Targeted Micronutrients for Successful Aging

Quality Report

Healthy aging recommendations from GW University School of Medicine (aka the DC3 approach)

A team of physicians at George Washington University School of Medicine recently published a nutrient-based approach to successful (resilient) aging. These recommendations aim to address concurrent issues of frailty, multiple drug prescriptions, multiple chronic conditions, and micronutrient deficiencies that commonly occur as we age. Let’s dive in on their proposed approach to targeted micronutrients, which we’ll call DC3. Bet you can’t guess what the last “C” stands for…

Vitamin D: Essential for bone health.

As summarized by Muller et al., Vitamin D is best known for its role in supporting calcium homeostasis and bone metabolism. Kogan et al. shared that Vitamin D insufficiency is common among older populations due to multiple factors, including spending less time outdoors, negative impacts of some medications, and lower synthesis by the skin. Meta analyses of clinical trials have shown that Vitamin D supplementation helped to decrease the risk of falls, as well as hip and nonvertebral bone fractures. NIH’s recommended daily dietary intake of Vitamin D is 600 IU (15 mcg) for people up to 70 years of age and 800 IU (20 mcg) for adults over 70 years old.

Choline: Essential for liver, muscle, and brain health.

Choline, a nutrient that supports liver, muscle, and brain health, is present in meat, milk grain, eggs, and fish. As described by Kansakar et al., choline helps to usher fat out of the liver, support muscle growth and strength, and help with cognitive function by serving as the precursor to acetylcholine.

In 1998, the FDA identified choline as an essential nutrient, with Adequate Intake levels defined as 550 mg/day for adult men and 425 mg/day for adult women. Vennemann et al. showed that most people had average choline intake below these levels. Eri et al.’s randomized placebo controlled clinical trial reported that citicoline (CDP-choline) improved memory among healthy older people.

Creatine: Gaining strength for, well, strength.

Creatine is used for energy metabolism and has gained increasing attention regarding its role in supporting muscle health. In a recent paper, Ostojic proposes establishing dietary reference intakes for creatine in adults. Since our bodies can readily make creatine, it is not an essential nutrient. There may be optimal levels, however, that are difficult to reach without added amounts from the diet or supplementation. Ostojic suggested approximately 400 mg/day for men and 240 mg/day for women. Primary dietary sources of creatine are meat, fish, and dairy products.

A meta-analysis from Lanhers et al. demonstrated that creatine supplementation improved lower limb muscle strength performance. Further, Delpino et al. showed in their clinical trial meta-analysis that creatine supplementation helped increase lean body mass, importantly, when used during a resistance training program.

C15:0: An emerging foundational nutrient delivering cellular resilience.

C15:0, an odd-chain saturated fatty acid and emerging foundational nutrient, made it onto the GW University School of Medicine team’s short list of four core nutrients needed to support healthy aging. Chances are, if you’re reading Science Says!, you already know why.

In their paper, Kogan et al. describe how C15:0 addresses multiple needs on the healthy aging front, including its involvement in longevity, cardiometabolic, immune, and liver health by targeting mutliple hallmarks of aging and well-established mechanisms of action. One of these core mechanisms is C15:0’s role in strengthening cell membranes, including red blood cells. In a randomized placebo-controlled clinical trial by Robinson et al., when daily C15:0 supplementation resulted in C15:0 levels > 5 ug/ml (20 uM), both liver and red blood cell function improved. In another controlled clinical trial by Chooi et al., C15:0 supplementation lowered LDL-cholesterol and improved the gut microbiome.

As a testament to how much traction C15:0 is gaining in the science world, the figure below from Pubmed shows the number of peer-reviewed C15:0 papers being published in the scientific literature (an average of about one per week for the last three years!). These studies are available at DiscoverC15.com.