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Bell, V.; Rodrigues, A.R.; Antoniadou, M.; Peponis, M.; Varzakas, T.; Fernandes, T. Importance of Micronutrients in the Older Adults. Encyclopedia. Available online: https://encyclopedia.pub/entry/52268 (accessed on 18 May 2024).
Bell V, Rodrigues AR, Antoniadou M, Peponis M, Varzakas T, Fernandes T. Importance of Micronutrients in the Older Adults. Encyclopedia. Available at: https://encyclopedia.pub/entry/52268. Accessed May 18, 2024.
Bell, Victoria, Ana Rita Rodrigues, Maria Antoniadou, Marios Peponis, Theodoros Varzakas, Tito Fernandes. "Importance of Micronutrients in the Older Adults" Encyclopedia, https://encyclopedia.pub/entry/52268 (accessed May 18, 2024).
Bell, V., Rodrigues, A.R., Antoniadou, M., Peponis, M., Varzakas, T., & Fernandes, T. (2023, December 01). Importance of Micronutrients in the Older Adults. In Encyclopedia. https://encyclopedia.pub/entry/52268
Bell, Victoria, et al. "Importance of Micronutrients in the Older Adults." Encyclopedia. Web. 01 December, 2023.
Importance of Micronutrients in the Older Adults
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This entry is adapted from the peer-reviewed paper 10.3390/nu15234900

Aging precipitates significant changes in physical, cognitive, and physiological realms, profoundly impacting nutritional needs. Aging brings declines in muscle mass, immune function, bone density, nutrient absorption, metabolism, and oral health status. Micronutrients (e.g., omega-3 fatty acids, vitamins, and minerals—selenium, fluoride, zinc, iron, and manganese), are of particular importance and are fundamental in terms of human metabolism, physiology, and general and oral health.

elderly interaction nutrients medication diet oral health decay dental caries

1. Introduction

The global increase in life expectancy presents multifaceted challenges, including nutritional considerations, diseases, and polypharmacy, all of which necessitate comprehensive examination to safeguard the health and well-being of the elderly [1]. Extensive research over several decades has explored the interactions between various foods/beverages and prescribed or non-prescribed drugs, uncovering side effects, alterations in drug bioavailability and nutrient absorption as well as their impact on conditions such as tooth decay [2]. While nutrients are fundamental units in nutrition, food/nutrient–drug interactions can arise from physical, biochemical, physiological, metabolic, or pathological interconnections between medications and food/nutrients [3]. Although these synergistic actions lack systematic study, understanding the potential interactions is pivotal for implementing dietary therapies or nutritional preventive approaches during pharmacological treatments [4][5]. The intricacies of this overview are heightened by imprecise nutrient requirement guidelines, ethical limitations on human trials, increased consumer expectations for quality and health outcomes, and the expanding market for food supplements and diet fortification promoted by influential food companies [6][7].
Global aging is a pervasive concern [8] and a paramount demographic shift in the 21st century [9]. Aging precipitates significant changes in physical, cognitive, and physiological realms, profoundly impacting nutritional needs. Aging brings declines in muscle mass, immune function, bone density, nutrient absorption, metabolism, and oral health status. This demographic encounters challenges in meeting the recommended nutrient requirements as food intake diminishes [10]. Additionally, reduced hunger stimulation, diminished sensations of thirst and taste, and potential hydro-electrolyte imbalances further hinder the attainment and maintenance of an ideal nutritional status [11][12].
An unbalanced diet, influenced by lifelong preferences, digestive changes, psychological factors, socioeconomic issues, disability, tooth loss, and prosthetic appliances, poses a risk of malnutrition in the elderly [13][14][15]. Dehydration, inherent to the aging process, contributes significantly to oral health problems, including xerostomia or dry mouth syndrome, which amplifies the likelihood of tooth decay [16]. Dry mouth, characterised by dysphagia, taste loss, and impaired appearance, not only impacts social lives but also leads to malnutrition, diminishing chewing ability, and causes nutrient deficiencies, limited food choices, poor diet quality, and compromised oral health [16][17]. Reduced salivary flow results in symptoms like burning, itching, chewing difficulties, taste impairment, and communication challenges [18][19], further correlating with issues such as difficulties wearing dentures, a poorer diet quality, and tooth decay [20][21]. Dental caries, stemming from oral bacteria’s fermentative actions on dietary sugars, introduces challenges in eating, pain, tooth loss, and a diminished quality of life [22]. Global surveys highlight widespread untreated caries, with peaks at 6, 25, and 70 years, the latter associated with increased root caries [23][24][25]. Key risk indicators for elderly caries encompass past root caries, surfaces at risk, poor oral hygiene, gender, age, periodontal disease, and nutritional discrepancies [15][26]. While fluoride has been effective, discussions increasingly stress the importance of diet and nutrient control for holistic oral disease prevention across all age groups, particularly among the elderly [27][28][29][30][31].
As aging progresses, numerous medications impact the nutritional status of the elderly, resulting in prevalent deficiencies in essential elements crucial for oral health and caries prevalence [32][33]. Precautions are vital to avoid interactions among medications, medications and foods (including beverages and dietary supplements), and medication, nutrients, and oral and gut microbiota [2]. The intricate five-way interaction—environment–host–drug–microbiota–nutrient—underscores the role of gut metabolites in energy metabolism, cell communication, host immunity, and various physiological activities, most notably aging [34]. These interactions, influenced by factors such as gender, age, body composition, nutritional status, clinical condition, and medication types and numbers, can manifest in various ways [35][36]. Chelation, a direct bio-transformation forming a non-absorbable complex between a drug and a food component, is one type of drug–nutrient interaction [37]. Such interactions pose the potential for either the augmentation or depletion of essential nutrients. Macroconstituents (proteins, lipids, and carbohydrates) provide molecular substrates for structural and metabolic processes, while micronutrients (vitamins and minerals) play crucial roles in maintaining optimal bodily function and the integrity of oral tissues. Given the aging body’s reduced ability to synthesise micronutrients, dietary supplementation becomes imperative in the presence of medications, requiring vigilant monitoring of nutrient intake levels [38][39][40][41].

