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Lech MA, Warpechowski M, Wojszel A, Rentflejsz J, Świętek M, Wojszel ZB. Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough? Nutrients 2024; 16:193. [PMID: 38257086 PMCID: PMC10819869 DOI: 10.3390/nu16020193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.
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Affiliation(s)
- Maksymilian Adam Lech
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Marcin Warpechowski
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Aleksandra Wojszel
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Justyna Rentflejsz
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland;
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
| | - Marta Świętek
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
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Associations of baseline use of fish oil with progression of cardiometabolic multimorbidity and mortality among patients with hypertension: a prospective study of UK Biobank. Eur J Nutr 2022; 61:3461-3470. [PMID: 35589868 PMCID: PMC9119234 DOI: 10.1007/s00394-022-02889-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/07/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE The role of fish oil in the prognosis of hypertensive patients is unknown. This study investigated the associations of fish oil supplementation with the progression of cardiometabolic multimorbidity (CMM) and mortality among patients with hypertension. METHODS Based on UK Biobank, we enrolled participants with hypertension and free of other cardiometabolic diseases. The exposure was baseline use of fish oil derived from questionnaires at baseline. The primary outcomes were the incidence of CMM and all-cause mortality. Competing risk models and flexible parametric proportion-hazards models were fitted to assess the adjusted hazard ratios (HRs) for the risk of CMM and mortality outcomes, respectively. RESULTS Among 81,579 participants involved [50.37%, men; mean age, 59.38 years (standard deviation, 7.23 years)], 15,990 CMM events and 6456 all-cause deaths were reported (median follow-up, 12.23 years). In multivariable-adjusted models, baseline use of fish oil was associated with 8% lower risk of CMM [95% confidence interval (95% CI) 0.89-0.96, P < 0.001] and 10% lower risk of all-cause mortality (95% CI 0.85-0.95, P < 0.001). CONCLUSION In individuals with hypertension, baseline use of fish oil was associated with a reduced risk of CMM and all-cause mortality, and further clinical trials are needed to prove this hypothesis.
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Keshavarz P, Shafiee M, Islam N, Whiting SJ, Vatanparast H. Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey. Appl Physiol Nutr Metab 2021; 46:1370-1377. [PMID: 34087082 DOI: 10.1139/apnm-2021-0090] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 y. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (Vitamins: A, C, D, B6, B12 and folate; Minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% CI = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty bullets • The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. • Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.
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Affiliation(s)
| | | | - Naorin Islam
- University of Saskatchewan, 7235, Saskatoon, Saskatchewan, Canada;
| | - Susan J Whiting
- University of Saskatchewan, College of Pharmacy and Nutrition, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada, S7N 5E5;
| | - Hassan Vatanparast
- University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2.,University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2;
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Affiliation(s)
- William B Grant
- From the Sunlight, Nutrition, and Health Research Center, San Francisco, CA (e-mail: )
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Knopf H. Selbstmedikation mit Vitaminen, Mineralstoffen und Nahrungsergänzungsmitteln in Deutschland. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:268-276. [DOI: 10.1007/s00103-016-2500-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Pitkälä KH, Suominen MH, Bell JS, Strandberg TE. Herbal medications and other dietary supplements. A clinical review for physicians caring for older people. Ann Med 2016; 48:586-602. [PMID: 27427263 DOI: 10.1080/07853890.2016.1197414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Evidence for the safety and effectiveness of dietary supplements is mixed. The extent to which older people use dietary supplements concomitantly with conventional medications is often under-appreciated by physicians. We conducted a literature review on clinical considerations associated with dietary supplement use, focusing on benefits and harms, motivations for use and contribution to polypharmacy among older people. Vitamin D ≥ 800 IU has demonstrated benefits in fracture prevention. Vitamins A, E, and β-carotene have been associated with an increase in total mortality in several meta-analyses. A range of non-vitamin dietary supplements have been studied in randomized controlled trials but their efficacy remains largely unclear. Supplement use has been associated with a range of adverse events and drug interactions yet physicians rarely initiate discussions about their use with older patients. Older people may take dietary supplements to exercise control over their health. Given the contribution of supplements to polypharmacy, supplements may be targeted for "deprescribing" if the risk of harm is judged to outweigh benefits. This is best done as part of a comprehensive, patient-centered approach. A respectful and non-judgmental discussion may result in a shared decision to reduce polypharmacy through cessation of dietary supplements. KEY MESSAGES Herbal medications and other dietary supplements are highly prevalent among older people. Physicians are often unaware that their patients use herbal medications and other dietary supplements concomitantly with conventional medications. Herbal medications and other dietary supplements contribute to high rates of polypharmacy, particularly among older people with multimorbidity. Herbal medications and other dietary supplements can interact with conventional medications and be associated with a range of adverse events. Physicians need to be patient-centered and non-judgmental when initiating discussions about herbal medications and other dietary supplements. This is important to maintain and develop patient empowerment and self-management skills.
