Genestra Multi-Vite 90 Capsules
Genestra Multi-Vite- 90 Capsules
• Complete multivitamin mineral formulation in tablets • Support immune system health and general health (1) • With enzymes and botanical ingredients • Pepsin, Pancreatin, Alfalfa, Parsley, Rose Hips and Watercress • Easy-to-use • One tablet, two times daily ensure patient compliance
Multi Vite provides a broad spectrum of vitamins, minerals, digestive enzymes and synergistic nutrients in tablets.
References: 1 NHPD Monograph on Multivitamin and Mineral. October 2007.
Additional product info: Aging is accompanied by a variety of physiological, psychological, economic and social changes that compromise nutritional status and/or affect nutritional requirements. For these reasons, the diets of many older adults do not currently meet the recommended intake levels of several essential vitamins and minerals; thus, low micronutrient status is often reported in this population. Nutritional status surveys of the elderly indicate a low to moderate prevalence of frank nutrient deficiencies, but an increased risk of malnutrition, along with evidence of subclinical deficiencies having a direct impact on physiologic function. Overt micronutrient deficiencies have been reported as prevalent in nursing home populations, and recommendations were made that all institutionalized older adults receive a multivitamin/mineral supplement for general nutritional prophylaxis. A clinical study has shown that multivitamin treatment for 8 weeks significantly increased, compared to placebo, plasma concentrations of vitamins D, E, pyridoxal phosphate, folate, B12, C, and improved the riboflavin activity coefficient. Supplementation with a multivitamin formulated at about 100% Daily Value can thus decrease the prevalence of suboptimal vitamin status in older adults and improve their micronutrient status to levels associated with reduced risk for several chronic diseases (2). The NHPD recommendations for zinc supplementation in adults to help maintain healthy skin are between 0.7-50 mg per day (3).
Corneal haze and myopic regression are the main undesirable complications after excimer laser treatment. In the past few years, several authors indicated that keratocytes and epithelial cells are mainly involved in the healing response. In particular, it was suggested that the disappearance of anterior stromal keratocytes in response to excimer laser surgery was an initiating factor, which could lead to epithelial hyperplasia and eventually to haze formation and regression. Vitamin A exerts a moderate antioxidant activity and plays an essential part in epithelial growth and limbal stem cell differentiation, promoting corneal wound healing. As slower tissue regeneration causes an increased risk of accumulation of oxidant inflicted damage in the tissue components, corneal re-epithelialisation time is crucial. A randomized, double masked clinical trial has been performed to evaluate the effect of a high dose vitamin A and E supplementation on corneal re-epithelialisation time, visual acuity and haze following photorefractive keratectomy (PRK). In this study, the results showed that vitamins A (25 000 IU retinol palmitate) and E (230 mg alpha-tocopheryl nicotinate) for 3 months post PRK significantly decreased re-epithelialisation time, haze formation, and myopic regression occurrence (4).
Calcium and vitamin D are both essential for the development and maintenance of skeletal health. Calcium plays a vital role in neuromuscular function, many enzyme-mediated processes, blood clotting and in providing rigidity to the skeleton by virtue of its phosphate salts. Over 99% of the body’s calcium is stored in the bone, where, apart from providing mechanical strength, it serves as a mineral reservoir that can be drawn upon to maintain normal plasma calcium. Vitamin D is required to maintain normal blood levels of calcium and phosphate, which are in turn needed for the normal mineralization of bone, muscle contraction, nerve conduction and the general cellular functioning of all body cells. Vitamin D, derived from both endogenous (skin) and exogenous (diet) sources, is converted into 25OHD in the liver and then into 1,25(OH)2D in the kidneys. The latter metabolite controls calcium absorption. However, plasma 25OHD closely reflects vitamin D nutritional status, and because it is the substrate for the renal enzyme that produces 1,25(OH)2D, it could have mainly an indirect and also a direct effect on calcium absorption. A vitamin D shortage would reduce the intestinal absorption of calcium, which could worsen if the diet is deficient of this element. Osteoporosis and its clinical consequence, fragility fractures, are now recognized as major public health problems. Bone mass declines and the risk of fractures increases as people age, especially postmenopausal women. An adequate intake of calcium and vitamin D, including supplementation, has been advocated as a universal primary intervention in the prevention and treatment of high-risk patients. Evidence shows that there is still a high proportion of people with inappropriately low calcium and vitamin D intake and serum levels. For selective groups of people, such as the elderly (frequently older than 70 years), those with low solar exposure and in generally poor or inadequate nutritional condition, guaranteeing a daily intake of at least 1 g of calcium and 700–800 IU of vitamin D with supplements would have beneficial effects on bone health. In those individuals with a high risk of osteoporotic fracture, calcium and vitamin D supplements are necessary but frequently insufficient (5).
