general idea of synbiotics was first proposed in 1995 when prebiotics were defined. But the concept was left open to interpretation, and since the U.S. Food and Drug Administration regulates supplements loosely, companies can sell products that may or may not provide health benefits.

“This consensus statement provides guidance for different stakeholders, including scientists in academia and industry, consumers, and even journalists. We want to remind each group that these terms should be used consistently, avoiding sensationalizing or overstating health claims,” says Hannah Holscher, panel member and assistant professor in the Department of Food Science and Human Nutrition at Illinois.

The updated definition for synbiotics is “a mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host.”

The terms prebiotic and probiotic have their own definitions and standards. By omitting those specific terms from the definition of synbiotic, the expert panel allows for the use of microorganisms and selectively utilized substrates that may work together to elicit a health benefit but may not fit the definitions of pre- and probiotics when administered independently.

“The old definition of synbiotic included pre- and probiotics, which may have restricted innovation,” Holscher explains.

Pre- and probiotics can still be combined under the new definition, as long as they’re tested together and shown to still provide positive, if not necessarily related, health outcomes. For example, a prebiotic might aid in digestive health while a probiotic may boost immunity after a flu vaccine. As long as they still provide those benefits in the host, they can be considered complementary synbiotics.

“The key there is testing. Even if the pre- and probiotics work separately, there could be some antagonism when put together. So really, they need be tested together in the target animal or human. We don’t want companies just randomly throwing things together,” Swanson says.

In contrast, the ingredients in synergistic synbiotics are additive, working together to produce a single, targeted health benefit. These are most likely to be made with novel ingredients not already categorized under the current definitions of pre- and probiotics.

“In synergistic synbiotics, the substrate would support probiotic survival,” Holscher says. “For example, providing an energy source for the probiotic or changing the microbiome to support the survival of the probiotic.”

In either case, testing the ingredients together is critical. The consensus panel lays out testing protocols for multiple hosts, including humans, pets, and livestock animals, and encourages researchers to consider the effects of age, health status, sex, and other important factors.

With better guiding documentation, the market for synbiotics is likely to grow. But before plunging into the new supplements, the researchers advise consumers to consult with medical professionals to choose the right product for their specific needs.

“Just because there’s a pre-, pro-, or synbiotic on the market, that doesn’t mean they’ll work across the board from infants to adults to geriatrics, from heart disease to gastrointestinal health. They’re all really there for a specific purpose,” Swanson says.

Holscher adds, “The question is not whether you should take a pre-, pro-, or synbiotic. The question is, ‘what do you need those products to do?’ We know a lot about the specific health outcomes of these products, so it’s a matter of finding what you need rather than thinking of them as a blanket cure-all.”

Source: University of Illinois at Urbana-Champaign


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Multivitamin, Mineral Supplement Linked to Less-severe, Shorter-lasting Illness Symptoms

Older adults who took a daily multivitamin and mineral supplement with zinc and high amounts of vitamin C in a 12-week study experienced sickness for shorter periods and with less severe symptoms than counterparts in a control group receiving a placebo.

The findings by Oregon State University researchers were published in the journal Nutrients.

The research by scientists at OSU’s Linus Pauling Institute involved 42 healthy people ages 55 to 75 and was designed to measure the supplement’s effects on certain immune system indicators. It also looked at bloodstream levels of zinc and vitamins C and D while taking the supplement, as these micronutrients are important for proper immune function.

The immune indicators, including white blood cells’ ability to kill incoming pathogens, were unaltered in the group receiving the supplement.

The multivitamin group showedimproved vitamin C and zinc status in the blood. Most intriguingly, illness symptoms reported by this group were less severe and went away faster than those experienced by the placebo group.

The same percentage of participants in each group reported symptoms, but days of sickness in the supplement group averaged fewer than three compared to more than six for the placebo group.

“The observed illness differences were striking,” said corresponding author Adrian Gombart, professor of biochemistry and biophysics in the OSU College of Science and a principal investigator at the Linus Pauling Institute. “While the study was limited to self-reported illness data and we did not design the study to answer this question, the observed differences suggest that additional larger studies designed for these outcomes are warranted – and, frankly, overdue.”

As people get older, the risk of vitamin and mineral deficiencies that contribute to age-related immune system deficiencies rises. Across the United States, Canada and Europe, research suggests more than one-third of older adults are deficient in at least one micronutrient, often more than one.

“That likely contributes to a decline in the immune system, most often characterized by increased levels of inflammation, reduced innate immune function and reduced T-cell function,” Gombart said. “Since multiple nutrients support immune function, older adults often benefit from multivitamin and mineral supplements. These are readily available, inexpensive and generally regarded as safe.”

The multivitamin supplement used in the study focused on vitamins and minerals typically thought to help immunity. It contained 700 micrograms of vitamin A; 400 international units of vitamin D; 45 milligrams of vitamin E; 6.6 milligrams of vitamin B6; 400 micrograms of folate; 9.6 micrograms of vitamin B12; 1,000 milligrams of vitamin C; 5 milligrams of iron; 0.9 milligrams of copper; 10 milligrams of zinc; and 110 micrograms of selenium.

“Supplementation was associated with significantly increased circulating levels of zinc and vitamin C, and with illness symptoms that were less severe and shorter lasting,” Gombart said. “This supports findings that stretch back decades, even to the days of Linus Pauling’s work with vitamin C. Our results suggest more and better designed research studies are needed to explore the positive role multivitamin and mineral supplementation might play in bolstering the immune system of older adults.”

Source: Oregon University