Micronutrients for Older Adults
Listed below are vitamin and mineral dietary intake recommendations for individuals over the age of 50 years. For each micronutrient, the Food and Nutrition Board of the Institute of Medicine establishes a recommended dietary allowance (RDA) or adequate intake (AI). Generally, the Linus Pauling Institute supports the recommendations of the Food and Nutrition Board, but any discrepancies in dietary recommendations are listed in the rightmost column of the table. Additionally, more information on the Linus Pauling Institute recommendation for a specific micronutrient can be found by clicking on the name of the micronutrient of interest.
| Table 1. Micronutrient Requirements for Older Adults (>50 years)
||Food and Nutrition Board Recommendations (RDA except where otherwise noted)
||Linus Pauling Institute Recommendation
||30 mcg/day (AI)
||30 mcg/day (AI)
||16 mg NE*/day
||14 mg NE/day
||5 mg/day (AI)
||5 mg/day (AI)
||900 mcg (3,000 IU)/day
||700 mcg (2,333 IU)/day
||100-400 mcg/day of crystalline vitamin B12
|Vitamin D (51-70 years)
||15 mcg (600 IU)/day
||15 mcg (600 IU)/day
||2,000 IU/day from supplements
|Vitamin D (>70 years)
||20 mcg (800 IU)/day
||20 mcg (800 IU)/day
||2,000 IU/day from supplements
||15 mg (22.5 IU)/day
||15 mg (22.5 IU)/day
||120 mcg/day (AI)
||90 mcg/day (AI)
|Calcium (51-70 years)
|Calcium (>70 years)
||30 mcg/day (AI)
||20 mcg/day (AI)
||4 mg/day (AI)
||3 mg/day (AI)
||No supplement providing >350 mg/day
||2.3 mg/day (AI)
||1.8 mg/day (AI)
||4.7 g/day (AI)
||4.7 g/day (AI)
|Sodium (51-70 years)
||1.3 g/day (AI)
||1.3 g/day (AI)
|Sodium (>70 years)
||1.2 g/day (AI)
||1.2 g/day (AI)
*NE, niacin equivalent: 1 mg NE = 60 mg of tryptophan = 1 mg niacin
#Vitamin B12 intake should be from supplements or fortified foods due to the age-related increase in malabsorption
Abbreviations: mcg=microgram; mg=milligram; g=gram; IU=International Unit; RDA=Recommended Dietary Allowance; AI=Adequate Intake
Linus Pauling Institute Recommendations
Presently, there is no indication that older adults have an increased requirement for biotin. If dietary biotin intake is not sufficient, a daily multivitamin/mineral supplement will generally provide an intake of at least 30 mcg/day of biotin.
The Linus Pauling Institute recommends that adults take a 400 mcg supplement of folic acid daily, in addition to folate and folic acid consumed in the diet. A daily multivitamin/mineral supplement, containing 100% of the Daily Value (DV) for folic acid provides 400 mcg of folic acid. Even with a larger than average intake of folic acid from fortified food, it is unlikely that an individual's daily folic acid intake would regularly exceed the tolerable upper intake level (UL) of 1,000 mcg/day established by the Food and Nutrition Board. The recommendation for 400 mcg/day of supplemental folic acid as part of a daily multivitamin/mineral supplement, in addition to a folate-rich diet, is especially important for older adults because blood homocysteine levels tend to increase with age.
Dietary surveys indicate that 15% to 25% of older adults do not consume enough niacin in their diets to meet the RDA (16 mg NE/day for men and 14 mg NE/day for women), and that dietary intake of niacin decreases between the ages of 60 and 90 years. Thus, it is advisable for older adults to supplement their dietary intake with a multivitamin/mineral supplement, which will generally provide at least 20 mg of niacin daily.
Presently, there is little evidence that older adults differ in their intake or requirement for pantothenic acid. Most multivitamin/mineral supplements provide at least 5 mg/day of pantothenic acid. The Linus Pauling Institute supports the recommendation by the Food and Nutrition Board of 5 mg/day of pantothenic acid for older adults. A varied diet should provide enough pantothenic acid for most people. Following the Linus Pauling Institute recommendation to take a daily multivitamin/mineral supplement, containing 100% of the Daily Value (DV), will ensure an intake of at least 5 mg/day of pantothenic acid.
Some experts in nutrition and aging feel that the RDA of riboflavin (1.3 mg/day for men and 1.1 mg/day for women) leaves little margin for error in people over 50 years of age (1, 2). A study of independently living people between 65 and 90 years of age found that almost 25% consumed less than the recommended riboflavin intake, and 10% had biochemical evidence of deficiency (3). Epidemiological studies of cataract prevalence indicate that riboflavin intakes of 1.6 to 2.2 mg/day may reduce the risk of developing age-related cataracts. Additionally, older people suffering from acute ischemic stroke were found to be deficient for riboflavin (4), and riboflavin deficiency has been linked to a higher risk of fracture in postmenopausal women with the MTHFR 677T variant (5). Individuals whose diets may not supply adequate riboflavin, especially those over 50 years of age, should consider taking a multivitamin/mineral supplement, which generally provides at least 1.7 mg/day of riboflavin.
Presently, there is no evidence that the requirement for thiamin is increased in older adults, but some studies have found inadequate dietary intake and thiamin insufficiency to be more common in elderly populations (2). Thus, it would be prudent for older adults to take a multivitamin/mineral supplement, which will generally provide at least 1.5 mg of thiamin/day.