The B vitamins folate, vitamin B6 (pyridoxine), and vitamin B12 (cobalamin) are important regulators of homocysteine metabolism in the body, and randomized controlled trials have demonstrated that supplementation with folate at doses up to 500 µg daily (natural dietary folate or the synthetic folic acid) alone or in combination with vitamins B6 and B12 significantly reduces blood homocysteine concentrations (6). Epidemiological evidence suggests that total plasma homocysteine level is an independent cardiovascular risk factor. Studies on the pathogenesis of homocysteine-induced vascular damage have suggested adverse interaction with vascular smooth muscle cells, endothelium function, plasma lipoproteins, and coagulation cascade. A study provides evidence that homocysteine-lowering therapy with folic acid (1 mg/d), vitamin B12 (cyanocobalamin, 400 ?g/d), and vitamin B6 (pyridoxine hydrochloride, 10 mg/d) for 6 months improves outcome after percutaneous coronary intervention (7). In a large cohort of male Finnish smokers, a high dietary folate intake was associated with a significantly lower risk of cerebral infarction (8).
Adequate zinc status is critical for immune function. Zinc deficiency reduces generation of T cells, depresses humoral and cell-mediated immunity, leads to lymphopenia and thymic atrophy, and increases the frequency and number of infections (9). About 30% of the world’s population is zinc deficient, most prevalent in children under 5 years of age in developing countries. Zinc deficiency is associated with impaired immune function which results in an increase in morbidity due to infections, growth retardation, hypogonadism and cognitive dysfunction (10). A prospective, randomized, controlled clinical trial was conducted involving 231 HIV-infected adults with low plasma zinc levels, who were randomly assigned to receive zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo for 18 months. Zinc supplementation given to HIV-infected adults resulted in a 4-fold decrease in the likelihood of immunological failure, defined as a decrease of CD4+ cell count to <200 cells/mm3, after 18 months of use, compared with placebo. Zinc supplementation also significantly reduced diarrhea, compared with placebo (11).
Chromium (Cr) is an essential element required for normal carbohydrate and lipid metabolism. Signs of Cr deficiency have been documented on numerous occasions, including elevated blood glucose, insulin, cholesterol and triglycerides, and decreased high density lipoproteins (HDL) in humans consuming normal diets. A review reports that the response to Cr supplementation for glucose, insulin, lipids, and related variables is related to the amount and form of supplemental Cr, the degree of glucose intolerance, and the duration of the study. Subjects with glucose intolerance but not diabetes usually respond to 200 µg of Cr daily as Cr chloride or other more bioavailable forms of Cr (12). The NHPD recommendations for chromium supplementation in adults to provide support for healthy glucose metabolism are between 2.2-500 µg per day (13).
Oxidative stress also plays an important role in the pathogenesis of cardiovascular disease (CVD). Growing evidence suggest that antioxidant vitamins might reduce the risk of disease outcomes by their ability to scavenge free radicals. A case-control study with vitamin E (400 IU/d) and vitamin C (500 mg/d) supplementation in 40 CVD patients for 2 months showed reduced lipid peroxidation and a strengthened antioxidant defense system. Hence, vitamin E and vitamin C supplementation may have beneficial effects on the heart by reducing oxidative stress in CVD patients (14).
Apigenin is a flavone found in vegetables, seasonings and oranges, and it possesses antioxidant activity in vitro. Parsley (Petroselinum crispum) contains large amounts of apigenin, and the low concentration of other flavonoids in this plant makes it suitable for an intervention study with a natural source of apigenin. Seven men and seven women participated in a randomized crossover trial to study the effect of intake of parsley on the urinary excretion of flavones and on biomarkers for oxidative stress. The subjects received a strictly controlled diet low in flavones and other naturally occurring antioxidants during the 2 weeks of intervention. This basic diet was supplemented with parsley providing 3.73–4.49 mg apigenin/MJ in one of the intervention weeks. The parsley intervention resulted in significant increases in the two antioxidant enzymes glutathione reductase (GR) and superoxide dismutase (SOD). Apigenin was detected in all the urine samples collected after parsley intervention (15).
