Vitamin E and Respiratory Infection in the Elderly

Abstract

Respiratory infections are prevalent in the elderly, resulting in increased morbidity, mortality, and utilization of health care services. Contributing to the increased incidence of infection with age is the well-described decline in immune response, which has been correlated with patterns of illness in the elderly. For example, there are higher morbidity and mortality from cancer, pneumonia, and post-operative complications in those who have diminished, delayed-type hypersensitivity skin test responses. Nutritional status is an important determinant of immune function. We have shown in double-blind, placebo-controlled trials that vitamin E supplementation significantly improved immune response, including DTH and response to vaccines. Furthermore, subjects receiving vitamin E in the 6-month trial had a 30% lower incidence of infectious diseases. That study, however, was not powered to demonstrate statistical significance, and the infections were self-reported. To overcome these limitations, we conducted a double-blind, placebo-controlled trial to determine the effect of one-year supplementation with 200 IU/day vitamin E on the incidence and duration of respiratory infections in 617 elderly nursing home residents. The results of this clinical trial show that vitamin E supplementation significantly reduces the incidence rate of common colds and the number of subjects who acquire a cold among elderly nursing home residents. A nonsignificant reduction in the duration of colds was also observed. Because of the high rate and more severe morbidity associated with common colds in this age group, these findings have important implications for the well being of the elderly as well as for the economic burden associated with their care.

Vitamin and Micronutrient Intake and the Risk of Community-Acquired Pneumonia in US Women

“…17, 34 Individuals with vitamin deficiencies are at increased risk for respiratory infections, 10 and vitamin supplementation has been shown to decrease the rate of respiratory infections in certain populations. [11][12][13][14][15][16][18][19][20] Micronutrients can improve cell-mediated immunity and reduce oxidative stress. 35 Vitamin E supplementation in healthy, well-nourished adults increased delayed hypersensitivity responses, response to hepatitis B vaccine, lymphocyte proliferation, and decreased formation of immunosuppressive prostaglandins.…”

“…[11][12][13][14][15][16] Other studies have found no benefit with vitamin supplementation in reducing the rate of respiratory infections. 6, 17-20 Merchant and colleagues demonstrated that vitamin E intake from food sources, but not total intake, was inversely associated with pneumonia risk in US men.…”

Adherence to the Nordic Nutrition Recommendations as a measure of a healthy diet and upper respiratory tract infection

“…For example, the fat-soluble vitamins A, D and E have been shown to affect immune cell lineage development, as well as several immune functions including apoptosis and phagocytosis (10) . In addition, vitamin E supplementation in the elderly has been shown to reduce susceptibility to infection (11) , and vitamin C has since 1937 been suggested to reduce the risk of URTI (12) . Other nutrients suggested to affect the risk of URTI are n-3 fatty acids, selenium and zinc (10,13,14) .…”

Dietary Intake and Supplement Use of Vitamins C and E and Upper Respiratory Tract Infection

“…It has been shown to be associated with immune function and resistance to infections in both animal [11] and human [12] studies. Some randomized trials with elderly participants (see [13] for a review) showed a protective effect of vitamin E supplementation against the common cold, with a RR of 0.80 (95% CI 0.64-0.98).…”

“…Most previous studies on antioxidants and URTI have studied the effect of large doses through supplement use [10,13,14]. Few studies have focused on antioxidants from food [15].…”