Presently, there is little evidence that the requirement for vitamin A in older adults differs from that of younger adults. Additionally, vitamin A toxicity may occur at lower doses in older adults than in younger adults. Further, data from observational studies suggested an inverse association between intakes of preformed vitamin A in excess of 1,500 mcg RAE (5,000 IU)/day and risk of hip fracture in older people (see the Safety section in the article on Vitamin A). Yet, following the Linus Pauling Institute’s recommendation to take a multivitamin/mineral supplement daily could supply as much as 5,000 IU/day of retinol, the amount that has been associated with adverse effects on bone health in older adults. For this reason, we recommend taking a multivitamin/mineral supplement that provides no more than 2,500 IU (750 mcg) of preformed vitamin A (usually labeled vitamin A acetate or vitamin A palmitate) and no more than 2,500 IU of additional vitamin A as β-carotene. As for all age groups, high potency vitamin A supplements should not be used without medical supervision due to the risk of toxicity.
Early metabolic studies have indicated that the requirement for vitamin B6 in older adults is approximately 2 mg daily (6). Yet, the analysis of the US population survey (NHANES) 2003-2004 showed that adequate vitamin B6 status and low homocysteine levels were associated with total vitamin B6 intakes equal to and above 3 mg/day in people aged 65 years and older (7). The Linus Pauling Institute recommends that older adults take a multivitamin/mineral supplement, which provides at least 2.0 mg of vitamin B6 daily.
Because vitamin B12 malabsorption and vitamin B12 deficiency are more common in older adults, the Linus Pauling Institute recommends that adults older than 50 years take 100 to 400 mcg/day of supplemental vitamin B12.
Although it is not yet known with certainty whether older adults have higher requirements for vitamin C, some older populations have been found to have vitamin C intakes considerably below the RDA of 75 and 90 mg/day for women and men, respectively. A vitamin C intake of at least 400 mg daily may be particularly important for older adults who are at higher risk for age-related chronic diseases. In addition, a meta-analysis of 36 publications examining the relationship between vitamin C intake and plasma concentrations of vitamin C concluded that older adults (aged 60-96 years) have considerably lower plasma levels of vitamin C following a certain intake of vitamin C compared with younger individuals (aged 15-65 years) (8), suggesting that older adults have higher vitamin C requirements. Pharmacokinetic studies in older adults have not yet been conducted, but evidence suggests that the efficiency of one of the molecular mechanisms for the cellular uptake of vitamin C declines with age (9). Because maximizing blood levels of vitamin C may be important in protection against oxidative damage to cells and biological molecules, a vitamin C intake of at least 400 mg daily is particularly important for older adults who are at higher risk for chronic diseases caused, in part, by oxidative damage, such as heart disease, stroke, certain cancers, and cataract.
The Linus Pauling Institute recommends that generally healthy adults take 2,000 IU (50 mcg) of supplemental vitamin D daily. Most multivitamins contain 400 IU of vitamin D, and single ingredient vitamin D supplements are available for additional supplementation. Sun exposure, diet, skin color, and obesity have variable, substantial impact on body vitamin D levels. To adjust for individual differences and ensure adequate body vitamin D status, the Linus Pauling Institute recommends aiming for a serum 25-hydroxyvitamin D level of at least 80 nmol/L (32 ng/mL). Numerous observational studies have found that serum 25-hydroxyvitamin D levels of 80 nmol/L (32 ng/mL) and above are associated with reduced risk of bone fractures, several cancers, multiple sclerosis, and type 1 (insulin-dependent) diabetes. Daily supplementation with 2,000 IU (50 mcg) of vitamin D is especially important for older adults because aging is associated with a reduced capacity to synthesize vitamin D in the skin upon sun exposure.
The RDA for adults of all ages is 15 mg (22.5 IU) per day of α-tocopherol. Notably, more than 90% of individuals aged two years and older in the US do not meet the daily requirement for vitamin E from food sources alone. Major sources of vitamin E in the American diet are vegetable oils, nuts, whole grains, and green leafy vegetables. LPI recommends that healthy older adults take a daily multivitamin/mineral supplement, which usually contains 30 IU of synthetic vitamin E, or 90% of the RDA.
Older adults are at increased risk of osteoporosis and hip fracture. Because adequate intake of vitamin K is essential in maintaining bone health, the Linus Pauling Institute recommends that adults take a multivitamin/mineral supplement and consume at least one cup of dark green leafy vegetables daily. Although the AI for vitamin K was recently increased, it is not clear if it will be enough to optimize the γ-carboxylation of vitamin K-dependent proteins in bone (see the section on Osteoporosis in the article on vitamin K). Multivitamins generally contain 10 to 25 mcg of vitamin K, whereas vitamin K or "bone" supplements may contain 100 to 120 mcg of vitamin K. To consume the amount of vitamin K associated with a decreased risk of hip fracture in the Framingham Heart Study (about 250 mcg/day) (10), an individual would need to eat a little more than ½ cup of chopped broccoli or a large salad of mixed greens every day. In addition to taking a multivitamin/mineral supplement and eating at least one cup of dark green leafy vegetables daily, replacing dietary saturated fat (e.g., butter and cheese) with monounsaturated fat (e.g., olive and canola oils) will increase dietary vitamin K intake and may also decrease the risk of cardiovascular disease.
