Do Older Adults Need Vitamins, Supplements?

senior man pouring pills into hand

Nov. 30, 2012 — At least half of adults age 65 and above take daily vitamins and other supplements, but only a fraction actually need them, says an Emory University expert.

The majority of older adults, he says, can improve their diet to get needed nutrients.

“A lot of money is wasted in providing unnecessary supplements to millions of people who don’t need them,” says Donald B. McCormick, PhD, an Emory professor emeritus of biochemistry and the graduate program in nutrition and health sciences at Emory.

He challenges what he says is a widely held belief that the older people get, the more vitamins and mineral supplements they need.

The scientific backup for that doesn’t exist, he says. “We know too little to suggest there is a greater need in the elderly for most of these vitamins and minerals.”

“A supplement does not cure the aging process,” he says. And in some cases, supplements may do harm, he says. Expense is another factor.

His report, which reviews numerous studies of vitamins and mineral supplements, is published in Advances in Nutrition.

Duffy MacKay, ND, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, an industry group representing dietary supplement makers, agrees that starting with a good diet is the best way to get needed nutrients.

But he says that is not always reality, especially for older adults who may have obstacles such as a reduced appetite.

Older-Adult Nutrient Needs

McCormick reviewed studies on dietary supplements in older adults published in the last 12 years.

He says that ”it is apparent that changes in requirements for the elderly do not suggest massive supplement use covering most micronutrients.” He says minor diet changes can fill needs for nutrients, ”with supplements included only where there is evidence of serious limitation of intake.”

He disagrees with a study suggesting that older adults should take two multivitamins a day. He found no evidence that older adults need more thiamin, riboflavin, or niacin than younger people. Some older adults may need more vitamin B6, B12, and folate, research suggests.

But vitamin C needs do not seem to change with age, he says, if an older adult does not smoke cigarettes.

McCormick also found no evidence that absorption or the body’s use of vitamin E changes as people get older. He says there is a decrease in the way the skin makes vitamin D. So for some older adults, supplemental vitamin D may be needed. In some research, taking 800 to 1,000 IUs of vitamin D a day helped women who were past menopause.

Copper requirements don’t seem to change with age, either, McCormick says.

Older adults often take in less chromium, but he says there is not evidence that there are any health consequences.

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Eczema in Adults: Dealing with Itching

The itching of eczema can sometimes feel unbearable. And yet, the more you scratch, the itchier your skin becomes.

To stop the cycle of eczema, here are six tips to soothe the itch.

1. Moisturize skin affected by eczema often.

In most cases, moisturizers are the first step in itch control. Applying moisturizer helps lock in your skin’s own moisture. “Recent studies reveal that individuals with eczema have gaps between the cells in their skin that allow allergens to get in,” says Andrea Cambio, MD, FAAD, medical director of Cambio Dermatology in southwest Florida. “Moisturizer can fill these gaps and make it harder for allergens to get into the skin.”

The key is to moisturize often, especially right after bathing or washing. Look for a moisturizer that is unscented, because additives and fragrances can irritate the skin. For the most moisture protection, choose a thicker ointment, like petroleum jelly. Ointments contain more oil than water and are more effective than creams or lotions at locking in moisture.

But the most important thing is to choose a moisturizer you like. “If you like how the moisturizer feels on your skin, you’re more likely to use it often,” says Lawrence Eichenfield, MD, chief of Pediatric Dermatology at Rady Children’s Hospital in San Diego.

2. Take an oatmeal or bleach bath.

A short bath in lukewarm water with colloidal oatmeal can help ease itching. Purchase a pre-packaged oatmeal bath mix at your local drug store. Follow the directions on the label and soak about 15 to 20 minutes. After your bath, gently pat yourself dry with a soft towel. Then apply moisturizer right away, ideally while the skin is still damp.

Diluted bleach baths can reduce your risk of getting a skin infection that may worsen your eczema symptoms. For a bleach bath, add 1/2 cup of bleach for a full tub of water, or 1/4 cup for a half tub of water and mix well. Soak for about 10 minutes, and then rinse your skin with clean lukewarm water. Because bleach can be caustic, be sure to talk to your doctor first.

