September - APNA

CLINICAL CARE
is important for healthy sperm
production and motility.
B group vitamins particularly B5
for testicular health and B12 to
increase sperm count and motility.
Omega 3 essential fatty acids
Research has highlighted the
importance of omega 3 essential
fatty acids (EFA) for conception,
pregnancy and breastfeeding. These
‘good fats’ must be obtained in
sufficient quantities in the diet for
healthy fertility, pregnancy and
breastfeeding.
Inadequate maternal and paternal
EFA levels have been associated with
infertility, particularly for men, as a
strong negative correlation has been
established with low omega 3 levels
and total sperm count, motility
and morphology. This is a strong
recommendation for increasing
consumption as part of
preconception preparations.
The metabolic demand for omega
3s, particularly docosahexaenoic
acid (DHA) increases in pregnancy
and during lactation. The benefits of
meeting requirements are many and
varied. A recent meta-analysis of
studies showed that
supplementation with fish oil in the
second half of the pregnancy
resulted in increased length of
gestation and slightly greater birth
weight. Higher maternal intake in
DHA has also been shown to have
beneficial effects on visual acuity,
cognitive function, hand-eye
co-ordination and maturity of sleep
patterns in infants. Supplementation
continuing through lactation
ensured higher concentrations of
DHA in breast milk, in order to
provide for the rapid growth of the
baby, particularly the brain. Human
milk DHA levels have been
positively correlated to visual
development in breastfed infants,
and investigations are continuing
into other areas, such as language
production, comprehension and
cognitive function.
It is recommended that pregnant
and breastfeeding mothers consume
2–3 servings of most types of fish
weekly. Blackmores Conceive Well
Gold and Pregnancy & Breastfeeding
Gold contain a range of
nutrients to support preconception
and pregnancy such as those
mentioned above.
Seniors
There is no doubt that Australia is
faced with an ageing population, and
this demographic has been identified
at a disproportionate risk of
nutritional deficiencies. Ageing is
associated with a decline in a
number of physiological functions
that can impact nutritional status in
addition to medication,
hospitalisation and other social
realities. The nutritional status of
older people is an important
determinant of quality of life.
A study published in the Journal of
the American Dietetic Association
suggested a significant proportion
of people over 50 do not receive
sufficient nutrients from diet alone
and therefore may benefit from
supplementation. Those that did
supplement were more likely to
receive adequate levels of essential
nutrients. Many members of this age
group are motivated to maintain
health and vitality through good
nutrition and are open to nutritional
education.
Key nutrients for seniors:
• Calcium is well recognised for
building strong healthy bones and
preventing osteoporosis, but is
also involved in cardiovascular
health particularly regulation of
healthy blood pressure.
• Co enzyme Q10 is a naturally
occurring nutrient; unfortunately,
human tissue concentrations
decrease with advancing age. This
potent antioxidant is concentrated
in metabolically active tissues and
supports cardiovascular health,
immune function, and energy
levels.
• Increasing evidence supports the
multifactor benefits of optimal
omega 3 EFA consumption,
including a protective role in
cardiovascular health, cognitive
function, visual acuity and
reduction of inflammatory states
such as arthritis.
• Vitamin B12 deficiency is
estimated to affect 10–15% of the
population aged over 60; however,
this can be difficult to diagnose
as the elderly do not frequently
display the classical signs and
symptoms. B12 deficiency may
be a result of atrophic gastritis,
hypochlorhydria and resulting
gastrointestinal dysbiosis binding
B12 and preventing absorption.
Adequate levels are necessary
for cognitive and psychiatric
performance and cardiovascular
health. Food fortification with
folate may further complicate
diagnosis of this deficiency.
• Antioxidants such as vitamin A,
E, carotenes and zinc may be
lowered resulting in lowered
immune resistance to infection,
delayed recovery and poor tissue
healing. Maximising consumption
of these nutrients may support
healthy immune resistance,
recovery from infection and
healthy tissue healing.
Vitamin D
Vitamin D has been identified as a
major deficiency in the ageing
Australian population — possibly
affecting up to 75% of this segment.
Older people are prone to deficiency
due to low dietary intake,
diminished exposure to sunlight,
poor intestinal absorption and
impaired hydroxylation in the
kidneys and liver (conversion of D3
into its metabolically active forms).
One of the most recognised
functions of vitamin D is to mediate
calcium homoeostasis to reduce
likelihood of osteoporosis. This is
achieved via stimulation of intestinal
calcium absorption, reabsorption of
calcium from the kidneys and
regulation of parathyroid hormone
influence on skeletal calcium stores.
Vitamin D supplementation has
been investigated for preservation
of muscle strength and functional
ability. Successful treatment with
vitamin D resulted in clinical
improvement in muscle strength,
walking distance, functional ability
and body sway; therefore identifying
vitamin D as an important nutrient
to reduce risk of bone fracture.
Higher concentrations of vitamin
D have been shown to have a
protective affect on age related
diseases, marking vitamin D as an
‘anti ageing’ vitamin. The American
Journal of Clinical Nutrition
published a study that identified
higher concentrations of vitamin D
with increased telomere length —
a chromosomal marker of ageing.
Researchers conclude that higher
levels of vitamin D may age more
slowly than those with low levels.
The National Health and Medical
Research Council has set the AI
(adequate intake) for vitamin D at
5–15 mcg for adult women and men.
There are two forms of vitamin D.
One is produced by the action of
sunlight on skin (D3 or cholecalciferol)
and the other is found in a
limited range of foods (D2 or
ergocalciferol). With current food
supplies and patterns of eating,
it is almost impossible to obtain
sufficient vitamin D from the diet
alone. Vitamin D in foods is fat
soluble and is biologically less active.
Supplementation provides a reliable
and convenient method to maintain
intake.
Danielle Steedman B. Hlth Sc, Ad Dip NAt,
DBM, DRM, MATMS
Danielle is a naturopath with over 10 years of
experience in clinical practice and the natural
supplement industry. Her interests are women’s
and children’s health, utilising dietary, nutritional
and herbal medicines to educate and motivate
patients to achieve optimal health.
September 2010 Primary Times 21