To minimize bone loss, older men (>70 years) and postmenopausal women should consume a total (diet plus supplements) of 1,200 mg/day of calcium. Men aged 51-70 years should consume 1,000 mg of calcium per day. No multivitamin/mineral supplement contains the RDA for calcium (1,000-1,200 mg/day) because the resulting pill would be too large to swallow. If your total daily calcium intake doesn't add up to 1,000 mg, LPI recommends taking an extra calcium supplement with a meal.
Although the requirement for chromium is not known to be higher for older adults, one study found that chromium concentrations in hair, sweat, and urine decreased with age (11). Following the Linus Pauling Institute recommendation to take a multivitamin/mineral supplement containing 100% of the daily values (DV) of most nutrients should provide sufficient chromium for most older adults.
Because impaired glucose tolerance and type 2 diabetes are associated with potentially serious health problems, individuals considering high-dose chromium supplementation to treat either condition should do so in collaboration with a qualified health care provider.
Aging has not been associated with significant changes in the requirement for copper (12); thus, the Linus Pauling Institute recommendation for copper intake in older adults is the same as younger adults. The RDA for copper (900 mcg/day for all adults) is sufficient to prevent deficiency, but the lack of clear indicators of copper nutritional status in humans makes it difficult to determine the level of copper intake most likely to promote optimum health or prevent chronic disease. A varied diet should provide enough copper for most people. For those who are concerned that their diet may not provide adequate copper, a multivitamin/mineral supplement will generally provide at least the RDA for copper.
The safety and public health benefits of optimally fluoridated water for prevention of tooth decay in people of all ages have been well established. The Linus Pauling Institute supports the recommendations of the American Dental Association and the Centers for Disease Control and Prevention, which include optimally fluoridated water and the use of fluoride toothpaste, fluoride mouth rinse, fluoride varnish, and when necessary, fluoride supplementation. Due to the risk of fluorosis, any fluoride supplementation should be prescribed and closely monitored by a dentist or physician.
The RDA for iodine (150 mcg/day for men and women) is sufficient to ensure normal thyroid function. There is presently no evidence that iodine intakes higher than the RDA are beneficial. Most people in the US consume more than sufficient iodine in their diets, making supplementation unnecessary.
A study in an elderly population found that high iron stores were much more common than iron deficiency (13). Thus, older adults should not generally take nutritional supplements containing iron unless they have been diagnosed with iron deficiency. Moreover, it is extremely important to determine the underlying cause of the iron deficiency, rather than simply treating it with iron supplements.
Older adults are less likely than younger adults to consume enough magnesium to meet their needs and should therefore take care to eat magnesium-rich food in addition to taking a multivitamin/mineral supplement daily. However, no multivitamin/mineral supplement contains 100% of the DV for magnesium. If you don’t eat plenty of green leafy vegetables, whole grains, and nuts, you likely are not getting enough magnesium from your diet. Older adults are more likely to have impaired kidney function than younger individuals, they should avoid taking more than 350 mg/day of supplemental magnesium without medical consultation (see the section on Safety in the article on magnesium).
The requirement for manganese is not known to be higher for older adults compared to younger adults. However, liver disease is more common in older adults and may increase the risk of manganese toxicity by decreasing the elimination of manganese from the body (see the section on Toxicity in the article on manganese). Manganese supplementation beyond 100% of the Daily Value (DV=2 mg/day) is not recommended.
Because aging has not been associated with significant changes in the requirement for molybdenum (14), the Linus Pauling Institute recommendation for older adults is the same as that for younger adults. Specifically, the RDA for molybdenum, 45 mcg/day for adults of all ages, is sufficient to prevent deficiency. Although the intake of molybdenum most likely to promote optimum health is not known, there is presently no evidence that intakes higher than the RDA are beneficial. Most people in the US consume more than sufficient molybdenum in their diets, making supplementation unnecessary. Following the Linus Pauling Institute's general recommendation to take a multivitamin/mineral supplement that contains 100% of the daily values (DV) for most nutrients is likely to provide 75 mcg/day of molybdenum because the DV for molybdenum has not been revised to reflect the most recent RDA. Although the amount of molybdenum presently found in most multivitamin/mineral supplements is higher than the RDA, it is well below the tolerable upper intake level (UL) of 2,000 mcg/day and should be safe for older adults.
At present, there is no evidence that phosphorus requirements of older adults differ from that of younger adults, and a varied diet should easily provide the RDA (700 mg/day) of phosphorus for those over 50 years of age.
A diet supplying at least 4.7 grams/day of potassium is appropriate for healthy older adults because such diets are associated with decreased risk of stroke, hypertension, osteoporosis, and kidney stones. This recommendation does not apply to individuals who have been advised to limit potassium consumption by a health care professional (see the section on Safety in the article on potassium).
Aging has not been associated with significant changes in the requirement for selenium. The Linus Pauling Institute supports the recommendation of the Food and Nutrition Board, which is 55 mcg/day of selenium for adults of all ages. Although the amount of selenium in multivitamin/mineral supplements varies considerably, multivitamin/mineral supplements rarely provide more than the Daily Value (DV) of 70 mcg. The average American diet is estimated to provide about 100 mcg/day of selenium (15, 16). Thus, eating a varied diet and taking a daily multivitamin/mineral supplement should provide sufficient selenium for most adults in the US.
