Elsevier

Nutrition

Volume 17, Issue 10, October 2001, Pages 858-867
Nutrition

Review article
Micronutrients in women’s health and immune function

https://doi.org/10.1016/S0899-9007(01)00649-9Get rights and content

Abstract

Lawrence J. Machlin’s contributions to elucidating the roles of nutrients in optimizing human health included the support of research in the areas of women’s health and immune function. Several essential nutrients have been shown to affect women’s health throughout the different life stages. Symptoms of premenstrual syndrome affect the vast majority of menstruating women, and calcium supplementation significantly reduces physical and emotional symptoms. Premenstrual syndrome in fact might be a predictor of osteoporosis induced by low calcium intake. Periconceptional multivitamin supplementation has reduced the risk of serious birth defects, premature delivery, and low birth weight by 50% and improved maternal health during pregnancy. Micronutrients of particular importance for prevention of adverse pregnancy outcomes are folic acid, zinc, and iron. However, if the preterm delivery is caused by preeclampsia, then data suggest that calcium supplementation and high doses of vitamins C and E significantly reduce that risk. Well-controlled studies consistently have shown that calcium supplementation, with or without vitamin D, significantly reduces the risk of hip fracture. Antioxidants such as vitamins C and E have been shown to reduce the risk of fracture in women smokers. As in the rapidly growing embryo, the immune system includes rapidly multiplying cells whose functions are dramatically affected by an individual’s micronutrient status. Multivitamins have been shown to enhance many aspects of immune response, and antioxidant micronutrients consistently have been found to enhance lymphocyte-proliferative responses and skin-test responses, especially in the elderly.

Introduction

Lawrence J. Machlin was a true renaissance scientist with broad interests in the physiologic and preventive roles of vitamins, minerals, and other bioactive molecules in human health.1, 2, 3, 4, 5 I had the privilege of working with Larry as a colleague and peer on a collaborative project to determine whether vitamin E affected the immune functions of laboratory animals.6, 7, 8, 9, 10, 11 Larry never mentioned that he was the leading expert in vitamin E; he simply pointed me to several of his seminal papers on the requirements of vitamin E for muscle integrity, reproductive success, and cardiovascular muscle function and a number of other key references. Larry cochaired two New York Academy of Sciences (NYAS) symposia on vitamin E. My “bibles” were the two annals that Larry coedited after those meetings in 1981 and 1988.12, 13

The results of our initial collaboration were very exciting and I was asked to join the Vitamin Research group at Roche. I then had the experience of working for Larry, as he was my supervisor for more than a decade at Roche. We worked together to move the laboratory findings for vitamin E and other antioxidants into clinical studies, and we were fortunate to work on the carotenoids as that science was just getting started.14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29 In the almost 20 y that we worked together, Larry and I coauthored 13 peer-reviewed papers and were coauthors of the text, Vitamin Intake and Health.26 Larry also edited his Handbook of Vitamins published in 1984 and issued the revised edition in 1991.30, 31 In 1986, he cochaired the NYAS conference on vitamin C.27 Larry’s favorite NYAS meeting that he cochaired and named was “Beyond Deficiency: New Views on the Function and Health Effects of Vitamins,” held in 1991 and published in 1992.28 At the same time, Larry, as Director of the Department of Clinical Nutrition at Roche, spearheaded collaborations with more than 100 academic researchers worldwide, and we provided clinical supplies (actives and matched placebos) specially formulated for numerous intervention studies, funding, labeled and purified vitamins and carotenoids for analytics and stable isotope studies, and technical expertise and advice.

Larry also introduced me to the world of editing professional reference books and I worked closely with him to revise his classic Handbook of Vitamins.30, 31 In addition, Larry opened the doors for me to enter the area of women’s health with Roche’s involvement in the unfolding story of folic acid and the prevention of serious birth defects.32, 33, 34, 35, 36 As Director, Larry set the supportive agenda and strongly encouraged me to organize the two NYAS symposia on “Micronutrients and Immune Functions” held in 198937 and “Maternal Nutrition and Pregnancy Outcome” held in 1992.34 When Larry retired, he remained active as a consultant until the day he passed away and thus continued to contribute to our knowledge of the importance of antioxidant vitamins, carotenoids, and many other bioactive molecules in preventing disease and optimizing health. The true legacy of Larry’s encouragement, enthusiasm, and dedication to scientific advancements in the area of micronutrients and optimizing human health may never be fully told because he gave so much to the researchers in this field.

After I left Roche and began research involving calcium and vitamin D, Larry was as interested in these new findings as he was in any of the studies with the antioxidants. Most importantly for me on a personal level, throughout the almost 20 y I knew him, Larry was a true mentor. Larry and his dear wife, Ruth, became close friends to me and my husband and we shared many life events including the births of our grandchildren and vacation photographs of natural wonders. As my tribute to Larry, this paper highlights many of the findings of the past decade on the critical roles of the essential nutrients in women’s health and immune function.

