Background: The present study aimed to evaluate the effectiveness of nutrition interventions on frailty and factors related to frailty, including malnutrition, sarcopenia and functional ability, among community dwelling older adults. A secondary aim was to synthesise current clinical guidelines for the identification and management of frailty, and then identify whether they aligned with the findings of the literature review. Methods: A systematic literature review was undertaken using four electronic databases to identify randomised controlled clinical trials that assessed the effect of nutrition interventions on frailty and outcomes related to frailty in community-dwelling older adults (PROSPERO #CRD42017069094). The quality of the included studies was appraised. A rapid review was conducted using the Google Scholar database to identify existing clinical recommendations relating to the second aim. Results: The search strategy identified 13 studies. Multifactorial interventions with nutritional education and protein-energy supplementation improved frailty stratus and physical performance in 75% and 58% of studies, respectively. Weight and nutritional status improved in 80% of studies that used oral nutritional support. The recommended process for clinical management of frailty involves screening, followed by full assessment using validated instruments and the development of a comprehensive management plan with a multidisciplinary team. Conclusions: Multifactorial interventions were found to be more effective than nutrition intervention alone for improving frailty and physical performance. Protein-energy supplementation tended to be effective only in malnourished older adults. The results were inconclusive for the use of micronutrient supplementation for frailty and outcomes related to frailty. Existing clinical guidelines are aligned with the evidence recommending comprehensive interventions to improve frailty.

Aim To investigate the relationship between nutritional status, functional ability and frailty in older adults participating in a 12‐week Transitional Aged Care Service program. Methods A retrospective analysis of a clinical cohort of older adults aged 65+ years after hospital discharge. At entry into the program and at completion, nutritional status was measured using the Mini Nutritional Assessment (MNA), frailty status was measured using the Groningen Frailty Indicator and functional ability was measured using the Modified Barthel Index (MBI). Demographic data were obtained from electronic medical records. Results Baseline data were available for 115 participants (mean age = 81.7 (SD =7.9) years; 20.9% classified as malnourished and 89.6% as frail). A positive association was found between nutritional status and frailty (r = 0.298; P = 0.001), and frailty and functional ability (r = 0.204; P = 0.029). Multiple regression analysis, accounting for the cofounders of baseline MNA, MBI, age, gender, length of hospital stay and living situation, found that nutritional status and functional ability were able to indicate the presence of frailty on admission to the program (P = 0.002, P = 0.007, respectively). In those program completers (n = 79), significant improvements were found in nutritional status, frailty and functional ability (P < 0.0005). Conclusions Nutrition status, frailty and functional ability are closely and positively related, and should therefore be considered simultaneously in rehabilitation for older adults. A post‐hospital transitional program with a multidisciplinary approach significantly improved all three outcomes, suggesting its value in enabling frail older people to remain independent for as long as possible.

Background/Objectives Vitamin D deficiency remains a global public health issue, particularly in minority ethnic groups. This review investigates the vitamin D status (as measured by 25(OH)D and dietary intake) of the African-Caribbean population globally. Subjects/Methods A systematic review was conducted by searching key databases (PUBMED, Web of Science, Scopus) from inception until October 2019. Search terms included ‘Vitamin D status’ and ‘African-Caribbean’. A random effects and fixed effects meta-analysis was performed by combining means and standard error of the mean. Result The search yielded 19 papers that included n = 5670 African-Caribbean participants from six countries. A meta-analysis found this population to have sufficient (>50 nmol/L) 25(OH)D levels at 67.8 nmol/L, 95% CI (57.9, 7.6) but poor dietary intake of vitamin D at only 3.0 µg/day, 95% CI (1.67,4.31). For those living at low latitudes ‘insufficient’ (as defined by study authors) 25(OH)D levels were found only in participants with type 2 diabetes and in those undergoing haemodialysis. Suboptimal dietary vitamin D intake (according to the UK recommended nutrient intake of 10 µg/day) was reported in all studies at high latitudes. Studies at lower latitudes, with lower recommended dietary intakes (Caribbean recommended dietary intake: 2.5 µg/day) found ‘sufficient’ intake in two out of three studies. Conclusions 25(OH)D sufficiency was found in African-Caribbean populations at lower latitudes. However, at higher latitudes, 25(OH)D deficiency and low dietary vitamin D intake was prevalent.

The vitamin D status of the United Kingdom (UK) African-Caribbean (AC) population remains under-researched, despite an increased risk of vitamin D deficiency due to darker skin phenotypes and living at a high latitude. This cross-sectional study explored the vitamin D status and intake of AC individuals (n = 4046 with a valid serum 25(OH)D measurement) from the UK Biobank Cohort, aged ≥40 years at baseline (2006–2010). Over one third of the population were deficient (<25 nmol/L), 41.1% were insufficient (25–50 nmol/L) and 15.9% were sufficient (>50 nmol/L). Median (IQR) 25(OH)D was 30.0 (20.9) nmol/L. Logistic regression showed that brown/black skin phenotype, winter blood draw, not consuming oily fish and not using vitamin D supplements predicted increased odds of vitamin D deficiency, whilst older age and a summer or autumn blood draw were significantly associated with reduced odds of vitamin D deficiency. Vitamin D deficiency and insufficiency were prevalent in this AC population and is of considerable concern given the individual and societal implications of increased morbidity. Public health messaging for this group should focus on year-round vitamin D supplementation and increasing intakes of culturally appropriate vitamin D-rich foods. These data also support the urgent requirement for a revised vitamin D RNI for ethnic groups.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

No abstract

No abstract

No abstract