A double-blind, placebo-controlled, crossover study examined the effect of Hyben Vital, a herbal remedy made from a subtype of Rosa canina which has recently been reported to have anti-inflammatory properties, on the symptoms of osteoarthritis. One hundred and twelve patients with osteoarthritis were randomly allocated to treatment with either Hyben Vital 5 g daily or an identical placebo for 3 months, followed immediately by the alternative treatment. The data of the study indicate that Hyben Vital reduces the symptoms of osteoarthritis (16). In another double-blind placebo-controlled trial, patients with rheumatoid arthritis (RA) according to ARA/ACR criteria were randomised to treatment with encapsulated rose-hip powder 5g daily or matching placebo for 6 months. Health Assessment Questionnaire (HAQ) in the rose-hip group improved whereas in the placebo group it worsened. The Physicians Global Scale demonstrated more improvement in the rose-hip compared to the placebo group. RAQoL and SF-12 physical score improved significantly in the rose-hip group compared to placebo. The results indicate that patients with RA may benefit from additional treatment with rose hip powder (17).
In terms of the active chemical species, cruciferous vegetables (CVs) are rich sources of glucosinolates, a class of sulfur- and nitrogen-containing glycosides that are hydrolyzed (by plant myrosinase or intestinal microflora) to form isothiocyanates. Watercress (Rorippa nasturtium-aquaticum) in particular contains one of the highest concentrations of glucosinolates per gram weight of any vegetable as well as containing high concentrations of carotenoids such as lutein and ?-carotene. A single-blind, randomized, crossover study was conducted in 30 men and 30 women (30 smokers and 30 non smokers) with a mean age of 33 years of age. The subjects were fed 85 grams raw watercress daily for 8 wk in addition to their habitual diet. Watercress supplementation (active compared with control phase) was associated with reductions in basal DNA damage, in basal plus oxidative purine DNA damage, and in basal DNA damage in response to ex vivo hydrogen peroxide challenge. Beneficial changes seen after watercress intervention were greater and more significant in smokers than in non smokers. Plasma lutein and ?-carotene increased significantly after watercress supplementation (18).
Short-term benefit of 8 weeks pancreatic enzyme supplementation has been shown to improve the absorption of dietary fat, protein, and total energy and nitrogen balance in patients receiving local resection longitudinal pancreaticojejunostomy (LR-LPJ) for chronic pancreatitis. Supplementing the diets of 11 patients with pancreatin at doses that were individualized according to the initial measurement of fecal fat excretion significantly increased the mean coefficients of absorption of dietary fat and energy during the first 4 weeks of study. Following randomization to pancreatin or placebo, continued enzyme supplementation sustained a significant improvement in protein absorption, whereas placebo substitution worsened the absorption of fat and total energy to levels lower than baseline. Improved protein absorption accounted for the significantly positive effect of pancreatin supplementation on mean nitrogen balance. Each capsule contained 8,000 USP U of lipase, 13,000 USP U of protease, and 30,000 USP U of amylase in enteric-coated microspheres and minimicrospheres (19). Attributes of Multi Vite covered by the NHPD Monographs: An antioxidant for the maintenance of good health. Helps in the development and maintenance of night vision, bones, cartilage, teeth and gums; helps the body to metabolize carbohydrates, fats and proteins and provides support for healthy glucose metabolism; helps in the absorption and use of calcium and phosphorus; helps in the function of the thyroid gland, in wound healing and normal growth and development; helps in tissue and connective tissue formation; helps to form red blood cells and helps in their proper function; helps to maintain eyesight, healthy skin, membranes, immune and proper muscle function; helps to reduce the risk of neural tube defects when taken daily prior to becoming pregnant and during early pregnancy; helps to prevent vitamin A, C, E, B6, B12, thiamine, riboflavin, niacin, folate, biotin, pantothenic acid, selenium, manganese and chromium deficiency. Calcium intake, when combined with sufficient vitamin D, a healthy diet, and regular exercise, may reduce the risk of developing osteoporosis.
