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PubMed1997

Intake of selected micronutrients and risk of colorectal cancer.

The relationship between various micronutrients and colorectal cancer risk was investigated using data from a case-control study conducted between January 1992 and June 1996 in Italy. Cases were 1,953 incident, histologically confirmed colorectal cancers (1,225 of the colon and 728 of the rectum), admitted to the major teaching and general hospitals in the study areas, and 4,154 controls with no history of cancer, admitted to hospitals in the same catchment areas for acute, non-neoplastic diseases unrelated to the digestive tract and requiring no long-term modifications of the diet. Dietary habits were investigated using a validated food-frequency questionnaire. Odds ratio (ORs) were computed after allowance for age, sex and other potential confounding factors, including physical activity, total energy and fibre intake. For most micronutrients, ORs were below unity with increasing quintile of intake. The most consistent protective effects were for carotene, riboflavin and vitamin C (Multivariate ORs from the continuous model, with unit set as the difference between the upper cut-point of the 4th quintile and that of the 1st one, were 0.65, 0.73 and 0.80, respectively). Inverse relationships were observed also for calcium and vitamin D (ORs of 0.85 and 0.93, respectively). When the combined effect of calcium and vitamin D and selected anti-oxidants was considered, the OR reached 0.46 in subjects reporting high calcium/vitamin D and high anti-oxidant intake compared to those reporting low intake of both groups of micronutrients. Most results were apparently stronger for colon cancer and among females. Our results provide further support for a protective effect of several micronutrients on colorectal cancer risk and some indications for a specific and stronger effect of selected anti-oxidants.

Adult↗
PubMed2006

The Nutrition, Aging, and Memory in Elders (NAME) study: design and methods for a study of micronutrients and cognitive function in a homebound elderly population.

BACKGROUND: Micronutrient status can affect cognitive function in the elderly; however, there is much to learn about the precise effects. Understanding mediating factors by which micronutrient status affects cognitive function would contribute to elders' quality of life and their ability to remain in the home. OBJECTIVES: The Nutrition, Aging, and Memory in Elders (NAME) Study is designed to advance the current level of knowledge by investigating potential mediating factors by which micronutrient status contributes to cognitive impairment and central nervous system abnormalities in the elderly. NAME targets homebound elders because they are understudied and particularly at risk for poor nutritional status. METHODS: Subjects are community-based elders aged 60 and older, recruited through area Aging Services Access Points. The NAME core data include demographics; neuropsychological testing and activities of daily living measures; food frequency, health and behavioral questionnaires; anthropometrics; gene status; plasma micronutrients, homocysteine, and other blood determinants. A neurological examination, psychiatric examination, and brain MRI and volumetric measurements are obtained from a sub-sample. RESULTS: Preliminary data from first 300 subjects are reported. These data show that the NAME protocol is feasible and that the enrolled subjects are racially diverse, at-risk, and had similar basic demographics to the population from which they were drawn. CONCLUSION: The goal of the NAME study is to evaluate novel relationships between nutritional factors and cognitive impairment. These data may provide important information on potential new therapeutic strategies and supplementation standards for the elderly to maintain cognitive function and potentially reduce the public health costs of dementia.

Activities of Daily Living↗
PubMed2003

[Antioxidant micronutrients and cataract. Review and comparison of the AREDS and REACT cataract studies].

Age-related cataract remains the major cause of preventable blindness throughout the world. It has long been realized that one of the important etiological factors for this disease is oxidative and in particular photooxidative damage to the lens. Therefore, the antioxidant micronutrients, vitamins C and E and the carotenoids, in particular beta-carotene, have been discussed as factors that could reduce the risk for this disease. The present article reviews what is known about the transport of these substances to the lens, their accumulation, and their concentrations in the lens. Furthermore, the available epidemiological literature is briefly mentioned, but more emphasis has been placed on a description and discussion of major clinical intervention studies. Finally, the design and results of two of those trials using antioxidant micronutrients, the Age-Related Eye Disease Study (AREDS) and the Roche European American Cataract Trial (REACT), are compared. The AREDS trial did show a positive effect only for age-related macular degeneration but not for cataract, while the REACT trial demonstrated a small but statistically significant deceleration of cataract progression. The techniques for following the course of a cataract in the REACT study were more sensitive to subtle changes than those used in the AREDS study, and this may have been one important factor accounting for the differences. The authors' detailed comparison of these studies, however, suggests that even more important may have been the fact that in the REACT study intervention started earlier in the disease process,with higher doses of vitamins C and E and beta-carotene and consequently with larger plasma concentrations of these antioxidant micronutrients. The REACT trial results support the early complementation of a diversified diet with supplements containing vitamins C and E and beta-carotene as well as other carotenoids. The authors also believe that it is reasonable to include these micronutrients in the therapeutic armamentarium of general ophthalmological practice.

