Dietary Factors Associated with Frailty in Old Adults: A Review of Nutritional Interventions to Prevent Frailty Development

Abstract

Frailty syndrome is a medical condition that is characterised by a functional decline, usually from 65 years old on, and creates the need for assistance to perform daily living activities. As the population ages, the need for specialised geriatric care will increase immensely, and consequently, the need for specialised services for the care of these people will increase accordingly. From a nutritional point of view, to control or balance the nutritional status of residents will be essential in order to prevent sarcopenia and, consequently, frailty development. In this line, previous studies have highlighted the association among low energy intake, inadequate intake of protein and vitamin D, and an increased risk of frailty development. However, there is a lack of intervention studies on frail patients, especially in the realm of quality clinical trials. The few studies performed to date seem to indicate that there is a protective role of protein supplementation against frailty syndrome. In this regard, it is tempting to suggest daily 30 g protein supplements to prevent frailty. However, it is well established that excess protein can also be harmful; therefore, specific individual characteristics should be considered before prescribing these supplements. On the other hand, the relevance of other nutritional interventions, such as vitamin D, omega-3, and medium-chain triglycerides, is much more scarce in the literature. Therefore, we encourage the development of new clinical trials to carry out effective therapies to prevent frailty development.

Association of Prediagnostic Frailty, Change in Frailty Status, and Mortality After Cancer Diagnosis in the Women’s Health Initiative

“… 31 Nutrition support may also play a role, although results of multimodal interventions combining nutrition and physical activity have been mixed. 32 Among cancer survivors, physical activity interventions are effective in preserving or increasing physical function, 33 and findings of observational studies 34 , 35 , 36 , 37 , 38 , 39 suggest that exercise may reduce mortality. Such supportive interventions might be considered if a patient is screened as frail at cancer diagnosis.…”

Association of 3‐Year Multidomain Intervention and Omega‐3 Supplementation with Frailty Incidence

“…Preventive interventions to protect against the incidence of frailty in at‐risk populations are needed to promote healthy aging and reduce health costs. Trials of physical activity and nutritional interventions on frailty reported conflicting results. Omega‐3 fatty acids are thought to have an anabolic role on skeletal muscle, but the effects of an omega‐3 supplementation on frailty have so far not been reported, and its effects on walking speed and grip strength, two components of the frailty phenotype, remain equivocal …”

Frailty predicts a higher risk of incident urolithiasis in 525 368 patients with diabetes mellitus: a population-based study

“…Immobilization induces increased bone turnover and leads to resorptive hypercalciuria 22. Second, frail individuals are often encouraged to increase their nutrient intake to avoid negative protein balance,23 and this high dietary protein intake significantly increases the probability of calciuria and renal stones 24. The association between protein intake and higher urine calcium excretion presumably stems from acid production during protein metabolism that buffers via bone mineral mobilization, along with enhanced intestinal calcium absorption, and an elevated glomerular filtration rate 25.…”