3. Use cold compresses to soothe itchy skin.

Cold compresses applied to the skin can also soothe itch. You can place an ice pack inside a plastic bag or soft towel. Hold the ice next to the itchy skin for a few minutes or as needed to help relieve itch.

4. Wear comfortable fabrics that feel good.

Choose comfortable, loose-fitting fabrics that make your skin feel good. Cottons and cotton blends are usually the most comfortable. Avoid course materials, wool, and synthetic fabrics since these fabrics can irritate your skin.

5. Keep your fingernails short to prevent skin damage.

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Men’s Midlife Crisis: What to Do

How to Get Out of a Midlife Crisis

By Eric Metcalf, MPH
WebMD Feature

Many men go through a phase when they take a hard look at the life they’re living. They think they could be happier, and if they need to make a big change, they feel the urge to do it soon.

These thoughts can trigger a midlife crisis. By realizing you’re in this phase, then making wise choices, you can steer yourself out of a midlife crisis and into a happier life. 

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How to Spot a Midlife Crisis

A true midlife crisis usually involves changing your entire life in a hurry, says Calvin Colarusso, MD, a clinical professor of psychiatry at the University of California San Diego. An example is a man he counseled who wrote a note to his wife, withdrew his money from the bank, and moved to another city without warning.

This type of midlife crisis is rare, Colarusso says. More often, men go through a midlife process in which they make smaller changes over time.

“You might tell your wife, ‘I’ve got to get out of this job,’ and you do. Or you say to your wife, ‘I’m done. The marriage isn’t working for me.’ You don’t change everything and you don’t do it frantically,” he says. “And for many people, after this agonizing reappraisal, they decide to stay with what they’ve got.”

Signs that you’re going through this midlife phase, or that you may soon, include:

You’ve hit your 40th birthday. Colarusso, who has a special interest in issues that affect adults as they age, most often sees men struggling with these midlife questions in their 40s and early 50s.

You’re uneasy about major elements in your life. Colarusso says this may include not be satisfied with your career, your marriage, or your health, and feel the urge to take action to make them better.

You feel that your time for taking a new direction is running short. Many men feel a pressing need to make changes, Colarusso says, when:

  • They notice that their appearance is changing or their stamina isn’t as high as it used to be.
  • They become a grandfather.
  • A friend or parent dies.

However, it’s not inevitable to go through a midlife crisis when those things happen. 

You’re making unusual choices. Men may go through a “teenage-like rebellion” at this point in their lives, says Boston psychologist Lynn Margolies, PhD. “A sure sign you may be in a midlife crisis is if you are feeling trapped and very tempted to act out in ways that will blow up your life,” she says. These may include:

  • Drinking more.
  • Having an affair.
  • Leaving your family.
  • Feeling that your life no longer fits you.
  • You’re more concerned about your appearance.
  • You feel more desire for excitement and thrills.

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Dissolvable Micro-Mirrors Enhance Imaging, Administer Heat, Deliver And Monitor Drugs

Main Category: Medical Devices / Diagnostics
Article Date: 30 Nov 2012 – 1:00 PST

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Tufts University School of Engineering researchers have demonstrated silk-based implantable optics that offer significant improvement in tissue imaging while simultaneously enabling photo thermal therapy, administering drugs and monitoring drug delivery. The devices also lend themselves to a variety of other biomedical functions.

Biodegradable and biocompatible, these tiny mirror-like devices dissolve harmlessly at predetermined rates and require no surgery to remove them.

The technology is the brainchild of a research team led by Fiorenzo Omenetto, Frank C. Doble Professor of Engineering at Tufts. For several years, Omenetto; David L. Kaplan, Stern Family Professor of Biomedical Engineering and Biomedical Engineering chair, and their colleagues have been exploring ways to leverage silk’s optical capabilities with its capacity as a resilient, biofriendly material that can stabilize materials while maintaining their biochemical functionality.