Animals↗
PubMed2004

Micronutrient intake during pregnancy in relation to birth size.

BACKGROUND: There exists very little information on possible effects on birth size of micronutrient intakes at levels that are usually encountered among pregnant women in developed countries. AIM OF THE STUDY: To examine the relation of the intake of 20 micronutrients with birth weight, placental weight, birth length and head circumference of the offspring. METHODS: In a cohort of 222 Caucasian women with singleton pregnancies in Boston, USA, diet during pregnancy was ascertained at the 27th gestational week through a validated semi-quantitative food frequency questionnaire, covering also intake of dietary supplements. Micronutrient intakes were correlated with birth size parameters after adjustment for confounding variables, including total energy intake. RESULTS: Pantothenic acid, sodium and vitamin E were positively associated with all four birth size parameters. For pantothenic acid the association was statistically significant with respect to birth length, whereas for sodium with respect to head circumference and for vitamin E with respect to birth weight. In contrast, zinc was inversely associated with all four birth size parameters and the association was statistically significant with respect to head circumference. CONCLUSIONS: In a moderately sized prospective study, we found evidence that pregnancy intake of pantothenic acid, vitamin E and sodium may be positively related with at least one of the studied birth size parameters, whereas an inverse association was found with respect to zinc intake. For the remaining 16 micronutrients, our findings indicate that they are not associated with birth size, at least within the range of intake encountered in this investigation. The results of this exploratory analysis need to be confirmed before pathophysiologic interpretations and generalizations are attempted.

Adolescent↗
PubMed2004

US youths in the early stages of HIV disease have low intakes of some micronutrients important for optimal immune function.

OBJECTIVE: We examined the association between micronutrient intakes and human immunodeficiency virus (HIV) infection in youths who were at increased nutritional risk because of the demands of growth and disease as well as poor dietary habits. DESIGN: This was a cross-sectional study to collect dietary intake data using the Block Food Frequency Questionnaire (98.2). Anthropometric, biochemical, clinical, and sociodemographic data were available.Subjects/Setting Participants included 264 HIV-infected and 127 HIV-uninfected adolescents and young adults from the Reaching for Excellence in Adolescent Care and Health network, a multisite observational study on HIV progression. Statistical analyses CD4(+) T cells were stratified for HIV-infected youths: >/=500, 200 to 499, and <200 cells/microL. Micronutrient intakes were compared by presence of HIV infection, using two-sample Student's t tests. Categoric analyses used chi(2) test. Generalized linear regression determined predictors of vitamins A, C, and E; iron; and zinc intakes. RESULTS: Almost half (49.0%) of the HIV-infected participants had CD4(+) T cells >/=500 cells/microL. After controlling for other factors, HIV-infected participants with CD4(+) T cells >/=500 had decreased iron intake (P<.05) and tended to be associated with lower intakes of vitamins C and E (P<.10) compared with those with more advanced disease and HIV-uninfected youths. Among those youths with CD4(+) T cells between 200 and 499 cells/microL, a high anxiety score was associated with a sixfold increase in vitamin A intake as compared with those with a low score.Applications/conclusions Given the increased micronutrient requirements, nutrition counseling with HIV-infected youths should focus on early increase of intake of foods rich in micronutrients to improve growth, slow disease progression, and increase survival.

Adolescent↗
PubMed1999

Micronutrients, vitamins, and cancer risk.

There is now considerable evidence that a high intake of fruit and vegetables can decrease the risk of developing cancer. While it is by no means clear how this particular diet alters cancer risk, there is substantial metabolic and experimental evidence to implicate antioxidant micronutrients, The dietary components include some vitamins, such as C and E, the carotenoids, and the flavinoids. In chemical systems, cell culture, and experimental animals, these components have the ability to quench the carcinogenic potential of reactive oxygen species and other carcinogens, such as N-nitrosocompounds. Some of these micronutrients can act synergistically, and high concentrations are often found in tissues, such as the leucocytes and mucosal cells, that are particularly prone to reactive species attack. Experimental systems containing these micronutrients also appear to be able to reduce DNA damage and mutagenesis. However, assessment of individual vitamin intake, as opposed to fruit and vegetable consumption, does not increase the protective association of these components, and the results of intervention studies in man, especially with carotenoids, have been disappointing. We await the results of other clinical trials, but as yet, there is insufficient evidence to recommend supplements of these particular micronutrients for the prevention of cancer. However, it would be prudent to suggest changes in diet that would increase consumption of fruit and vegetables, such as a diet is clearly associated with protection.

