Can a Short Period of Micronutrient Supplementation in Older Institutionalized People Improve Response to Influenza Vaccine? A Randomized, Controlled Trial

“…Improving nutritional status, broadly defined, has been studied as a means to improve immune response to influenza vaccination, particularly among older individuals who may have reduced antibody response and poor nutritional status compared to younger individuals. Most studies have involved supplementation with a combination nutritional formula, primarily antioxidant-based, but results have been mixed with some studies describing a beneficial effect on antibody response [21, 22] and others reporting no effect [23, 24]. In general, these studies were of relatively short duration, and included frail or elderly subjects residing in nursing homes or long term care facilities; these studies did not investigate the independent effect of weight status per se , making it difficult to draw comparisons with our results.…”

Section: Discussionmentioning

confidence: 99%

Association between obesity and vulnerability and serologic response to influenza vaccination in older adults

Talbot

Coleman

Crimin

et al. 2012

Vaccine

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Background Serologic response to influenza vaccination declines with age. Few other host factors are known to be associated with serologic response. Our objective was to determine whether obesity and vulnerability independently predicted serologic response to influenza vaccination. Methods Adults ≥ 50 yrs were recruited during the 2008-09 influenza season. Subjects provided pre- and post-vaccination sera for measuring antibody titers to 2008-09 vaccine components. Body mass index (BMI) was calculated as weight (kg) ÷ height (m)2. Data were collected on vulnerability using the Vulnerable Elders Survey (VES13). Logistic regression evaluated the associations between obesity and vulnerability and the serologic response to vaccination (both seroprotection andseroconversion), adjusting for gender, age, comorbidities, pre-vaccination titer, and site. Results Mean (± standard deviation) age of 415 study subjects was 65 ± 10 yrs; 40% were obese. Mean BMI was 29 ± 5.6 kg/m2; mean VES13 was 1.6 ± 1.8. The proportions of subjects who seroconverted and had seroprotective titers were 40% and 49%, respectively, for A/Brisbane/59 (H1N1); 73% and 80% for A/Brisbane/10 (H3N2); and 34% and 94% for B/Florida. Modified VES-13 (score 0 to 10, with 10 being most vulnerable) was not associated with seroprotection against H1N1 or H3N2, and VES-13 was directly associated with seroconversion to H1N1 but not H3N2 or B. Obesity (BMI ≥ 30 kg/m2 vs. BMI 18.5 – 30) was not associated with seroprotection for H1N1 or H3N2; obesity was directly associated with seroconversion to H3N2 but not H1N1 or B. Age was inversely associated with seroprotection and seroconversion against H1N1 and with seroconversion to influenza B. Conclusion Based on this sample of older healthy subjects, there were no consistent relationships between VES 13 or obesity and either seroprotection or seroconversion to three influenza vaccine antigens.

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“…We have however been unable to detect any improvement in sero-conversion by one month's supplementation with a balanced trace element and vitamin preparation. 76 Taken overall, a meta-analysis showed that there is little if any benefit from a multivitamin and mineral supplement, in terms of incidence of infections in an elderly population, 77 and this has recently been confirmed in a large free living population in Scotland. 78 Cognitive function It has long been thought that supplements of vitamins and trace elements may improve aspects of cognitive function, and studies of well school children have suggested that concentration ability may be improved as a result of such supplements.…”

Section: Infections In the Elderly Populationmentioning

confidence: 99%

Micronutrients in health and disease

Shenkin

2006

Postgraduate Medical Journal

279

163

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Micronutrients play a central part in metabolism and in the maintenance of tissue function. An adequate intake therefore is necessary, but provision of excess supplements to people who do not need them may be harmful. Single micronutrient deficiency states are comparatively easily recognised and treated. Subclinical deficiency, often of multiple micronutrients, is more difficult to recognise, and laboratory assessment is often complicated by the acute phase response. Clinical benefit is most likely in those people who are severely depleted and at risk of complications, and is unlikely if this is not the case. There is little evidence for supplements leading to a reduction in the incidence of infections in the elderly population, in coronary artery disease, or in malignant disease. The best evidence for benefit is in critical illness, and in children in developing countries consuming a deficient diet. More clinical trials are required with good clinical outcomes to optimise intake in prevention and treatment of disease.

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Can a Short Period of Micronutrient Supplementation in Older Institutionalized People Improve Response to Influenza Vaccine? A Randomized, Controlled Trial

Abstract: A micronutrient supplement providing the reference nutrient intake administered over 8 weeks had no beneficial effect on antibody response to influenza vaccine in older people living in long-term care.

Cited by 35 publications

References 13 publications

A systematic review of multivitamin and multimineral supplementation for infection

A systematic review of multivitamin and multimineral supplementation for infection

Association between obesity and vulnerability and serologic response to influenza vaccination in older adults

Micronutrients in health and disease

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