The technology is described in the paper “Implantable Multifunctional Bioresorbable Optics,” published in the Proceedings of the National Academy of Sciences.

“This work showcases the potential of silk to bring together form and function. In this case an implantable optical form – the mirror – can go beyond imaging to serve multiple biomedical functions,” Omenetto says.

Turning Silk into Mirrors

To create the optical devices, the Tufts bioengineers poured a purified silk protein solution into molds of multiple micro-sized prism reflectors, or microprism arrays (MPAs). They pre-determined the rates at which the devices would dissolve in the body by regulating the water content of the solution during processing. The cast solution was then air dried to form solid silk films in the form of the mold. The resulting silk sheets were much like the reflective tape found on safety garments or on traffic signs.

When implanted, these MPAs reflected back photons that are ordinarily lost with reflection-based imaging technologies, thereby enhancing imaging, even in deep tissue.

The researchers tested the devices using solid and liquid “phantoms” (materials that mimic the scattering that occurs when light passes through human tissue). The tiny mirror-like devices reflected substantially stronger optical signals than implanted silk films that had not been formed as MPAs.

Preventing Infection, Fighting Cancer

The Tufts researchers also demonstrated the silk mirrors’ potential to administer therapeutic treatments.

In one experiment, the researchers mixed gold nanoparticles in the silk protein solution before casting the MPAs. They then implanted the gold-silk mirror under the skin of mice. When illuminated with green laser light, the nanoparticles converted light to heat. Similar in-vitro experiments showed that the devices inhibited bacterial growth while maintaining optical performance.

The team also embedded the cancer-fighting drug doxorubicin in the MPAs. The embedded drug remained active even at high temperatures (60 degree C), underscoring the ability of silk to stabilize chemical and biological dopants.

When exposed to enzymes in vitro, the doxorubicin was released as the mirror gradually dissolved. The amount of reflected light decreased as the mirror degraded, allowing the researchers to accurately assess the rate of drug delivery.

“The important implication here is that using a single biofriendly, resorbable device one could image a site of interest, such as a tumor, apply therapy as needed and then monitor the progress of the therapy,” says Omenetto.

Collaborating with Omenetto and Kaplan from Tufts Department of Biomedical Engineering were Hu Tao, research assistant professor; Jana M. Kainerstorfer, post-doctoral researcher; Sean M. Siebert, a Tufts undergraduate; Eleanor M. Pritchard, former post-doctoral researcher; Angelo Sassaroli, research assistant professor; Bruce J.B. Panilaitis, research assistant professor; Mark A. Brenckle, graduate student; Jason Amsden, former post-doctoral researcher; Jonathan Levitt, post-doctoral researcher, and Professor Sergio Fantini.

At Tufts, Fiorenzo Omenetto also has an appointment in the Department of Physics in the School of Arts and Sciences, and David Kaplan also has appointments in the Department of Chemical and Biological Engineering, the Department of Chemistry in the School of Arts and Sciences, the Sackler School of Graduate Biomedical Sciences, and the School of Dental Medicine.

The work was supported by the United States Army Research Laboratory, the United States Army Research Office, the Defense Advanced Research Projects Agency, the Air Force Office of Scientific Research, the Tissue Engineering Resource Center of the National Institutes of Health under award number P41EB00250 and the National Science Foundation.

Tao, H., Kainerstorfer, J.M., Siebert, S.M., Pritchard, E.M., Sassaroli, A., Panilaitis, B., Brenckle, M.A., Amsden, J., Levitt, J., Fantini, S., Kaplan, D. L., and Omenetto, F.G. (2012),.Implantable Multifunctional Bioresorbable Optics, Proceedings of the National Academy of Sciences. Doi:10.1073/pnas.1209056109

Tufts University

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Hope For Arthritis Patients ‘Walking On Marbles’

Main Category:
Article Date: 29 Nov 2012 – 1:00 PST

Hope For Arthritis Patients ‘Walking On Marbles’

Researchers at the University of Southampton are to undertake a new stage of a study aimed at improving the health and mobility of those suffering from the common complaint of ‘walking on marbles’ associated with Rheumatoid Arthritis (RA) in the feet.