Anticarcinogenic Agents↗
PubMed1997

Micronutrients, dietary questionnaires and cancer.

There is increasing evidence that many chemicals, although present in the diet at only low levels, play an important role in protection against cancer. Micronutrients are defined as nutrients present in the body in amounts less than 0.005% of body weight. Some micronutrients suggested to play a protective role in cancer are beta-carotene, vitamin E and vitamin C. In addition to those chemicals with an established role in nutrition, there is also a less well-defined group of chemicals, often referred to as phytochemicals, which may prove even more important. Examples here are a group of sulphur-containing chemicals present in brassicaceous vegetables, such as broccoli and cabbage, that appear to be very effective anticarcinogens. Epidemiology will be essential in accurately defining the role of phytochemicals and micronutrients in cancer. However, the large prospective studies that would be most desirable increasingly utilize food frequency questionnaires containing a limited number of questions. Such an approach has been well validated for macronutrients. However, there is often less accurate information available on micronutrients and phytochemicals, and the food combinations necessary (and acceptable) for macronutrients may be inappropriate for these other factors. It would be most desirable that fruits and vegetables are individually itemized or grouped according to plant families rather than macronutrient status. This may be the most appropriate way of identifying potentially novel protective factors in the diets of countries such as Morocco or New Zealand.

Anticarcinogenic Agents↗
PubMed2003

Micronutrient intakes of wild primates: are humans different?

Low micronutrient intake is implicated in a diversity of human health problems, ranging from problems associated with food insufficiency to those associated with food over-consumption. Humans are members of the order primates, suborder anthropoidea, and are most closely related to the great apes. Humans and apes are remarkably similar biologically. In the wild, apes and monkeys consume diets composed largely of plant foods, primarily the fruits and leaves of tropical forest trees and vines. Considerable evidence indicates that the ancestral line giving rise to humans (Homo spp.) was likewise strongly herbivorous (plant-eating). The wild plant parts consumed by apes and monkeys show moderate to high levels of many minerals and vitamins. The estimated daily intake of specific minerals, vitamin C and some other vitamins by wild primates is often quite high in comparison to intake levels of these same micronutrients recommended for humans. Are the high micronutrient intakes of wild primates simply a non-functional, unavoidable by-product of their strongly plant-based diets or might they actually be serving important as yet undetermined immunological or other beneficial functions? A better understanding of the basis for this apparent difference between humans and wild primates could help to clarify the range and proportions of micronutrients best suited for optimal human development, health and longevity.

Animal Feed↗
PubMed2000

Micronutrient and iron supplementation and effective antimalarial treatment synergistically improve childhood anaemia.

The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of >/= 90%. The mean haemoglobin (Hb) level increased by 8 g/l more in children on supplement (95% CI 3-12) during the 5-month study. All age groups benefited from the intervention including severely anaemic subjects. The mean erythrocyte cell volume (MCV) increased but Hb in children >/= 24 months improved independently of MCV and no relation was found with hookworm infection. The data therefore suggest that micronutrients other than iron also contributed to Hb improvement. In the supplement group of children who had received sulfadoxine-pyrimethamine (SP) treatment, the mean Hb level increased synergistically by 22 g/l (95% CI 13-30) compared to 7 g/l (95% CI 3-10) in those without such treatment. Supplementation did not affect malaria incidence. In conclusion, micronutrient supplementation improves childhood anaemia in malaria holoendemic areas and this effect is synergistically enhanced by temporary clearance of parasitaemia.

Anemia, Iron-Deficiency↗
PubMed2002

Predictors of micronutrient status in men and women over 75 years old living in the community.

