摘要：We challenge the suggestion of Congress that the Older Americans Act (OAA) Nutrition Program should provide multivitamin–mineral supplements (MVMs) in addition to meals. MVMs are not a quick fix for poor diets. They do not contain calories, protein, essential fatty acids, or fiber, nor do they adequately address nutritional gaps of some vitamins and minerals. Older adults with chronic health conditions who take multiple medications are at greater risk than the general healthy population for nutrient–drug interactions and toxicity. The OAA Nutrition Program is not an appropriate venue to indiscriminately distribute MVMs, because there is insufficient evidence of their benefits and safety. The program’s limited funds and efforts should instead be directed to nutrient-dense healthy meals, quality food service, and greater accessibility to individualized nutrition services. THE OLDER AMERICANS ACT (OAA) Nutrition Program provides nutritious congregate (sometimes called senior dining) and home-delivered (commonly called meals on wheels) meals and nutrition services to older adults who are at higher nutritional risk than the older population in general. 1 – 3 Program participants are older, have lower incomes, and may have more limited access to food than the older adult population as a whole. In addition, adults receiving home-delivered meals are frailer and have a greater number of functional impairments caused by nutrition-related diseases and conditions. 1 As part of the 2006 reauthorization of the OAA, Congress, for the first time, provided an opinion in “sense of Congress” language (i.e., a formally expressed opinion about a subject of current national interest) regarding nutrition’s contribution to the health of older adults. 4 Congress stated that although diet is the preferred source of nutrition, use of a single daily multivitamin–mineral supplement (MVM) may be an effective, safe, and inexpensive way of addressing nutritional gaps that exist among older adults, especially the poor, to help prevent common nutritional deficiencies. 4 According to Congress, nutrition providers should consider whether individuals participating in congregate and home-delivered meal programs would benefit from a single, daily multivitamin-mineral supplement that is in compliance with all applicable government quality standards and provides at least 2/3 of the essential vitamins and minerals at 100% of the daily value levels as determined by the Commissioner of Food and Drugs. 4 We assess the potential benefits and risks of the indiscriminate addition of MVMs to meals in the OAA Nutrition Program.