There is consistent evidence that diets relatively low in salt (5.8 grams/day or less) and high in potassium (at least 4.7 grams/day) are associated with decreased risk of high blood pressure and hypertension, as well as the associated risks of cardiovascular and kidney diseases. Diets low in sodium and rich in potassium are likely to be of particular benefit for older individuals, who are at increased risk of high blood pressure. Moreover, the Dietary Approaches to Stop Hypertension (DASH) trial demonstrated that a diet emphasizing fruit, vegetables, whole grains, nuts, and low-fat dairy products substantially lowered blood pressure, an effect that was enhanced by reducing salt intake to 5.8 grams/day or less. For more information on the DASH diet, see the article on Sodium. The Linus Pauling Institute recommends a diet that is rich in fruit and vegetables (at least 5 servings/day) and limits processed foods that are high in salt. Sensitivity to the blood pressure-raising effects of salt increases with age; therefore, consuming diets that are low in salt and high in potassium may especially benefit older adults.
Diets rich in potassium (at least 4.7 grams/day) and low in salt (5.8 grams/day or less) are likely to be of particular benefit for older adults, who are at increased risk of high blood pressure along with its associated risks of cardiovascular and kidney diseases. Since sensitivity to the blood pressure-raising effects of salt increases with age, consuming diets that are low in salt and high in potassium may especially benefit older adults.
Although the requirement for zinc is not known to be higher for older adults, their average zinc intake tends to be considerably less than the RDA. A reduced capacity to absorb zinc, increased likelihood of disease states that alter zinc utilization, and increased use of drugs that increase zinc excretion may contribute to an increased risk of mild zinc deficiency in older adults. Because the consequences of mild zinc deficiency, such as impaired immune system function, are particularly relevant to the health of older adults, they should pay particular attention to maintaining adequate zinc intake.
Little is known regarding the amount of dietary choline most likely to promote optimum health or prevent chronic disease in older adults. At present, there is no evidence to support a different intake of choline from that of younger adults (550 mg/day for men and 425 mg/day for women).
Essential fatty acids
α-Linolenic acid (ALA), an omega-3 fatty acid, and linoleic acid (LA), an omega-6 fatty acid, are considered essential fatty acids because they cannot be synthesized by humans. In 2002, the Food and Nutrition Board of the US Institute of Medicine established adequate intake (AI) levels for omega-6 and omega-3 fatty acids. Essential fatty acid recommendations for adults over the age of 50 are listed in Table 2. For more information on ALA and LA, see the article on Essential Fatty Acids.
| Table 2. Adequate Intake (AI) for Essential Fatty Acids (17)
|Essential Fatty Acid
|ALA (>50 years)
|LA (>50 years)
Abbreviations: ALA=α-linolenic acid; LA=linoleic acid; g=grams
Upon request of the European Commission, the European Food Safety Authority (EFSA) proposed adequate intakes (AI) for the essential fatty acids LA and ALA, as well as the long-chain omega-3 fatty acids EPA and DHA (18). EFSA recommends an LA intake of 4% of total energy and an ALA intake of 0.5% of total energy; an AI of 250 mg/day is recommended for EPA plus DHA.
The World Health Organization recommends an acceptable macronutrient distribution range (AMDR) for omega-6 fatty acid intake of 6-11% of energy and for omega-3 fatty acid intake of 0.5-2% of energy (19). Their AMDR for EPA plus DHA is 0.250-2 g/day (the upper limit applying to the secondary prevention of coronary heart disease).
The International Society for the Study of Fatty Acids and Lipids (ISSFAL) recommends for healthy adults an LA intake of 2% energy, ALA intake of 0.7% energy, and a minimum of 500 mg/day of EPA plus DHA for cardiovascular health (20).
American Heart Association recommendation
The American Heart Association recommends that people without documented coronary heart disease (CHD) eat a variety of fish (preferably oily) at least twice weekly (21). Two servings of oily fish provide approximately 500 mg of EPA plus DHA. People with documented CHD are advised to consume approximately 1 g/day of EPA + DHA preferably from oily fish, or to consider EPA + DHA supplements in consultation with a physician. Patients who need to lower serum triglycerides may take 2-4 g/day of EPA + DHA supplements under a physician's care.
Linus Pauling Institute recommendation
The Linus Pauling Institute recommends that generally healthy adults increase their intake of omega-3 fats by eating fish twice weekly and consuming foods rich in α-linolenic acid, such as walnuts, flaxseeds, and flaxseed or canola oil. If you don't regularly consume fish, consider taking a two-gram fish oil supplement several times a week. If you are prone to bleeding or take anticoagulant drugs, consult your physician.
Age-related declines in mitochondrial function and increases in mitochondrial oxidant production are thought to be important contributors to the adverse effects of aging. Tissue L-carnitine levels have been found to decline with age in humans and animals (22). One study found that feeding aged rats acetyl-L-carnitine (ALCAR) reversed the age-related declines in tissue L-carnitine levels and also reversed a number of age-related changes in liver mitochondrial function; however, high doses of ALCAR increased liver mitochondrial oxidant production (23). More recently, two studies found that supplementing aged rats with either ALCAR or α-lipoic acid, a mitochondrial cofactor and antioxidant, improved mitochondrial energy metabolism, decreased oxidative stress, and improved memory (24, 25). Interestingly, co-supplementation of ALCAR and α-lipoic acid resulted in even greater improvements than either compound administered alone. Likewise, several studies have reported that supplementing rats with both L-carnitine and α-lipoic acid blunts the age-related increases in reactive oxygen species (ROS), lipid peroxidation, protein carbonylation, and DNA strand breaks in a variety of tissues (heart, skeletal muscle, brain). Improvements in mitochondrial enzyme and respiratory chain activities were also observed (26-33). While these findings are very exciting, it is important to realize that these studies used relatively high doses (100 to 300 mg/kg body weight/day) of the compounds and only for a short time (one month). It is not yet known whether taking relatively high doses of these two naturally occurring substances will benefit rats in the long-term or will have similar effects in humans. Clinical trials in humans are planned, but it will be several years before the results are available. If you choose to take carnitine supplements, the Linus Pauling Institute recommends acetyl-L-carnitine at a daily dose of 500 to 1,000 mg.
