Will your retirement be good for your health?

For:

Vitamin supplements contain antioxidants to help combat the effects of free radicals, compounds that we get from food and even the air we breathe, which are thought to accelerate ageing. We may not be getting sufficient vitamins from the foods we eat, even with a balanced diet.

Against:

Recent research suggests that taking too much of certain vitamins can be dangerous at worst, and useless at best. One study from the Johns Hopkins University School of Medicine in America found that large doses of vitamin E increased chances of dying early, despite earlier evidence that it can reduce heart attacks. When this vitamin is combined with betacarotene (a precursor of vitamin A, meaning that it converts to vitamin A), there is an increased risk of cancer. Vitamin E may raise heart risk among elderly with chronic conditions.

Those in favour of taking extra vitamins point out that the bad news is associated with megadoses, not moderate ones. Those against say that moderate doses of daily vitamins are a waste of money.

Don’t we get sufficient vitamins and minerals in a balanced diet?

The general consensus is yes, but you may not be getting as much as you think.

• New potatoes and freshly picked apples contain more vitamin C than those stored for use in the winter months. Even storing in a fridge for any length of time reduces vitamin content.

• Milk left in sunlight loses riboflavin, part of the vitamin B complex.

• Orange juice loses vitamin C when opened. Freshly squeezed is best, and that really means squeezing or pressing, rather than whizzing in an extractor, where loss is greater.

• Vitamin C is also lost in pre-soaking and cooking: boiled vegetables often have more vitamin content in the water they were cooked in, especially if the veg are reheated.

• Dried fruits lose virtually all of their vitamin C content.

• Vitamin A may be lost through storing of food, even in the fridge.

• Refining and processing – white bread, for instance – reduces thiamine and nicotinic acid, both part of the vitamin B complex. Vitamins E and A, and carotene, are reduced in processed foods.

• Crop spraying may also reduce vitamin content: a recent analysis showed that organic blueberries contained more nutrients and higher vitamin content than non-organic blueberries.

• Soil depletion may reduce the vitamin and mineral content of vegetables and fruit.

• The mineral selenium is generally acknowledged to be deficient in the soil in western countries.

• Osteoporosis, brittle bones, is associated with too little calcium and vitamin D.

Does this mean that taking supplements is essential?

Not necessarily. You may still be getting good supplies of vitamins from fresh fruit and vegetables, as well as minerals. It’s partly a matter of lifestyle: smokers are in danger of vitamin C deficiency, as are heavy drinkers. Dieting can reduce intake of various nutrients, as can extreme vegetarian and vegan diets. Stress, even exercise, can increase daily needs of vitamins and minerals. And there may be an increased need for vitamins in old age, especially B complex, C and E, as absorption and utilization are impaired in later life.
 

How much is too much?

If you do go for supplements, you could play safe and stay within the Recommended Daily Allowances (RDA), agreed by the Food Standards Agency (FSA). A multivitamin and mineral mix is best for this. Look at the (very) small print on the bottles of supplements to see how much you are getting. The list will show the RDAs and percentage in each pill or capsule. In some, you will see that content is greater than RDA, but this is not necessarily dangerous. The agreed RDA varies from country to country and from time to time.

The FSA website www.food.gov.uk  has issued the following statement:

`Current intakes of most vitamins and minerals are not thought to be harmful. However…:

• Chromium in the form of chromium picolinate may have the potential to cause cancer; consumers are advised not to take chromium in this form. The FSA has consulted on a proposal to ban its use in the manufacture of food supplements. Having 10mg/day or less in total of chromium in other forms is unlikely to cause any harm.

• Levels of vitamin C above 1000mg/day could cause abdominal pain and diarrhoea. Similarly, high intakes of calcium (above 1500mg/day) and iron (above 17mg/day) may result in similar symptoms in some people. These symptoms should disappear once people stop taking the supplements.

• There are some substances that may have irreversible harmful effects if taken for long periods at the highest supplemental doses. These include betacarotene (especially for smokers and those exposed to asbestos), nicotinic acid, zinc, manganese (especially for older people) and phosphorus.

• Current advice on vitamin B6 is being re-emphasised. The Agency advises against taking more than 10mg/day of vitamin B6 from dietary supplements unless acting on medical advice. High intakes taken over a long period of time can lead to a loss of feeling in the arms and legs.’

If you choose to take an extra supplement, say more calcium because your multivitamin and mineral pack contains less than you would like to have, then do the sums and make sure you don’t get too much overall.

Why vitamin C is special

There is evidence from respectable medical sources that regular intake of vitamin C helps: improve breathing rate in elderly women,

• reduces cholesterol levels,

• increases immune responses if taken before intense exercise,

• compensates smoke-induced damage in smokers and in passive smokers,

• significantly lowers risk of heart disease, is protective against gum disease.
  Vitamin C is considered safe in quantities up to 1000mg, though it’s best to take this amount only for a few days, to reduce the effects of a cold.

Fish oil supplements

A balanced diet should contain some oily fish, but levels in the UK diet are less than half the amount recommended by the government. Oily fish provides Omega-3 DHA, a vital component of cardiovascular and brain health.
DHA is the long chain Omega-3 essential fatty acid. The FSA recommends a weekly intake of one to four portions of oil rich fish which, translated into omega-3 intake, equates to 0.45 - 0.9g omega-3s a day.
If you doubt that you get this amount, then a fish oil supplement is a good idea. You don’t need to take it daily. A supplement two or three times a week may be enough, as otherwise you could be getting too much mercury. Assess the amount of oily fish you eat in any week - herring, mackerel, sardines, tuna, salmon are the ones. High levels of mercury are found in oily fish and they may be present in the supplements too.

Other anti-ageing supplements

Glucosamine and chondroitin relieve and help protect against arthritis. Glucosamine has consistently shown to be effective in clinical trials. Combined with chondroitin it may be even more useful, though not all trials show this. Up to 1200 mg daily of both are appropriate doses.

The following are not proven to be effective, though many complementary practitioners do recommend them:

Coenzyme Q10 is said to improve energy levels and may help protect against gum disease.
Combined with L-carnitine plus magnesium, it is considered by some complementary practitioners to have an anti-ageing effect.
Ginko biloba may help memory and brain activity.

Supplements and prescription drugs

If you take a regular dose of vitamins, minerals, fish oils or herbal remedies, as well as one or more prescribed drug, you need to check out their possible interaction.
There’s more unknown than known about the possible interactions, and very few reports to suggest that they are serious. But it’s as well to be informed of what’s on record, even if the number of incidents is very small.

• Omega-3 fish oils, cod liver oil, flaxseed oil and evening primrose oils are considered safe to combine with most prescription drugs at recommended doses.

• Evening primrose oil is not advised for people with a rare form of epilepsy, known as temporal lobe epilepsy, as it may make the condition worse.

• Omega-3 fish oils may increase the potential for bleeding in people taking warfarin or aspirin.

If you want to know more about the medicines you take and possible drug interactions, go to: www.askaboutmedicines.org

 

Previous editions of this series
 
Part 1           Exercise in retirement

Part two      Healthy eating in Retirement

Part three   Supplements in retirement

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