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Affiliation(s)
- Kaisu H Pitkälä
- a Department of General Practice and Primary Health Care , Helsinki , Finland.,b Unit of Primary Health Care, University of Helsinki, and Helsinki University Hospital , Helsinki , Finland
| | - Merja H Suominen
- a Department of General Practice and Primary Health Care , Helsinki , Finland.,b Unit of Primary Health Care, University of Helsinki, and Helsinki University Hospital , Helsinki , Finland
| | - J Simon Bell
- c Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences , Monash University , Melbourne , Australia.,d Sansom Institute, University of South Australia , Adelaide , Australia.,e Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland
| | - Timo E Strandberg
- f University of Helsinki, Clinicum , Helsinki , Finland.,g Helsinki University Hospital , Helsinki , Finland.,h University of Oulu, Centre for Life Course Health Research , Oulu , Finland
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Marques-Vidal P, Vollenweider P, Waeber G. Trends in vitamin, mineral and dietary supplement use in Switzerland. The CoLaus study. Eur J Clin Nutr 2016; 71:122-127. [DOI: 10.1038/ejcn.2016.137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 06/03/2016] [Accepted: 07/04/2016] [Indexed: 12/20/2022]
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Orisakwe OE, Mbagwu HOC, Ajaezi GC, Edet UW, Uwana PU. Heavy Metals in Seafood and Farm Produce from Uyo, Nigeria: Levels and health implications. Sultan Qaboos Univ Med J 2015; 15:e275-82. [PMID: 26052462 PMCID: PMC4450792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 10/31/2014] [Accepted: 01/15/2014] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVES This study aimed to obtain representative data on the levels of heavy metals in seafood and farm produce consumed by the general population in Uyo, Akwa Ibom State, Nigeria, a region known for the exploration and exploitation of crude oil. METHODS In May 2012, 25 food items, including common types of seafood, cereals, root crops and vegetables, were purchased in Uyo or collected from farmland in the region. Dried samples were ground, digested and centrifuged. Levels of heavy metals (lead, cadmium, nickel, cobalt and chromium) were analysed using an atomic absorption spectrophotometer. Average daily intake and target hazard quotients (THQ) were estimated. RESULTS Eight food items (millet, maize, periwinkle, crayfish, stock fish, sabina fish, bonga fish and pumpkin leaf) had THQ values over 1.0 for cadmium, indicating a potential health risk in their consumption. All other heavy metals had THQ values below 1.0, indicating insignificant health risks. The total THQ for the heavy metals ranged from 0.389 to 2.986. There were 14 items with total THQ values greater than 1.0, indicating potential health risks in their consumption. CONCLUSION The regular consumption of certain types of farm produce and seafood available in Uyo, Akwa Ibom State, Nigeria, is likely adding to the body burden of heavy metals among those living in this region.
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Affiliation(s)
- Orish E. Orisakwe
- Toxicology Unit, Clinical Pharmacy, Faculty of Pharmacy, University of Port-Harcourt, Port-Harcourt, Nigeria
| | - Herbert O. C. Mbagwu
- Department of Pharmacology, Faculty of Pharmacy, University of Uyo, Uyo, Nigeria
| | - Godwin C. Ajaezi
- Department of Medical Laboratory Science, Faculty of Science, Rivers State University of Science & Technology, Port-Harcourt, Nigeria
| | - Ukeme W. Edet
- Department of Pharmacology, Faculty of Pharmacy, University of Uyo, Uyo, Nigeria
| | - Patrick U. Uwana
- Department of Pharmacology, Faculty of Pharmacy, University of Uyo, Uyo, Nigeria
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