Using Biochemical Indicators of Nutritional Status for Resilience
What is good health? According to the World Health Organization, it is more than the absence of disease. The social well-being of people in a community must be considered when defining good health. The Samueli Institute writes of resilience – the ability of individuals and societies to respond to stressful challenges, including our ability to cope mentally and physically.
Dr Barberger-Gateau explores nutritional opportunities to support the brain during aging. He summarizes literature associating brain structure and function with long-chain omega-3 polyunsaturated fatty acids, vitamins C and E, carotenoids, polyphenols and B vitamins. He proposes that vitamins D and K may have been overlooked.
Most importantly, Barberger-Gateau builds upon themes proposed by others (Blumberg & Frei, 2007 and Blumberg et al, 2010) that the inability to show benefits in RCTS with nutritional supplements is founded in a lack of sensitivity of selected outcomes, short duration of interventions, a narrow focus on a single nutrient when many may be involved, and the lack of a true placebo control. The reality is that everyone has a nutritional status. It may not be optimal but we all eat. Participants read about new research findings and these reports sometimes affect our food and supplement choices during the course of the intervention.
Without biological assessments of nutritional status, e.g. serum α-tocopherol concentrations and/or urinary α-CEHC concentrations, RCTs provide limited insight into the role of nutrients on functional outcomes, e.g. cognitive function. A simple statistical comparison of treatment vs placebo,, especially when compliance is low, fails to consider the role of nutritional status on the outcome.
Nutritional screening and routine clinical laboratory measurements help predict adverse outcomes in hospitalized patients. Similar clinical laboratory measurements of nutritional status should be applied to healthy populations. More people should be screened using the blood and urinary biochemical indicators reported in the CDC’s Second Nutrition Report.
With biochemical nutritional assessments in hand, individuals and policy makers could take steps to increase resilience.
Barberger-Gateau P. Nutrition and aging: how can we move ahead? 2014 EJCN doi: 10.1038/ejcn.2014.177
Blumberg JB, Frei B. Why clinical trials of vitamin E and cardiovascular disease are fatally flawed. Commentary on “The Relationship Between Dose of Vitamin E and Suppression of Oxidative Stress in Humans”. 2007 Free Rad Biol Med doi: 10.1016/j.freeradbiomed.2007.08.017
Blumberg J, Heaney RP, Huncharek M, Scholl T, Stampfer M, Vieth R, Weaver CM, Zeisel SH. Evidence-based criteria in nutritional context. 2010 Nutr Rev doi: 10.1111/j.1753-4887.2010.00307.x
Lebold KM, Ang A, Traber MG, Arab L. Urinary α-carboxyethyl hydroxychroman can be used as a predictor of α-tocopherol adequacy, as demonstrated in the Energetics Study. 2012 Am J Clin Nutr doi: 10.3945/ajcn.112.03862
Chen ZY, Gao C, Ye T, Zuo XZ, Wang GH, Xu XS, Yao Y. Association between nutritional risk and routine clinical laboratory measurements and adverse outcomes: a prospective study in hospitalized patients of wuhan tongj hospital. 2014 EJCN doi: 10.1038/ejcn.2014.239