Can Nuts Mitigate Malnutrition in Older Adults? A Conceptual Framework

Abstract

The proportion of adults aged over 60 years in the world is expected to reach 20% by the year 2050. Ageing is associated with several physiological changes that increase the risk of malnutrition among this population. Malnutrition is characterized by deficiencies or insufficiencies of macro- and micronutrients. Malnutrition has detrimental effects on the health, wellbeing, and quality of life in older adults. Nuts are rich in energy, unsaturated fats, and protein, as well as other nutrients that provide a range of health benefits. While the effects of nuts on overnutrition have been studied extensively, very few studies have been specifically designed to understand the role of nuts in mitigating undernutrition in the elderly. Therefore, this review explores the potential role of nuts in improving the nutritional status of older adults who are at risk of undernutrition. Several properties of whole nuts, some of which appear important for addressing overnutrition, (e.g., hardness, lower-than-expected nutrient availability, satiety-enhancing effects) may limit their effectiveness as a food to combat undernutrition. However, we propose that modifications such as transforming the physical form of nuts, addressing the timing of nut ingestion, and introducing variety may overcome these barriers. This review also discusses the feasibility of using nuts to prevent and reverse undernutrition among older adults. We conclude with a recommendation to conduct clinical studies in the future to test this conceptual framework.

Associations between nut intake, cognitive function and non‐alcoholic fatty liver disease (NAFLD) in older adults in the United States: NHANES 2011-14

“…Overall, we observed higher overall nutrient intake with higher nut consumption in older adults. This is consistent with findings from other studies that nut intake improves overall nutrient intake [ 3 ]. Although higher total fat intake was observed with higher nut consumption, percentage energy intake from saturated fat did not differ between nut intake categories, hence not a major concern.…”

“…Nuts included in this study were almonds, almond butter, Brazil nuts, cashews, cashew butter, hazelnuts, macadamias, pecans, pine nuts, pistachios, walnuts, peanuts, and peanut butter. Although each nut type may have slight variations in individual nutrient composition, they are considered to be nutrient-dense and often grouped collectively [ 3 ]. To ensure accurate estimation of nut intake from all food sources, this study considered nuts consumed alone, as well as nuts that were used in foods and recipes from the Food Commodity Intake Database (FCID).…”

“…Being physically active [ 1 ] and following a healthy diet [ 2 ] are two of the most important lifestyle factors to promote healthy aging and enhance quality of life in older adults. However, an official guideline still has not been established to promote physical, mental health and wellbeing in older adults with comorbidities, plus consuming an adequate diet to support good health can be challenging in some older adults [ 3 ]. Adding snacks to main meals has been shown to improve the overall dietary intake of older adults [ 4 ].…”

Nuts and Older Adults’ Health: A Narrative Review

“…We propose that nuts may improve the quality of life of older adults through the promotion of better health, cognitive function, and functional capacity in this population, as depicted in a conceptual framework below ( Figure 1 ). This framework is based on the premise that nuts, which are high in essential nutrients, improve diet quality and the overall nutritional status of older adults (see previous review [ 5 ]). As outlined in this framework, better nutrition and diet quality will, in turn, improve the health, wellbeing, and the quality of life of older adults.…”

“…Hence, the results from studies that focused primarily on dietary patterns only should not be over-interpreted. Furthermore, although different nuts are high in certain nutrients, all nuts share very similar overall nutritional profiles, i.e., high in unsaturated fats, fibre, and nutrients that are essential for good health [ 5 ]. For this reason, all nut types are considered comparable nutritionally, and dietary recommendations focus on all nuts instead of specific nut types.…”