According to the free radical and mitochondrial theories of aging, oxidative damage of cell structures by reactive oxygen species (ROS) plays an important role in the functional declines that accompany aging (34). ROS are generated by mitochondria as a byproduct of ATP production. If not neutralized by antioxidants, ROS may damage mitochondria over time, causing them to function less efficiently and to generate more damaging ROS in a self-perpetuating cycle. Coenzyme Q10 plays an important role in mitochondrial ATP synthesis and functions as an antioxidant in mitochondrial membranes. Moreover, tissue levels of coenzyme Q10 have been reported to decline with age (35). One of the hallmarks of aging is a decline in energy metabolism in many tissues, especially liver, heart, and skeletal muscle. It has been proposed that age-associated declines in tissue coenzyme Q10 levels may play a role in this decline (36). In recent studies, lifelong dietary supplementation with coenzyme Q10 did not increase the life spans of rats or mice (37, 38); however, one study showed that coenzyme Q10 supplementation attenuates the age-related increase in DNA damage (39). Presently, there is no scientific evidence that coenzyme Q10 supplementation prolongs life or prevents age-related functional declines in humans.
α-Lipoic acid alone or in combination with other antioxidants or L-carnitine has been found to improve measures of memory in animal models of age-associated cognitive decline, including rats (24, 25), mice (40), and dogs (41). However, it is not clear whether oral α-lipoic acid supplementation can slow cognitive decline related to aging or other pathology in humans. An uncontrolled, open-label trial in nine patients with Alzheimer's disease and related dementias, who were also taking acetylcholinesterase inhibitors, reported that oral supplementation with 600 mg/day of racemic lipoic acid appeared to stabilize cognitive function over a one-year period (42). However, the significance of these findings is difficult to assess without a control group for comparison. A randomized controlled trial found that oral supplementation with 1,200 mg/day of racemic lipoic acid for 10 weeks was of no benefit in treating HIV-associated cognitive impairment (43). Although studies in animals suggest that α-lipoic acid may be helpful in slowing age-related cognitive decline, randomized controlled trials are needed to determine whether lipoic acid supplementation is effective in preventing or slowing cognitive decline associated with age or neurodegenerative disease. If you choose to take α-lipoic acid supplements, the Linus Pauling Institute recommends a daily dose of 200-400 mg/day of racemic α-lipoic acid for generally healthy people.
The prevalence of several neurodegenerative diseases increases with advanced age. Inflammation, oxidative stress, and transition metal accumulation appear to play a role in the pathology of several neurodegenerative diseases, including Parkinson's disease and Alzheimer's disease. Because flavonoids have anti-inflammatory, antioxidant and metal-chelating properties, scientists are interested in the neuroprotective potential of flavonoid-rich diets or individual flavonoids. At present, the extent to which various dietary flavonoids and flavonoid metabolites cross the blood-brain barrier in humans is not known (44). Although flavonoid-rich diets and flavonoid administration have been found to prevent cognitive impairment associated with aging and inflammation in some animal studies (45-48), prospective cohort studies have not found consistent inverse associations between flavonoid intake and the risk of dementia or neurodegenerative disease in humans (49-53).
In a cohort of Japanese-American men followed for 25-30 years, flavonoid intake from tea during midlife was not associated with the risk of Alzheimer's or other types of dementia in late life (49). Surprisingly, higher intakes of isoflavone-rich tofu during midlife were associated with cognitive impairment and brain atrophy in late life (see the article on Soy Isoflavones) (50). A prospective study of Dutch adults found that total dietary flavonoid intake was not associated with the risk of developing Parkinson's disease (51) or Alzheimer's disease (52), except in current smokers whose risk of Alzheimer's disease decreased by 50% for every 12 mg increase in daily flavonoid intake. In contrast, a study of elderly French men and women found that those with the lowest flavonoid intakes had a risk of developing dementia over the next five years that was 50% higher than those with the highest intakes (53). More recently, a study in 1,640 elderly men and women found that those with higher dietary flavonoid intake (>13.6 mg/day) had better cognitive performance at baseline and experienced significantly less age-related cognitive decline over a 10-year period than those with a lower flavonoid intake (0-10.4 mg/day) (54). Additionally, a randomized, double-blind, placebo-controlled clinical trial in 202 postmenopausal women reported that daily supplementation with 25.6 g of soy protein (containing 99 mg of isoflavones) for one year did not improve cognitive function (55). However, a randomized, double-blind, placebo-controlled, cross-over trial in 77 postmenopausal women found that six-month supplementation with 60 mg/day of isoflavones improved some measures of cognitive performance (56). Although scientists are interested in the potential of flavonoids to protect the aging brain, it is not yet clear how flavonoid consumption affects neurodegenerative disease risk in humans.