Section snippets

Women’s health

The studies that are highlighted in this overview were chosen mainly because of the involvement of Larry, myself, or both of us in the initiation, development, and/or expansion of the scientific knowledge base. Women’s health is a term that covers many topics; this review is limited to nutritional aspects of premenstrual syndrome (PMS), pregnancy outcomes including reduction in birth defects, preterm and low–birth-weight (LBW) outcomes, preeclampsia, and osteoporosis.

Conclusions

Lawrence J. Machlin contributed greatly to our understanding of the importance of optimal intakes of micronutrients for enhancing health and reducing the risk of chronic disease. There are several essential nutrients that have been shown to affect women’s health throughout their different life stages (Table I). With the commencement of menstruation, requirements for certain micronutrients appear to be critical for the maintenance of good health throughout the menstrual cycle. PMS symptoms

References (134)

  • J.G Penland et al.

    Dietary calcium and manganese effects on menstrual cycle symptoms

    Am J Obstet Gynecol

    (1993)
  • S Thys-Jacobs et al.

    Calcium carbonate and the premenstrual syndromeeffects on premenstrual and menstrual symptoms

    Am J Obstet Gynecol

    (1998)
  • S.J Lee et al.

    An association between osteoporosis and premenstrual and postmenopausal symptoms

    J Bone Miner Res

    (1994)
  • R.W Smithells et al.

    Possible prevention of neural tube defects by periconceptional vitamin supplementation

    Lancet

    (1980)
  • U Ramakrishnan et al.

    Micronutrients and pregnancy outcomea review of the literature

    Nutr Res

    (1999)
  • W.W Fawzi et al.

    Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1 infected women in Tanzania

    Lancet

    (1998)
  • L.C Chappell et al.

    Effects of antioxidants on the occurrence of pre-eclampsia in women at increased riska randomized trial

    Lancet

    (1999)
  • Y.P Wang et al.

    Maternal levels of prostacyclin, thromboxane, vitamin E, and lipid peroxides throughout normal pregnancy

    Am J Obstet Gynecol

    (1991)
  • I Reid et al.

    Long-term effects of calcium supplementation on bone loss and fractures in post-menopausal womena randomized controlled trial

    Am J Med

    (1995)
  • A Bendich et al.

    Supplemental calcium for the prevention of hip fracturepotential health-economic benefits

    Clin Ther

    (1999)
  • J.W Nieves et al.

    Calcium potentiates the effect of estrogen and calcitonin on bone massreview and analysis

    Am J Clin Nutr

    (1998)
  • L.J Machlin et al.

    Stimulation of growth hormone secretion by median eminence extracts in the sheep

    Endocrinology

    (1967)
  • L.J Machlin et al.

    Plasma growth hormone and insulin levels in the pig

    Endocrinology

    (1968)
  • L.J Machlin

    Effect of porcine growth hormone on growth and carcass composition of the pig

    J Anim Sci

    (1972)
  • L.J Machlin et al.

    Influence of vitamin E on platelet aggregation and thrombocythemia in the rat

    Proc Soc Exp Biol Med

    (1975)
  • A Bendich et al.

    Differences in vitamin E levels in tissues of the spontaneously hypertensive and Wistar-Kyoto rats

    Proc Soc Exp Biol Med

    (1983)
  • E Gabriel et al.

    Strain differences in testes degeneration, myopathy, and the lymphocyte mitogen response in vitamin E deficient rats

    Proc Soc Exp Biol Med

    (1984)
  • A Bendich et al.

    Effect of vitamin E on rat lymphocyte mitogen responses

  • A Bendich et al.

    Depression of rat and guinea pig lymphocyte blastogenic responses by vitamin E deficiencya new model for reproducible immune modulation

  • L.J Machlin et al.

    Free radical damageprotective role of antioxidant nutrients

    FASEB J

    (1987)
  • A Bendich

    A role for carotenoids in immune function

    Clin Nutr

    (1988)
  • A Bendich

    The safety of beta carotene

    Nutr Cancer

    (1988)
  • A Bendich et al.

    The safety of oral intake of vitamin Edata from clinical studies from 1986 to 1991

  • P Weber et al.

    Vitamin C and human health—a review of recent data relevant to human requirements

    Int J Vit Nutr Res

    (1996)
  • L.J Machlin et al.

    The safety of vitamin E

  • U Moser et al.

    Vitamin C

  • Machlin LJ, ed. Handbook of vitamins, 1st ed. New York: Marcel Dekker,...
  • Machlin LJ, ed. Handbook of vitamins, 2nd ed, revised and expanded. New York: Marcel Dekker,...
  • A Bendich

    Folic acid and neural tube defectsintroduction to part II

  • A Bendich

    Importance of vitamin status to pregnancy outcomes

  • A Bendich et al.

    Influence of maternal nutrition on pregnancy outcomepublic policy issues

  • A Bendich

    Lifestyles and environmental factors that can adversely affect maternal nutritional status and pregnancy outcomes

  • T.O Scholl et al.

    Use of multivitamin-mineral prenatal supplementsInfluence on the outcome of pregnancy

    Am J Epidemiol

    (1997)
  • Premenstrual syndrome (ACOG committee opinion)

    Int J Gynaecol Obstet

    (1995)
  • Cited by (0)

    View full text