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Prevention of food-drug interactions with special emphasis on older adults

McCabe, Beverly J

Current Opinion in Clinical Nutrition & Metabolic Care:
Ageing: biology and nutrition
Abstract

Purpose of the review: Adverse drug interactions may be the fourth leading cause of death in hospitalized patients. In children and older adults undetected food-drug interactions may lead to serious morbidity and mortality and be misdiagnosed as chronic disease progression. Recent recognition of the effects of certain foods on many drugs metabolized by CYP450 families or drugs susceptible to chelation and adsorption have increased awareness for prevention of food-drug interactions.

Recent findings: Polypharmacy, self-medications with non-prescription drugs including herbal remedies, dietary/nutritional supplements, fortified foods, and polymorphism in drug metabolism increase the need to consider food-drug interactions. Improved food processing and analysis have led to overall decreased risk in monoamine oxidase inhibitor regimens with counseling. Drugs may create submarginal nutrient deficiencies with serious consequences, such as diuretics contributing to thiamin deficiency and further cardiac failure. Foods may contain compounds that lead to therapeutic failure, such as calcium-fortified foods producing therapeutic failure and promoting resistance in antibiotic therapy. Poor nutritional status can lead to poor health outcomes.

Summary: Prevention of adverse events from food-herb-drug interactions requires clinical monitoring in high-risk regimens and populations. Nutritional status has an important impact on the quality of life as well as appropriate responses to drug therapy. Both diet-drug histories and counseling are needed. As new foods and drugs emerge and more self-medication is promoted, research in the prevention of food-drug interactions is needed.

Author Information

Lower Mississippi Delta Nutrition Intervention Research Initiative, Agriculture Research Service, United States Department of Agriculture and College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Correspondence to Beverly J. McCabe, PhD, RD, LD, 2609 North Pierce Street, Little Rock, AR 72207, USA Tel: +1 501 954 8882; fax: +1 501 954 9596; e-mail: bmccabe-sellers@spa.ars.usda.gov

Abbreviations CYP: cytochrome P450 MAOI: monoamine oxidase inhibitor

© 2004 Lippincott Williams & Wilkins, Inc.