Caloric restriction is known to extend the lifespan of a number of species, including yeast, worms, flies, fish, rats, and mice (57). In yeast (Saccharomyces cerevisiae), caloric restriction stimulates the activity of an enzyme known as Silent information regulator 2 protein (Sir2) or sirtuin (58). Yeast Sir2 is a nicotinamide adenine dinucleotide (NAD)-dependent deacetylase enzyme that removes the acetyl group from acetylated lysine residues in target proteins.
Providing resveratrol to yeast increased Sir2 activity in the absence of caloric restriction and extended the replicative (but not the chronological) lifespan of yeast by 70% (59). Resveratrol feeding also extended the lifespan of worms (Caenorhabditis elegans) and fruit flies (Drosophila melanogaster) by a similar mechanism (60). Additionally, resveratrol dose-dependently increased the lifespan of a vertebrate fish (Nothobranchius furzeri) (61). Resveratrol was also found to extend the lifespan of mice on a high-calorie diet such that their lifespan was similar to that of mice fed a standard diet 62. Although resveratrol increased the activity of the Sir2 homologous human sirtuin 1 (SIRT1) in the test tube (59), there are no epidemiological data to link resveratrol, SIRT1 activation, and extended human lifespan. Moreover, the supraphysiological concentrations of resveratrol required to increase human SIRT1 activity were considerably higher than concentrations that have been measured in human plasma after oral consumption.
The Linus Pauling Institute provides dietary and lifestyle recommendations for generally healthy individuals interested in optimum health and prevention of chronic diseases such as cardiovascular disease (heart disease and stroke), diabetes, cancer, and osteoporosis. These recommendations are contained in the Linus Pauling Institute's Rx for Health.
Click on a topic below for a list of related articles.
Last updated 3/16/15 Copyright 2008-2015 Linus Pauling Institute
1. Blumberg J. Nutritional needs of seniors. J Am Coll Nutr. 1997;16(6):517-523. (PubMed)
2. Russell RM, Suter PM. Vitamin requirements of elderly people: an update. Am J Clin Nutr. 1993;58(1):4-14. (PubMed)
3. López-Sobaler AM, Ortega RM, Quintas ME, et al. The influence of vitamin B2 intake on the activation coefficient of erythrocyte glutation reductase in the elderly. J Nutr Health Aging. 2002;6(1):60-62. (PubMed)
4. Gariballa S, Ullegaddi R. Riboflavin status in acute ischaemic stroke. Eur J Clin Nutr. 2007;61(10):1237-1240. (PubMed)
5. Yazdanpanah N, Uitterlinden AG, Zillikens MC, et al. Low dietary riboflavin but not folate predicts increased fracture risk in postmenopausal women homozygous for the MTHFR 677 T allele. J Bone Miner Res. 2008;23(1):86-94. (PubMed)
6. Ribaya-Mercado JD, Russell RM, Sahyoun N, Morrow FD, Gershoff SN. Vitamin B-6 requirements of elderly men and women. J Nutr. 1991;121(7):1062-1074. (PubMed)
7. Morris MS, Picciano MF, Jacques PF, Selhub J. Plasma pyridoxal 5'-phosphate in the US population: the National Health and Nutrition Examination Survey, 2003-2004. Am J Clin Nutr. 2008;87(5):1446-1454. (PubMed)
8. Brubacher D, Moser U, Jordan P. Vitamin C concentrations in plasma as a function of intake: a meta-analysis. Int J Vitam Nutr Res. 2000;70(5):226-237. (PubMed)
9. Michels AJ, Joisher N, Hagen TM. Age-related decline of sodium-dependent ascorbic acid transport in isolated rat hepatocytes. Arch Biochem Biophys. 2003;410(1):112-120. (PubMed)
10. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr. 2000;71(5):1201-1208. (PubMed)
11. Davies S, McLaren Howard J, Hunnisett A, Howard M. Age-related decreases in chromium levels in 51,665 hair, sweat, and serum samples from 40,872 patients--implications for the prevention of cardiovascular disease and type II diabetes mellitus. Metabolism. 1997;46(5):469-473. (PubMed)
12. Wood RJ, Suter PM, Russell RM. Mineral requirements of elderly people. Am J Clin Nutr. 1995;62(3):493-505. (PubMed)
13. Fleming DJ, Jacques PF, Tucker KL, et al. Iron status of the free-living, elderly Framingham Heart Study cohort: an iron-replete population with a high prevalence of elevated iron stores. Am J Clin Nutr. 2001;73(3):638-646. (PubMed)
14. Food and Nutrition Board, Institute of Medicine. Molybdenum. Dietary reference intakes for vitamin A, vitamin K, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, D.C.: National Academy Press; 2001:420-441. (National Academies Press)
15. Burk RF, Levander OA. Selenium. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease. Philadelphia: Lippincott Williams & Wilkins; 2006:482-497.
16. Food and Nutrition Board, Institute of Medicine. Selenium. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, D.C.: National Academy Press; 2000:284-324. (National Academy Press)
17. Food and Nutrition Board, Institute of Medicine. Dietary Fats: Total Fat and Fatty Acids. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, D.C.: National Academies Press; 2002:422-541. (National Academies Press)
18. European Food Safety Authority Panel on Dietetic Products, Nutrition, and Allergies (NDA) Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. EFSA J. 2010;8(3):107. Available at: http://www.efsa.europa.eu. Accessed 3/12/15.