References: 2 McKay DL, Perrone G, Rasmussen H, Dallal G, Hartman W, Cao G, Prior RL, Roubenoff R, Blumberg JB. The effects of a multivitamin/mineral supplement on micronutrient status, antioxidant capacity and cytokine production in healthy older adults consuming a fortified diet. J Am Coll Nutr. 2000 Oct;19(5):613-21. Abstract; Page 613, Introduction; Page 616, Water-Soluble Vitamins, 1st paragraph 3 NHPD Monograph on Multivitamin and Mineral. October 2007. 4 Vetrugno M, Maino A, Cardia G, Quaranta GM, Cardia L. A randomised, double masked, clinical trial of high dose vitamin A and vitamin E supplementation after photorefractive keratectomy. Br J Ophthalmol. 2001 May;85(5):537-9. Abstract; Page 537, Introduction, 1st paragraph; Page 538, Discussion, 1st paragraph; Page 538, 1st paragraph; Page 539, Conclusion 5 Díaz-López B, Cannata-Andía JB. Supplementation of vitamin D and calcium: advantages and risks. Nephrol Dial Transplant. 2006 Sep;21(9):2375-7. Page 2375, Introduction, 1st, 3rd and 4th paragraphs; Page 2376, last 2 paragraphs 6 Larsson SC, Männistö S, Virtanen MJ, Kontto J, Albanes D, Virtamo J. Folate, vitamin B6, vitamin B12, and methionine intakes and risk of stroke subtypes in male smokers. Am J Epidemiol. 2008 Apr 15;167(8):954-61. Abstract; Page 954, 2nd paragraph; Page 957, Discussion, 1st sentence 7 Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA. 2002 Aug 28;288(8):973-9. Page 973, Abstract; Page 973, Introduction, 1st paragraph; Page 977, Comment, 1st paragraph 8 Larsson SC, Männistö S, Virtanen MJ, Kontto J, Albanes D, Virtamo J. Folate, vitamin B6, vitamin B12, and methionine intakes and risk of stroke subtypes in male smokers. Am J Epidemiol. 2008 Apr 15;167(8):954-61. Abstract; Page 954, 2nd paragraph; Page 957, Discussion, 1st sentence 9 Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60. Abstract; Page 1653, 1st paragraph;Page 1657, Discussion, 1st paragraph; Page 1658, Conclusion 10 Yakoob MY, Theodoratou E, Jabeen A, Imdad A, Eisele TP, Ferguson J, Jhass A, Rudan I, Campbell H, Black RE, Bhutta ZA. Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria. BMC Public Health. 2011 Apr 13;11 Suppl 3:S23. 11 Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60. Abstract; Page 1653, 1st paragraph;Page 1657, Discussion, 1st paragraph; Page 1658, Conclusion 12 Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr. 1998 Dec;17(6):548-55. Page 548, Introduction, 1st paragraph; Page 553, Summary, 1st paragaph 13 NHPD Monograph on Multivitamin and Mineral. October 2007. 14 Karajibani M, Hashemi M, Montazerifar F, Dikshit M. Effect of vitamin E and C supplements on antioxidant defense system in cardiovascular disease patients in Zahedan, southeast Iran. J Nutr Sci Vitaminol (Tokyo). 2010;56(6):436-40. Abstract; Page 436, Introduction, 1st paragraph; Page 439, Conclusion 15 Nielsen SE, Young JF, Daneshvar B, Lauridsen ST, Knuthsen P, Sandström B, Dragsted LO. Effect of parsley (Petroselinum crispum) intake on urinary apigenin excretion, blood antioxidant enzymes and biomarkers for oxidative stress in human subjects. Br J Nutr. 1999 Jun;81(6):447-55. Yellow highlights 16 Rein E, Kharazmi A, Winther K. A herbal remedy, Hyben Vital (stand. powder of a subspecies of Rosa canina fruits), reduces pain and improves general wellbeing in patients with osteoarthritis--a double-blind, placebo-controlled, randomised trial. Phytomedicine. 2004 Jul;11(5):383-91. Abstract 17 Willich SN, Rossnagel K, Roll S, Wagner A, Mune O, Erlendson J, Kharazmi A, Sörensen H, Winther K. Rose hip herbal remedy in patients with rheumatoid arthritis - a randomised controlled trial. Phytomedicine. 2010 Feb;17(2):87-93. Abstract 18 Gill CI, Haldar S, Boyd LA, Bennett R, Whiteford J, Butler M, Pearson JR, Bradbury I, Rowland IR. Watercress supplementation in diet reduces lymphocyte DNA damage and alters blood antioxidant status in healthy adults. Am J Clin Nutr. 2007 Feb;85(2):504-10. Yellow highlights 19 Van Hoozen CM, Peeke PG, Taubeneck M, Frey CF, Halsted CH. Efficacy of enzyme supplementation after surgery for chronic pancreatitis. Pancreas. 1997 Mar;14(2):174-80. Yellow highlights
Other ingredients: Cellulose, croscarmellose sodium, magnesium stearate, silica, pharmaceutical glaze