Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial.
BMC Geriatr. 2018 Nov 21;18(1):286. doi: 10.1186/s12877-018-0976-z.
von Berens Å1, Fielding RA2, Gustafsson T3, Kirn D2, Laussen J2, Nydahl M4, Reid K2, Travison TG5,6,7, Zhu H7, Cederholm T8, Koochek A8,4.
RCT participants initially had Vitamin D 22.5–60 nmol/l
800 IU increased levels average of only 36%
- 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018
- Note: Seniors typically need higher doses
- Higher quality of life associated with higher levels of vitamin D
10 reasons why seniors need more vitamin D has the following
- Senior skin produces 3X less Vitamin D for the same sun intensity
- Seniors have fewer vitamin D receptors as they age
(The effect of low Vitamin D receptor genes does not show up on vitamin D test results)
- Seniors are indoors more than when when they were younger
not as agile, weaker muscles; frail, no longer enjoy hot temperatures
(if outside, stay in the shade), however, seniors might start outdoor activities like gardening, biking, etc.
- Seniors wear more clothing outdoors than when younger
fear skin cancer/wrinkles, sometimes avoid bright light after cataract surgery
- Seniors often take various drugs which reduce vitamin D (some would not show up on vitamin D test) statins, chemotherapy, anti-depressants, blood pressure, beta-blockers, etc
- Seniors often have one or more diseases which consume vitamin D ( osteoporosis, diabetes, MS, ...)
- Seniors generally put on weight at they age - and a heavier body requires more vitamin D
- Seniors often (40%) have fatty livers – which do not process vitamin D as well
- Seniors not have as much Magnesium needed to use vitamin D
(would not show up on vitamin D test)
- Seniors with poorly functioning kidneys do not process vitamin D as well
(would not show up on vitamin D test) 2009 full text online Also PDF 2009
- Vitamin D is not as bioavailable in senior digestive systems (Stomach acid or intestines?)
- Category Seniors and Vitamin D
Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults.
In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.5 ± 5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5-60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2-3 times/ week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed).
For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (- 4.5, - 0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories.
CONCLUSIONS: This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.
TRIAL REGISTRATION: Registered at ClinicalTrials.gov, March 2 2012, NCT01542892 .