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In an ideal world, everyone would get all the vitamins and minerals they need from their food. In reality, however, few of us achieve this. Although diet should always come first, we tend to eat less with age due to reduced appetite, when cutting back to lose weight or when choosing to avoid certain foods.
Yet, as we get older our need for many vitamins and minerals increases and, at the same time, our ability to absorb nutrients decreases. The amount of vitamin D we make in our skin when the sun shines is also reduced.
Although it may sound obvious, vitamins, minerals and other nutrients can only provide a benefit if they are absorbed from your food or supplements, and presented to your cells in a form they can use.
The absorption of many minerals depends on the presence of good levels of stomach acidity (pH) which dissolves mineral salts and releases electrolytes such as calcium, iron, magnesium, zinc and phosphate for absorption within the small intestines.
Your stomach lining becomes less active with age, however, so the production of stomach acid is reduced (hypochlorhydria). In some cases, the production of hydrochloric acid may even stop altogether – a condition called achlorhydria – due to inflammation of the stomach lining (atrophic gastritis).
Although this is not a widely known problem, it is relatively common. Research shows that atrophic gastritis affects as many as one in five people (19%) in their 50s, one in four (24%) people in their 60s, one in three (32%) in their 70s and 40% of those in the 80+ age group – an overall prevalence of 31.5% of those aged 60 or more.1
Lack of stomach acid can lead to a number of nutritional deficiencies, especially of folic acid, vitamin B12, carotenoids, iron, zinc and calcium. In fact, as many as 60% of people aged over 75 years are deficient in vitamin B12 – mostly due to atrophic gastritis.2
This is why multivitamins aimed at people aged 50+ or 70+ have different, usually increased, levels of certain micronutrients. About the only micronutrient you need less of in later life is iron – especially for women who no longer menstruate.
Half of adults take at least one prescribed drug and, according to Age UK, nearly 2 million older people are taking 7 or more prescription medicines! Overall, an astonishing one in ten people over the age of 65 are taking at least eight different medications, increasing to one in four among the over-85s.3
Many medicines affect your ability to absorb and use vitamins and minerals. For example:
The National Institute for Health and Care Excellence (NICE) recommends that everyone takes a daily vitamin D supplement, as it is needed to absorb calcium to maintain strong bones, and also plays an important role in immunity.
Vitamin D supplements are especially important for people over the age of 50 because the ability to synthesise the vitamin in the skin reduces with age, and your ability to absorb vitamin D from foods such as oily fish, egg yolk, liver and fortified foods also decreases.
In one study, researchers found that people aged 62 to 80 years synthesised four times less natural vitamin D than those aged 20 to 30 years.4 This makes vitamin D supplements particularly important for older people.
Many vitamins and minerals are needed to help maintain normal immunity, including vitamins A, B6, B12, C, D and folic acid, plus the minerals selenium, zinc, copper and iron.
Lack of these micronutrients may impair your ability to fight off infections. In one study, 96 healthy older people took a vitamin and mineral supplement or placebo every day for one year. After 12 months, blood tests showed they had improved immune function (higher T-cell subsets, higher natural killer cell numbers and activity, enhanced proliferation response and increased antibody response) than those taking placebo.
Those taking the multivitamin supplements also had fewer days of illness per year: 23 days versus 48 days of illness in control groups.5 They also mounted a better response to influenza vaccination.
A 50+ formula typically provides 150% to 200% of the RDA/NRV found in supplements aimed at younger adults, in order to account for reduced intestinal absorption. These supplements often contain additional beneficial ingredients such as antioxidant bioflavonoids or herbal extracts such as Ginkgo biloba.
A menopause formula designed for older women may provide additional bone-friendly nutrients such as calcium and magnesium, plus soy isoflavones for their oestrogen-like action.
A 70+ formula typically offers 200% to 300% of nutrients such as B vitamins, which you absorb less efficiently with age. Additional beneficial 'energising' ingredients that may be included are alpha lipoic acid, l-carnitine, coenzyme Q10 and/or Siberian ginseng.
Nutrient requirements and the ability to absorb nutrients from food and supplements changes as we get older. It therefore makes sense to select a supplement especially designed for your age group.
Dr Sarah Brewer is Healthspan's Medical Director and holds degrees in Natural Sciences, Surgery and Medicine from the University of Cambridge. Having worked as a GP and hospital doctor, Dr Sarah now holds an MSc in Nutritional Medicine from the University of Surrey and specialises in nutrition. She is also an award-winning writer and author.
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.