Serum ferritin, serum vitamin B12, erythrocyte folate, plasma vitamin C and plasma 25-hydroxycholecalciferol levels were measured in 208 men and 197 women, >75 years old and living in the community, in order to assess micronutrient status. Anthropometric measurements (height, weight, demispan and mid-upper arm circumference) were made and a 114-item questionnaire covering a wide range of health and diet-related topics was administered by an interviewer. Only 4 % of subjects had a BMI <20, but the prevalence of marginal deficiency of the micronutrients ranged from 7 % for Fe to 47 % for vitamin D. There was no association between low micronutrient status (defined as being in the lowest third of the distribution of micronutrient status) and having BMI or mid-upper arm circumference in the lowest third of the distribution for any of the nutrients. Leaving food on the plate was strongly associated with both low Fe status and low vitamin D status. Having breakfast cereal less than once per week was strongly associated with low folate status, while having fresh fruit juice less than once per week, having had less than two portions of fruits and vegetables the previous day and believing that food is not important for health were strongly associated with low vitamin C status. Low vitamin D status was strongly associated with a wide range of general health and disability measures. Having a weekly household income of less than pound 150 was associated with low status of Fe, folate, vitamin C and vitamin D.

Aged↗
PubMed2005

Micronutrients and Alzheimer's disease.

The current high life expectancy is overshadowed by neurodegenerative illnesses that lead to dementia and dependence. Alzheimer's disease (AD) is the most common of these conditions, and is considered to be a proteinopathy, with amyloid-beta42 as a key factor, leading via a cascade of events to neurodegeneration. Major factors involved are oxidative stress, perturbed Ca homeostasis and impaired energy metabolism. Protection against oxidative stress by micronutrients (including secondary bioactive substances) has been shown in transgenic Alzheimer model systems to delay AD. Epidemiological evidence is less conclusive, but the vast majority of the evidence supports a protective effect on cognitive functions in old age and AD. Thus, a diet rich in fruits and vegetables but also containing meat and fish is the most suitable to provide adequate micronutrients. The strong link between cardiovascular risk and AD may be explained by common pathogenetic mechanisms mediated, for example, by homocysteine and thus dependant on B-vitamins (folate and vitamins B(12) and B(6)). However, micronutrients may also be harmful. The high affinity of amyloid for metals (Fe, Al and Zn) favours the generation of reactive oxygen species and triggers an inflammatory response. Micronutrients in a balanced diet have a long-lasting, albeit low, protective impact on brain aging, hence prevention should be life long.

Aging↗
PubMed2004

Micronutrient deficiencies as predisposing factors for hypertension in lacto-vegetarian Indian adults.

OBJECTIVE: With the increasing knowledge about the antioxidant potential of many micronutrients such as zinc and vitamin C, their roles in oxidative stress related health disorders have been postulated. This study therefore investigated low micronutrient status as a predisposing factor for hypertension in a traditionally lacto-vegetarian population like Indians. METHODS: Micronutrient profile was assessed in 109 hypertensives with age-gender-socio-economic status matched 115 healthy normotensives (30-58 years of age). Food intakes were estimated through a semi-quantitative food frequency questionnaire. Nutrient intakes were then evaluated by previous estimates of cooked foods from our laboratory. Systolic and diastolic blood pressure (SBP, DBP), age, weight, height, waist and hip circumference, occupation, physical activity, smoking habits were recorded. Fasting blood samples were analyzed for hemoglobin, serum level of glucose, triglycerides, total cholesterol, HDL, ceruloplasmin, plasma level of ascorbic acid, folic acid, retinol, erythrocyte glutathione reductase activity coefficient (EGRAC) and erythrocyte membrane zinc. RESULTS: There were no significant differences between protein, fat intakes of normal and hypertensive individuals, though intakes of men were higher than those of women (p < 0.05). Intakes of omega-6 fatty acids were higher (p = 0.08) and omega-3 fatty acids were lower in hypertensive men than normotensive men (p = 0.04). Gender differences were also significant for micronutrient intakes except vitamin C and beta-carotene. Intakes of potassium, copper, folic acid and vitamin C were significantly lower in hypertensive individuals than in normotenisves. No significant association was found between occupation or activity level and hypertension (p > 0.2) in these subjects. Conditional logistic regression analysis indicated that intakes of vitamin C, folic acid and zinc were associated with 18% (OR = 1.18, 95% CI:1.08, 1.26), 51% (OR = 1.51, 95% CI 0.94, 2.1) higher odds for hypertension, and 3% lower odds for hypertension (OR = 0.97, 95% CI 0.92, 1.01), respectively. Mean plasma vitamin C and folic acid were significantly higher (p < 0.01), and serum ceruloplasmin and erythrocyte membrane zinc were marginally higher (p = 0.07) in normal than hypertensive subjects. In multivariate linear regression analyses, plasma vitamin C, serum ceruloplasmin and erythrocyte membrane zinc were negatively associated with SBP (p = 0.00001) and plasma vitamin C was negatively associated with DBP (p = 0.0001). CONCLUSION: Low dietary intakes of vitamin C, folic acid and zinc emerged as the possible risk factors for hypertension. Further, lower levels of plasma vitamin C, erythrocyte membrane zinc and ceruloplasmin were found to be the putative intermediary biomarkers in pathogenesis of hypertension.