19. FAO/WHO. Interim Summary of Conclusions and Dietary Recommendations on Total Fat & Fatty Acids. Joint FAO/WHO Expert Consultation on Fats and Fatty Acids in Human Nutrition. Geneva: WHO; 2008:1-14. http://www.who.int/nutrition/topics/FFA_summary_rec_conclusion.pdf.
20. International Society for the Study of Fatty Acids and Lipids. Recommendations for Intake of Polyunsaturated Fatty Acids in Healthy Adults. Available at: http://www.issfal.org/statements/pufa-recommendations. Accessed 4/25/14.
21. American Heart Association. Frequently Asked Questions About Fish. Available at: http://www.heart.org/HEARTORG/General/Frequently-Asked-Questions-About-F.... Accessed 4/25/14.
22. Costell M, O'Connor JE, Grisolia S. Age-dependent decrease of carnitine content in muscle of mice and humans. Biochem Biophys Res Commun. 1989;161(3):1135-1143. (PubMed)
23. Hagen TM, Ingersoll RT, Wehr CM, et al. Acetyl-L-carnitine fed to old rats partially restores mitochondrial function and ambulatory activity. Proc Natl Acad Sci U S A. 1998;95(16):9562-9566. (PubMed)
24. Hagen TM, Liu J, Lykkesfeldt J, et al. Feeding acetyl-L-carnitine and lipoic acid to old rats significantly improves metabolic function while decreasing oxidative stress. Proc Natl Acad Sci U S A. 2002;99(4):1870-1875. (PubMed)
25. Liu J, Head E, Gharib AM, et al. Memory loss in old rats is associated with brain mitochondrial decay and RNA/DNA oxidation: partial reversal by feeding acetyl-L-carnitine and/or R-alpha -lipoic acid. Proc Natl Acad Sci U S A. 2002;99(4):2356-2361. (PubMed)
26. Savitha S, Panneerselvam C. Mitochondrial membrane damage during aging process in rat heart: potential efficacy of L-carnitine and DL alpha lipoic acid. Mech Ageing Dev. 2006;127(4):349-355. (PubMed)
27. Savitha S, Sivarajan K, Haripriya D, Kokilavani V, Panneerselvam C. Efficacy of levo carnitine and alpha lipoic acid in ameliorating the decline in mitochondrial enzymes during aging. Clin Nutr. 2005;24(5):794-800. (PubMed)
28. Sethumadhavan S, Chinnakannu P. L-carnitine and alpha-lipoic acid improve age-associated decline in mitochondrial respiratory chain activity of rat heart muscle. J Gerontol A Biol Sci Med Sci. 2006;61(7):650-659. (PubMed)
29. Sethumadhavan S, Chinnakannu P. Carnitine and lipoic acid alleviates protein oxidation in heart mitochondria during aging process. Biogerontology. 2006;7(2):101-109. (PubMed)
30. Sundaram K, Panneerselvam KS. Oxidative stress and DNA single strand breaks in skeletal muscle of aged rats: role of carnitine and lipoicacid. Biogerontology. 2006;7(2):111-118. (PubMed)
31. Kumaran S, Panneerselvam KS, Shila S, Sivarajan K, Panneerselvam C. Age-associated deficit of mitochondrial oxidative phosphorylation in skeletal muscle: role of carnitine and lipoic acid. Mol Cell Biochem. 2005;280(1-2):83-89. (PubMed)
32. Kumaran S, Subathra M, Balu M, Panneerselvam C. Supplementation of L-carnitine improves mitochondrial enzymes in heart and skeletal muscle of aged rats. Exp Aging Res. 2005;31(1):55-67. (PubMed)
33. Muthuswamy AD, Vedagiri K, Ganesan M, Chinnakannu P. Oxidative stress-mediated macromolecular damage and dwindle in antioxidant status in aged rat brain regions: role of L-carnitine and DL-alpha-lipoic acid. Clin Chim Acta. 2006;368(1-2):84-92. (PubMed)
34. Beckman KB, Ames BN. Mitochondrial aging: open questions. Ann N Y Acad Sci. 1998;854:118-127. (PubMed)
35. Kalen A, Appelkvist EL, Dallner G. Age-related changes in the lipid compositions of rat and human tissues. Lipids. 1989;24(7):579-584. (PubMed)
36. Alho H, Lonnrot K. Coenzyme Q supplementation and longevity. In: Kagan V, Quinn P, eds. Coenzyme Q: Molecular Mechanisms in Health and Disease. Boca Raton: CRC Press; 2001.