RA is the second most common form of arthritis in the UK, affecting almost 600,000 people, which results in the destruction of joints around the body caused by inflammation.

Forefeet often contain some of the first joints to be affected and those with the condition often say that they feel like they are ‘walking on marbles’. Mostly, people have thought that this was due to walking on foot joints that are affected by the RA.

The Health Sciences’ FeeTURA study however, developed new ways of assessing the forefeet through the use of diagnostic ultrasound and magnetic resonance imaging techniques. From this work, the team discovered that some of the swellings and associated feeling of ‘walking on marbles’ were related to inflamed bursae (a fluid-filled sac usually found in areas subject to friction) that had developed underneath the forefoot joints. These inflamed bursae were rarely detected by clinical examination.

The exact cause of the inflamed bursae is not known and a cure is yet to be found, however, the team is now looking at identifying inflammatory and mechanical markers to find the best ways of treating this complication in people suffering with RA. They will evaluate foot health treatments, such as targeted steroid injections, as well as medical management through the use of new drugs (called biologics).

This new stage of the study will be funded through a partnership between Solent NHS Trust and the Faculty of Health Sciences at the University of Southampton and supported by a National Institute for Health Research (NIHR) clinical academic fellowship.

During the first stage of the study, which took place between 2006 and 2009, researchers at the University of Southampton developed a technique to better evaluate the forefeet and diagnose the ‘marbles’ using diagnostic ultrasound. Participants’ who were assessed at the NIHR Wellcome Trust Clinical Research Facility (WTCRF), based at Southampton General Hospital, returned for re-assessment in the second stage of the study which discovered the changes that had occurred in the condition.

A third stage used an MRI scan to visualise the anatomical structures and ‘marbles’ more clearly in the forefeet and resulted in researchers developing the first ever atlas to categorise the swellings originally identified in stage one.

Led by senior lecturer for Advanced Clinical and Expert Practice, Dr Catherine Bowen, this new stage of the treatment study will be carried out by clinical academic researcher, Lindsey Hooper, who recently won a prestigious special award from Wessex HIEC for the previously completed MRI work.

Dr Bowen comments: “Although more common in the UK than leukaemia and multiple sclerosis, awareness of the severity of rheumatoid arthritis is limited.

“Our linked study aims to significantly improve the lives of those affected by the condition in their forefeet, reducing the severity of the symptoms including pain, inflammation, poor sleep, fatigue and depression, and therefore helping improve their mobility and wellbeing.”

Lindsey Hooper adds: “This is an amazing opportunity to be involved in a study that is potentially life-changing for the many people suffering from this progressively debilitating condition.

“As I am maintaining my clinical role as a rheumatology podiatrist whilst also completing the research it means the findings can be fed directly back into clinical practice, so that local patients receive the most up-to-date care options.”

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Expert Answers to Your Exfoliation Questions

Get Glowing: Exfoliation Products for Your Face and Body

Our head to toe guide to scrubs, peels, and lotions.

WebMD the Magazine – Feature

Is your skin feeling a little rough around the edges? Cosmetic dermatologist Naila Malik, MD, says regular exfoliation is an important part of a skin care regimen.

Cells move from the base of the epidermis up to the top in a cycle of about 30 days. If the old cells remain on the surface and build up, Malik says, they can contribute to a flat, dull appearance, blemishes, and scaling. Exfoliation also helps improve the penetration of your other skin products.

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Dermatologist Jessica Wu, MD, agrees. “While exfoliating has year-round benefits, as the weather gets colder and the humidity levels drop, more cells dry out and accumulate on the surface,” Wu says. “They need to be removed to uncover smooth, fresh skin.”