Adult↗
PubMed1999

Micronutrient supplementation and immune function in the elderly.

Immunologic function, particularly cell-mediated immunity, declines with age, contributing to the increased incidence of infectious diseases in the elderly. Nutrition may play a pivotal role in maintaining immune competence in older adults. Most studies to date have focused on micronutrient deficiencies and supplementation, sometimes using "mega-dose" formulations. Multivitamin/mineral supplements or specific micronutrients such as zinc and vitamin E may be of value; however, data suggest there is likely a therapeutic range for many micronutrients, and oversupplementation may be harmful. Specific alterations of dietary lipids may also be useful for modulating immune responses in the elderly. This review summarizes the prevalence of vitamin and mineral deficiencies in older adults and highlights the outcomes of trials of micronutrient supplementation to augment immune function in the elderly.

Aged↗
PubMed1999

Energy intake and micronutrient intake in elderly Europeans: seeking the minimum requirement in the SENECA study.

OBJECTIVE: To examine energy intake of elderly people participating in the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA) study in relation to the adequacy of micronutrient intake. DESIGN: Data from eight countries on 486 men and 519 women who were 74-79 years old. Dietary intakes of energy, iron, thiamine, riboflavin and pyridoxine were calculated. RESULTS: There was inadequate intake of one or more nutrients in 23.9% of men and 46.8% of women. The prevalence of inadequate intakes decreased gradually with higher energy intakes. Of all people with energy intakes exceeding 1500 kcal, 19% of men and 26% of women still had an inadequate intake of at least one micronutrient. CONCLUSION: We found no single criterion ensuring level of energy intake with an adequate micronutrient supply. The prevalence of an inadequate intake of micronutrients was high at all energy intake levels, especially in women.

Aged↗
PubMed1999

Effect of iron-, iodine-, and beta-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial.

BACKGROUND: Deficiencies of iron, iodine, and vitamin A are prevalent worldwide and can affect the mental development and learning ability of schoolchildren. OBJECTIVE: The aim of this study was to determine the effect of micronutrient-fortified biscuits on the micronutrient status of primary school children. DESIGN: Micronutrient status was assessed in 115 children aged 6-11 y before and after consumption of biscuits (fortified with iron, iodine, and beta-carotene) for 43 wk over a 12-mo period and was compared with that in a control group (n = 113) who consumed nonfortified biscuits. Cognitive function, growth, and morbidity were assessed as secondary outcomes. RESULTS: There was a significant between-group treatment effect on serum retinol, serum ferritin, serum iron, transferrin saturation, and urinary iodine (P <0.0001) and in hemoglobin and hematocrit (P <0.05). The prevalence of low serum retinol concentrations (<0.70 micromol/L) decreased from 39.1% to 12.2%, of low serum ferritin concentrations (<20 microg/L) from 27.8% to 13.9%, of anemia (hemoglobin <120 g/L) from 29.6% to 15.6%, and of low urinary iodine concentrations (<100 microg/L) from 97.5% to 5.4%. There was a significant between-group treatment effect (P <0.05) in cognitive function with the digit span forward task (short-term memory). Fewer school days were missed in the intervention than in the control group because of respiratory- (P = 0.097) and diarrhea-related (P = 0.013) illnesses. The intervention had no effect on anthropometric status [corrected]. CONCLUSIONS: Fortified biscuits resulted in a significant improvement in the micronutrient status of primary school children from a poor rural community and also appeared to have a favorable effect on morbidity and cognitive function [corrected].

Anthropometry↗
PubMed2001

Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia.