2. Roles of Micronutrients in the Older Adults

The escalating life expectancy gives rise to a concomitant surge in the prevalence of chronic diseases, exerting inevitable ramifications on health, long-term care infrastructures, and overall quality of life [42]. Optimal well-being and nutritional status, it is asserted, should be cultivated well in advance of attaining senior age and prior to the irrevocable manifestation of diverse disease processes [43].
Micronutrients (e.g., omega-3 fatty acids, vitamins, and minerals—selenium, fluoride, zinc, iron, and manganese), are of particular importance and are fundamental in terms of human metabolism, physiology, and general and oral health. They participate in the maintenance of homeostasis and metabolism of the body, in the promotion and maintenance of health, and in the prevention of dental caries and other general diseases throughout our lifetime [44]. They participate in numerous biological processes, including the growth of bones, teeth, and tissues, synthesis of hormones and enzymes, cell and membrane repair, and reactions of energy metabolism, to mention a few [45]. Therefore, a deficit or excess of micronutrients can lead to the development of structural or functional changes and the occurrence of pathologies [46].
More specifically, the possibility of immunomodulation by certain foods has emerged, namely, the role of dietary glucans (β-1,3-glucans), from their bioactive role in various immune reactions and the treatment of cancer, and has been widely studied [47][48]. Consuming the recommended amount of β-glucans through diet may not cause side effects, but taking a β-glucan supplement may cause unintended adverse effects when interacting with medications that decrease the immune system’s response (immunosuppressants) [49]. Further, coenzyme 10 (CoQ10) is synthesised in the human body and is a substance naturally found (e.g., in the heart, liver, kidney, and pancreas) acting as an antioxidant protecting cells against oxidative stress and is involved in energy (ATP) production. Low levels of CoQ10 may be associated with older age, certain medications, genetic defects, nutritional deficiencies, and specific health conditions [50]. A deficiency of CoQ10 was found in inflamed human gingiva and has been found to be responsible for periodontal destruction and loss of teeth [51]. CoQ10, considered a nutraceutical, may make medications (e.g., statins and insulin) less effective at thinning the blood and interfere with antihypertensive, antiglycaemic, and chemotherapy drugs [52], resulting in oral inflammations that increase the risk of dental caries too [53].
Undoubtedly, the spectrum of metabolic interactions between drugs and nutrients is notably extensive. Within cellular structures, an array of highly specific signalling receptors exists, and drugs exert their influence on the cell membrane through physical and/or chemical interactions with these receptors, facilitated by chemical forces or bonds, often involving inner binding sites [54]. Notably, diets that induce acid formation contribute to urine acidification, thereby augmenting the elimination of alkaline drugs like amphetamines. Conversely, drugs with a base-forming nature enhance the elimination of acidic drugs, exemplified by barbiturates [55]. However, this domain is quite complex since it is impossible to study one binding interaction in isolation from the others at an interface. In practice, a synergistic response between non-covalent interactions and molecular responses is observed [56].

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Subjects: Health Policy & Services
Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :
Victoria Bell
,
Ana Rita Rodrigues
,
Maria Antoniadou
,
Marios Peponis
,
Theodoros Varzakas
,
Tito Fernandes
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Update Date: 04 Dec 2023
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