Malik’s top exfoliator picks:

For the face, I like the combination of crystals for mechanical exfoliation and lactic acid for chemical exfoliation in the Olay Regenerist Microdermabrasion & Peel System. For a more gentle treatment, Neutrogena Deep Clean Invigorating Foaming Scrub uses softer beads to loosen dead skin.

Hands, feet, and back can tolerate stronger exfoliants than your chest and shoulders. A combination product like Eucerin Intensive Repair Body Lotion combines exfoliants with moisturizer to help avoid irritation while smoothing rough spots.

Smoothing the thick, easily calloused skin on your heels can be tough. You may need to use a scrub to loosen skin and then tackle rough spots with a foot file like the Tweezerman Spa Callus Smoother.

Wu’s top exfoliator picks:

Acne-causing bacteria feed on the oil trapped by skin cells that don’t turn over quickly enough. So sloughing is important for preventing breakouts. One of my favorite products is Clean & Clear Advantage 3-in-1 Exfoliating Cleanser. The microbeads help loosen blackheads, but they’re smooth and won’t scratch your skin. And the benzoyl peroxide kills acne-causing bacteria.

Incorporate a scrub into your daily shower routine if your skin tolerates it. Using a product like de-luxe Bain Foaming Body Scrub with apricot kernel powder can help keep elbows and knees free of rough patches and reduce dead-skin cell build up.

If your skin is prone to sensitivity, look for salicylic or glycolic acid washes like Neutrogena Body Clear Body Wash, Pink Grapefruit to gently slough dry skin.

Feet can handle slightly more aggressive treatment. The pumice particles in Dr. Scholl’s For Her Liquid Pumice Foot Scrub work beautifully on the thick scales that develop on the heels and balls of your feet.

Exfoliation How-To

Our skin experts warn that people with certain skin types should be careful not to exfoliate too much.

Sensitive skin. Exfoliation for those with very reactive skin can lead to severe irritation and even scarring. Plus, you risk shedding too much of the skin’s protective barrier, which may cause inflammation, dryness, and sun sensitivity. No matter your skin type, it’s important to follow with a moisturizer since exfoliation can make your skin prone to dryness.

Pigmented skin. People with darker complexions need to be cautious with exfoliation because they are prone to post-inflammatory pigmentation, which is difficult to reverse.

Acne-prone skin. While gentle exfoliation can help prevent breakouts, being too rough with harsh, excessive rubbing can aggravate acne by causing inflammation and providing more openings for bacteria.

The opinions expressed in this section are those of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.

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Skin-Softening Bath Blend

Skin-Softening Bath Blend

WebMD Feature

Dry bath mixes have a fairly long shelf life, but you should use them within 3 to 6 months. Keep in a tightly sealed container. Do not store bath bags with oils or honey in them.

1/4 cup oatmeal (rolled or minute type)

1/4 cup milk powder

1/4 cup brown sugar

1/4 cup herbs of choice

10 to 15 drops of essential oils of choice

2 tablespoons of honey

2 teaspoons of body oil of choice

Grind oatmeal, milk powder, sugar and herbs in a food processor until coarsely processed. In a separate bowl, mix essential oil, honey and body oil. Combine and add to a muslin bath bag. Steep in the tub for a few minutes, covered in hot water. Add more water to the bath and enjoy. Use cold tea bags (green tea or chamomile) over your eyes as your relax in your bath.

(Courtesy of Trisha Shirey of the Lake Austin Spa Resort in Austin, Texas)

Reviewed on November 27, 2012

© 2012 WebMD, LLC. All rights reserved.

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Coffee Energizing Body Scrub

Coffee Energizing Body Scrub

WebMD Feature

Coffee is very exfoliating and energizing. Use this scrub on your arms, legs, feet, elbows and rough places where you need more exfoliation. If you like the smell of coffee, this is for you.

1/4 cup of sugar

1 4-inch sprig of fresh rosemary

1/4 cup coffee beans, finely ground

2 tablespoons bentonite clay

3 tablespoons of the body oil best for your skin

3 drops each of rosemary oil and grapefruit or peppermint oils

Combine sugar and rosemary in a spice grinder and process until the rosemary is finely ground. Mix with remaining ingredients. Scrub skin lightly with the mix and shower off. Moisturize afterward with additional body oil.

