Minerals are the inorganic compounds of food, in other words, they are those that are found in nature but are not part of a living being. They play a very important role, as they are necessary for the formation of tissues, hormone synthesis as well as the majority of the metabolic reactions where enzymes intervene (proteins).
Minerals can be divided into three groups. The macroelements (sulphur, calcium, chloride, phosphorous, magnesium, potassium, fluoride, sodium) which the body needs at a larger quantity, measured in grams-milligrams. On the other hand, the microelements (cobalt, copper, manganese, iron, zinc, iodine, chrome, etc.) are required in less quantity and are measured in milligrams (thousandths of a gram). Finally, oligoelements or trace elements are those that are required in very low amounts, measured in micrograms (millionths of a gram).
The most important minerals to consider in the elderly are:
Calcium (Ca). This is one of the most important minerals in the adult, due to its vital role in bone metabolism. This mainly affects women, as once they reach menopause, many suffer from accelerated bone loss, which would explain the high incidence of this pathology in the elderly. It is recommendable to regularly consume dairy products along with moderate physical exercise, and in certain cases add vitamin D supplements to the diet, always under medical supervision. Also, it is important to note that in many cases, the elderly present an increased stomach pH (achlorhydria), which complicates the intestinal absorption of this element.
Iron (Fe). Low iron levels in the elderly are generally due to either insufficient consumption or the presence of certain chronic blood-related disorders. The absorption rate of vegetable-based iron (non-hemo) decreases throughout age, while the absorption of animal-origin iron (hemo) does not change. In order to avoid anemias, at least 10 mg/day of iron should be consumed.
Vitamins are substances that are necessary for the body, used for proper growth, development and function.
They are divided into two categories: hydrosolubles or soluble in water (vitamin C, B1, B2, B3, B5, B6, B8, B9, B12). They are eliminated in the urine. Liposolubles or soluble in fat (vitamin A, D, E, K) are stored in the liver and fat tissue. In general, vitamins are consumed in a balanced and varied diet, although some are produced in the body, such as vitamins D and K.
In this stage of life, the most important vitamin deficiencies detected are of the vitamins group B and C. This is mainly due to the insufficient consumption of fruits and vegetables in this population. The cells of the immune system are exposed to frequent oxidative processes with increased production of free radicals. In general, these cells present higher antioxidant concentrations than others. However, it is known that a deficiency in antioxidant nutrients such as vitamin C, A, E and certain minerals, negatively affect the immune response, especially in the elderly.
Vitamin C (ascorbic acid)
Of all the nutrients, vitamin C is quite possibly the most interesting one due to its role in the immune system and the prevention of infections. Consequently, it is recommended to consume at least 1 gram of ascorbic acid per day, although this is still in debate among the clinicians.
Vitamin C, along with other antioxidant vitamins such as A and E, consumed during long periods of time has been shown to decrease the chance of cataracts, which is very frequent in this population. However, vitamin C supplementation must be taken with caution, since its excess can cause secondary effects such as the formation of oxalate crystals in the kidneys or block the absorption of certain vitamins B.
On the other hand, vitamin C levels in plasma below 0.5 mg/L have been associated with higher risk of mortality due to heart disease. For this reason, it is recommendable to increase the consumption of this vitamin in the elderly, however this is still a matter of debate and should be further investigated.
Vitamin B1 (thiamine) y B2 (riboflavin).
The deficiency of these vitamins slows down numerous metabolic processes implicated in energy production, affecting systems that depend on large amounts of energy such as the brain and muscles. Approximately 40% of the elderly do not consume even half of the daily requirements of these vitamins.
In order to assure the required amounts, it is recommended to increase the consumption of pork and liver, which are rich in these vitamins. In this manner it is possible to reach the desired amounts in the elderly. As it is well known, many elderly have very low incomes, which limit their possibilities to acquire these foods. Therefore, as these vitamins are regularly eliminated through the urine, and thus there is no risk for intoxication due to their accumulation in the body, it is possible to include them in the form of supplements under medical supervision.
Vitamin B3 (niacin)
This vitamin is highly recommended for the elderly, in order to avoid states of confusion or severe deficiencies that may affect the muscular and nervous systems. It has been shown that a diet rich in this vitamin can delay the onset of Alzheimer´s disease as well as the cognitive degeneration in the elderly. Niacin can play a very important role in this stage of life, improving the lipidic profile of the individuals by increasing HDL levels (“good” cholesterol). However, the consumption of supplements with this vitamin must be well controlled by a clinician, as an excess can give rise to hepatic problems or aggravate those that already present them.
Vitamin B9 (folic acid)
Inadequate levels of this vitamin in the diet can increase the levels of homocysteine, which at high concentrations can give rise to cardiovascular disorders. Folic acid helps maintain normal levels of serotonin, an important neurotransmitter. There is a relation between vitamin B9 deficiency and depression, which is quite common in the elderly. It is possible to recommend supplements of this vitamin, as always under guidance of a specialist.
Vitamin A (retinol)
This vitamin controls numerous body functions and is found in many animal-based foods, liver, eggs, butter, whole milk, cheese, enriched margarines and oily fish, among others. There are components related to vitamin A in vegetables that, despite not functioning exactly as this vitamin, are important antioxidants. These include licopenes, carotenes and carotenoids present in tomatoes, watermelons and cherries. It is also important to mention luteins, present in chard, spinach, broccoli, and especially eggs. Lutein is a very potent antioxidant that seems to play a role in avoiding macular degeneration (the central part of the retina), which affects a large number of elderly.
It is for these reasons that the elderly should consume a higher amount of foods rich in carotenes.
Vitamin D (calciferol)
As commented in the beginning of this section, osteoporosis in the elderly is very frequent. This vitamin is in charge of stimulating the absorption of calcium and phosphorous in the small intestine, the storage of calcium phosphate in the bones and teeth, and regulating calcium levels in the blood. Vitamin D can be obtained by skin exposure to the sun, although always with moderation. Precursors of this vitamin are present in oily fish, eggs, dairy products, liver and foods that have been enriched with this vitamin.
Vitamin E (tocopherol)
This vitamin is a powerful antioxidant that helps to avoid muscular deterioration, arteriosclerosis and neuronal degeneration. The elderly with low levels of vitamin E have a higher risk of suffering from accelerated physical deterioration. This is another reason to consume extra virgin olive oil, which is rich in this vitamin.
There is certain controversy as to the toxicity of excess vitamin E intake. In general it is considered a safe vitamin that can readily be taken orally in the form of supplements, however certain studies indicate that excess levels of vitamin E can increase the risk of hemorrhages. This is especially relevant in individuals with risk for brain and heart strokes. Furthermore, being a liposoluble vitamin indicates that it is stored in the liver, which may give rise to health problems in that organ. These studies have indicated that certain supplements present extremely high doses of vitamin E, which in certain individuals can be dangerous. It is for this reason that, vitamin E supplementation, as with other vitamins, should be regulated and controlled by a physician, indicating the correct dosage for the individual. On the other hand, excess vitamin E consumption through the diet does not seem to present any problem, and can be freely taken. In general, a healthy, balanced diet contains the necessary levels of this vitamin, and would not require supplementation.