BACKGROUND: Deficiencies of vitamin A, iron, and zinc are prevalent worldwide, affecting vulnerable groups such as lactating women and infants. However, the existence of concurrent deficiencies has received little attention. OBJECTIVE: The aim was to investigate the extent to which deficiencies of vitamin A, iron, and zinc coexist and the nutritional relation between lactating mothers and their infants. DESIGN: In a cross-sectional survey in rural West Java, Indonesia, 155 lactating mothers and their healthy infants were assessed anthropometrically and blood, urine, and breast-milk samples were obtained. RESULTS: Marginal vitamin A deficiency was found in 54% of the infants and 18% of the mothers. More than 50% of the mothers and infants were anemic and 17% of the infants and 25% of the mothers were zinc deficient. There was a strong interrelation between the micronutrient status of the mothers and infants and the concentrations of retinol and beta-carotene in breast milk. Vitamin A deficiency in infants led to an increased risk of anemia and zinc deficiency (odds ratios: 2.5 and 2.9, respectively), whereas in mothers the risk of anemia and iron deficiency (odds ratios: 3.8 and 4.8, respectively) increased. In infants, concentrations of insulin-like growth factor I were related to concentrations of plasma retinol and beta-carotene but not to zinc. CONCLUSIONS: Micronutrient deficiencies were prevalent in West Java. The micronutrient status of lactating mothers and that of their infants were closely related; breast milk was a key connecting factor for vitamin A status. Furthermore, concurrent micronutrient deficiencies appeared to be the norm.

Adolescent↗
PubMed2003

Effects of maternal micronutrient supplementation on fetal loss and infant mortality: a cluster-randomized trial in Nepal.

BACKGROUND: We previously reported that maternal micronutrient supplementation in rural Nepal decreased low birth weight by approximately 15%. OBJECTIVE: We examined the effect of daily maternal micronutrient supplementation on fetal loss and infant mortality. DESIGN: The study was a double-blind, cluster-randomized, controlled trial among 4926 pregnant women and their 4130 infants in rural Nepal. In addition to vitamin A (1000 microg retinol equivalents), the intervention groups received either folic acid (FA; 400 microg), FA + iron (60 mg), FA + iron + zinc (30 mg), or multiple micronutrients (MNs; the foregoing plus 10 microg vitamin D, 10 mg vitamin E, 1.6 mg thiamine, 1.8 mg riboflavin, 2.2 mg vitamin B-6, 2.6 microg vitamin B-12, 100 mg vitamin C, 64 microg vitamin K, 20 mg niacin, 2 mg Cu, and 100 mg Mg). The control group received vitamin A only. RESULTS: None of the supplements reduced fetal loss. Compared with control infants, infants whose mothers received FA alone or with iron or iron + zinc had a consistent pattern of 15-20% lower 3-mo mortality; this pattern was not observed with MNs. The effect on mortality was restricted to preterm infants, among whom the relative risks (RRs) were 0.36 (95% CI: 0.18, 0.75) for FA, 0.53 (0.30, 0.92) for FA + iron, 0.77 (0.45, 1.32) for FA + iron + zinc, and 0.70 (0.41, 1.17) for MNs. Among term infants, the RR for mortality was close to 1 for all supplements except MNs (RR: 1.74; 95% CI: 1.00, 3.04). CONCLUSIONS: Maternal micronutrient supplementation failed to reduce overall fetal loss or early infant mortality. Among preterm infants, FA alone or with iron reduced mortality in the first 3 mo of life. MNs may increase mortality risk among term infants, but this effect needs further evaluation.

Adult↗
PubMed2005

Micronutrient requirements in older women.

The nutritional requirements of older women is an area of great interest because the extended life expectancy leads to an increase in women living into their 80s, 90s, and longer. The recommended dietary allowances (RDAs) and dietary reference intakes (DRIs) are not specific for women living to advanced ages, and little research has been conducted specifically on the micronutrient needs of elderly women. Older adults are at greater risk for nutritional deficiencies than are younger adults due to physiologic changes associated with aging, acute and chronic illnesses, prescription and over-the-counter medications, financial and social status, and functional decline. Among the significant age-associated changes in nutrient requirements, the need for energy decreases and the requirements for protein increase with age. Among the micronutrients, the significant ones that may be associated with deficiencies in elderly women include vitamin B-12, vitamin A, vitamin C, vitamin D, calcium, iron, zinc, and other trace minerals. In old and very old women, these are micronutrients of interest but there is a great need for research to determine appropriate recommendations. The importance of these selected nutrients and the reasons for the likelihood of deficiency are discussed briefly. However, there is little specific information regarding micronutrient requirements for elderly women. One reason for this is the difficulty in conducting reliable and valid studies due to the heterogeneity of older adults and their unique rate of aging associated with their health status, limited income, disability, and living situation.

Adult↗