(Courtesy of Trisha Shirey of the Lake Austin Spa Resort in Austin, Texas)

Reviewed on November 27, 2012

© 2012 WebMD, LLC. All rights reserved.

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Purifying Lemon Ginger Foot Soak

Purifying Lemon Ginger Foot Soak

WebMD Feature

Get your feet feeling good with this soak. This recipe is quick to make anytime your feet need some TLC.

1 gallon very warm water

Juice of 1 lemon

1/2 cup sea salt

2 tablespoons ground ginger

Fill a small basin with enough water to completely cover your feet up to your ankles. Make sure the water is hot enough to stay warm for the duration of your soak, but not too hot that it burns your feet. Add the lemon juice, sea salt and ground ginger to the water and stir. Slowly put both feet into the basin. Relax and soak your feet for 10 to 20 minutes.

(Courtesy of Annie Price, founder of the blog AllNaturalAnnie.com)

Reviewed on November 27, 2012

© 2012 WebMD, LLC. All rights reserved.

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Papaya No-More-Pores Double Mask Treatment

WebMD Feature

Mask 1:

This mask’s slight bleaching action helps even skin tone and leaves skin with a wonderful glow. The papaya and pineapple help to dissolve and lift away dry scaly skin, which, over time, can build up on your skin and leave a dull appearance.

Recommended for: all skin types except sensitive, irritated, sunburned, or windburned skin.

Use: 1 time per week

Follow with: moisturizer

Prep time: 10 to 15 minutes

Blending tools: mortar and pestle or small bowl and fork

Do not store; mix as needed

Yield: 1 treatment for Mask 1; 1 treatment for Mask 2

1/4 cup freshly mashed raw papaya

1 teaspoon fresh, raw pineapple juice (optional)

Using a mortar and pestle or a small bowl and fork, mash the papaya and combine with the pineapple juice (if available and desired) until the two are thoroughly mixed and a smooth paste is formed.

Application tips: Gently pat this juicy pulp onto the face and neck with your fingers, then lie down for 15 to 20 minutes with a towel around your head and behind your neck – the product can be a bit runny. Your face will probably tingle during this time but you can relax; it just means the natural fruit acids are working. After 20 minutes, rinse.

After using Mask 1, apply Everyone’s Basic Clay Mask, using strong sage or rosemary tea or an infusion made with 1 teaspoon of herb in place of the cream, milk, or water as the liquid to mix with the clay. Note: If your skin is especially sensitive or irritated, use milk or cream as the mixing liquid.

Application tips: Apply as directed in the recipe. Those with dry skin can apply a thin layer of moisturizer before proceeding with the clay mask. All skin types should apply moisturizer after this mask. After you’ve finished, your face will look smoother and more refined.

Mask 2: Everyone’s Basic Clay Mask

All clay masks gently exfoliate as they tighten, stimulate circulation, and soften the skin. Because you can customize it for your skin type, this mask is gentle enough for anyone.

Recommended for: all skin types

Use: 1 or 2 times per week

Follow with: moisturizer

Prep time: approximately 5 minutes

Blending tools: small bowl, spoon or tiny whisk

Store in: do not store; mix as needed

Yield: 1 treatment

1 tablespoon white clay

Cream (for dry skin), milk (low fat or whole; for normal skin), or water (for oily skin)

In a small bowl, combine the clay with enough of the appropriate liquid (determined by your skin type) to form a smooth, spreadable paste. Stir with a small spoon or whisk to remove any lumps.

Application tips: Using fingers, spread paste onto the face, neck, and décolleté (if desired), and allow to dry completely for 20 to 30 minutes, preferably while you are lying down. The mask will seemingly lift and tighten the skin. Rinse.

(Excerpted from Organic Body Care Recipes © by Stephanie Tourles. Used with permission from Storey Publishing.)

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