A Pharmacist's Guide to OTC Therapy: Nutritional Supplements for the Aging Population

A nutritional supplement is defined as a product that is intended to be used as an adjunct to a diet, contains one or more dietary ingredients such as vitamins, minerals, and trace elements, and is available in an assortment of forms including tablets, capsules, drinks, powders, and energy bars. Today many supplements contain herbs, botanicals, and amino acids as well.

As individuals age, their nutritional needs change. Some vitamins become increasingly important, because older individuals absorb and store nutrients differently. Many older individuals do not eat a sufficient number of calories so as to obtain an adequate amount of essential nutrients. Therefore, supplements typically are used to meet daily nutritional needs. Common deficiencies include vitamins A, B¹ (thiamine), B² (riboflavin), B⁶ (pyridoxine), B¹² (cobalamin), and C; folic acid; and the minerals calcium, zinc, magnesium, chromium, and iron, as well as other trace elements.¹

Goals

Nutritional supplements should be used in conjunction with a balanced diet and not in place of eating nutritious foods. There are, however, several other reasons for using nutritional supplements²:

• Weight gain
• Boosting energy and strength
• Aiding in recovery from illness or during chemotherapy treatments
• Offsetting declining appetite after surgery or from certain medications or illnesses
• Building up stores of nutrients prior to and after surgery
• Overcoming difficulty in swallowing
• Providing extra calcium for menopausal women

Currently, many formulations of nutritional supplements target the patient population over 50 years of age (Table 1). Many products are formulated to address specific health needs, such as cardiovascular health, prostate health (for men), or protection against osteoporosis (primarily for women). Also, a variety of different formulations are marketed as meal-replacement products for individuals who are attempting to lose weight, those with active lifestyles, and those seeking to ensure that they receive adequate nutrition (Table 2).

The Role of the Pharmacist

It is important for pharmacists to become familiar with good nutritional practices in order to aid patients, in selecting nutritional supplements and to provide counseling on their proper use. Pharmacists are in a key position to identify possible drug interactions with certain vitamins and minerals and to make clinical recommendations to physicians when needed. Pharmacists also should inform patients to only use the recommended amount of a supplement, because excessive amounts of some vitamins and minerals can mask deficiencies in others.

It is essential for patients to understand that there is no substitute for eating a healthy balanced diet. Pharmacists can refer patients to registered dietitians when deemed appropriate to help them make wise nutritional choices with regard to diet plans as well as supplements.³

Ms. Terrie is a clinical pharmacy writer based in the northern Virginia area.