37. Singh RB, Niaz MA, Kumar A, Sindberg CD, Moesgaard S, Littarru GP. Effect on absorption and oxidative stress of different oral Coenzyme Q10 dosages and intake strategy in healthy men. Biofactors. 2005;25(1-4):219-224. (PubMed)
38. Sohal RS, Kamzalov S, Sumien N, et al. Effect of coenzyme Q10 intake on endogenous coenzyme Q content, mitochondrial electron transport chain, antioxidative defenses, and life span of mice. Free Radic Biol Med. 2006;40(3):480-487. (PubMed)
39. Quiles JL, Ochoa JJ, Battino M, et al. Life-long supplementation with a low dosage of coenzyme Q10 in the rat: effects on antioxidant status and DNA damage. Biofactors. 2005;25(1-4):73-86. (PubMed)
40. Farr SA, Poon HF, Dogrukol-Ak D, et al. The antioxidants alpha-lipoic acid and N-acetylcysteine reverse memory impairment and brain oxidative stress in aged SAMP8 mice. J Neurochem. 2003;84(5):1173-1183. (PubMed)
41. Milgram NW, Head E, Zicker SC, et al. Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortification: a two-year longitudinal study. Neurobiol Aging. 2005;26(1):77-90. (PubMed)
42. Hager K, Marahrens A, Kenklies M, Riederer P, Munch G. Alpha-lipoic acid as a new treatment option for Azheimer type dementia. Arch Gerontol Geriatr. 2001;32(3):275-282. (PubMed)
43. A randomized, double-blind, placebo-controlled trial of deprenyl and thioctic acid in human immunodeficiency virus-associated cognitive impairment. Dana Consortium on the Therapy of HIV Dementia and Related Cognitive Disorders. Neurology. 1998;50(3):645-651. (PubMed)
44. Youdim KA, Qaiser MZ, Begley DJ, Rice-Evans CA, Abbott NJ. Flavonoid permeability across an in situ model of the blood-brain barrier. Free Radic Biol Med. 2004;36(5):592-604. (PubMed)
45. Patil CS, Singh VP, Satyanarayan PS, Jain NK, Singh A, Kulkarni SK. Protective effect of flavonoids against aging- and lipopolysaccharide-induced cognitive impairment in mice. Pharmacology. 2003;69(2):59-67. (PubMed)
46. Joseph JA, Denisova NA, Arendash G, et al. Blueberry supplementation enhances signaling and prevents behavioral deficits in an Alzheimer disease model. Nutr Neurosci. 2003;6(3):153-162. (PubMed)
47. Joseph JA, Shukitt-Hale B, Denisova NA, et al. Reversals of age-related declines in neuronal signal transduction, cognitive, and motor behavioral deficits with blueberry, spinach, or strawberry dietary supplementation. J Neurosci. 1999;19(18):8114-8121. (PubMed)
48. Goyarzu P, Malin DH, Lau FC, et al. Blueberry supplemented diet: effects on object recognition memory and nuclear factor-kappa B levels in aged rats. Nutr Neurosci. 2004;7(2):75-83. (PubMed)
49. Commenges D, Scotet V, Renaud S, Jacqmin-Gadda H, Barberger-Gateau P, Dartigues JF. Intake of flavonoids and risk of dementia. Eur J Epidemiol. 2000;16(4):357-363. (PubMed)
50. Engelhart MJ, Geerlings MI, Ruitenberg A, et al. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA. 2002;287(24):3223-3229. (PubMed)
51. de Rijk MC, Breteler MM, den Breeijen JH, et al. Dietary antioxidants and Parkinson disease. The Rotterdam Study. Arch Neurol. 1997;54(6):762-765. (PubMed)
52. White LR, Petrovitch H, Ross GW, et al. Brain aging and midlife tofu consumption. J Am Coll Nutr. 2000;19(2):242-255. (PubMed)
53. Laurin D, Masaki KH, Foley DJ, White LR, Launer LJ. Midlife dietary intake of antioxidants and risk of late-life incident dementia: the Honolulu-Asia Aging Study. Am J Epidemiol. 2004;159(10):959-967. (PubMed)
54. Letenneur L, Proust-Lima C, Le Gouge A, Dartigues JF, Barberger-Gateau P. Flavonoid intake and cognitive decline over a 10-year period. Am J Epidemiol. 2007;165(12):1364-1371. (PubMed)
55. Kreijkamp-Kaspers S, Kok L, Grobbee DE, et al. Effect of soy protein containing isoflavones on cognitive function, bone mineral density, and plasma lipids in postmenopausal women: a randomized controlled trial. JAMA. 2004;292(1):65-74. (PubMed)
56. Casini ML, Marelli G, Papaleo E, Ferrari A, D'Ambrosio F, Unfer V. Psychological assessment of the effects of treatment with phytoestrogens on postmenopausal women: a randomized, double-blind, crossover, placebo-controlled study. Fertil Steril. 2006;85(4):972-978. (PubMed)
57. Heilbronn LK, Ravussin E. Calorie restriction and aging: review of the literature and implications for studies in humans. Am J Clin Nutr. 2003;78(3):361-369. (PubMed)
58. Lin SJ, Defossez PA, Guarente L. Requirement of NAD and SIR2 for life-span extension by calorie restriction in Saccharomyces cerevisiae. Science. 2000;289(5487):2126-2128. (PubMed)
59. Howitz KT, Bitterman KJ, Cohen HY, et al. Small molecule activators of sirtuins extend Saccharomyces cerevisiae lifespan. Nature. 2003;425(6954):191-196. (PubMed)
60. Wood JG, Rogina B, Lavu S, et al. Sirtuin activators mimic caloric restriction and delay ageing in metazoans. Nature. 2004;430(7000):686-689. (PubMed)
61. Valenzano DR, Terzibasi E, Genade T, Cattaneo A, Domenici L, Cellerino A. Resveratrol prolongs lifespan and retards the onset of age-related markers in a short-lived vertebrate. Curr Biol. 2006;16(3):296-300. (PubMed)
62. Baur JA, Pearson KJ, Price NL, et al. Resveratrol improves health and survival of mice on a high-calorie diet. Nature. 2006;444(7117):337-342. (PubMed)