Mediterranean Diet attenuates risk of frailty and sarcopenia: New insights and future directions

Abstract

Sarcopenia and physical frailty are associated with progressive disability and predictive of negative health outcomes. Dietary interventions are considered the cornerstone in the management of sarcopenic symptomology and physical frailty. However few studies have investigated preventative strategies. Moreover, most studies have focused on the efficacy of individual nutrients or supplements rather than dietary patterns. The Mediterranean Diet (MedDiet) is a dietary pattern that provides evidence for an association between diet quality, healthy ageing and disease prevention. The purpose of this paper was to examine, synthesise and develop a narrative review of the current literature, investigating the potential benefits associated with adherence to a MedDiet and attenuation of physical frailty and sarcopenic symptomology in older adults. We also explored the underlying mechanisms underpinning the potential benefits of the MedDiet on ameliorating physical frailty and sarcopenic symptomology. Synthesis of the reviewed literature is suggestive of a decreased risk of physical frailty and sarcopenic symptomology with greater adherence to a MedDiet. We identified the anti-inflammatory and high antioxidant components of the MedDiet as two potential biological mechanisms involved. Due to a lack of evidence from RCTs to support the proposed physiological mechanisms, we suggest investigating these observations in older adults with type 2 diabetes (T2DM) whom are vulnerable to physical frailty and disability. A number of biological mechanisms describing the pathway to disability in older adults with T2DM have been postulated with many of these mechanisms potentially mitigated with dietary interventions involving the MedDiet. Exploring these mechanisms with the use of well-designed, longer-term dietary intervention studies in older adults with an increased vulnerability to physical frailty and sarcopenia is warranted.

Effects of dietary patterns and low protein intake on sarcopenia risk in the very old: The Newcastle 85+ study

“…We are aware of only a few studies [40e42; and reviewed in 43,44] that used a 'whole diet' approach to investigate the risk of sarcopenia in adults aged !55, and none in the very old. This limits the opportunity for direct comparisons of our findings with those from other studies.…”

“…A few studies have utilised these methods to investigate associations between DPs and sarcopenia (e.g. [40e42], reviewed in [43,44])d the Mediterranean DP has been the most common approach and none of the studies has been conducted in the very old.…”

Silver linings on the horizon: highlights from the 10th Cachexia Conference

“…Only in the remune treated group a significant increase in fat mass and improvement in exercise capacity measured as 6 min walk distance test were shown. A multicompound supplemented nutrition strategy seems to be the right direction . Interestingly, John Morley stated ‘nutrition is different from malnutrition through both share weight loss’.…”

“…A multicompound supplemented nutrition strategy seems to be the right direction. 38 Interestingly, John Morley stated 'nutrition is different from malnutrition through both share weight loss'. Roger Fielding et al 39 (Tufts University, USA) presented the LIFE study a Phase 3 multicentre randomized controlled trial designed to evaluate the efficacy of a longterm physical activity intervention compared with a successful ageing health education intervention for reducing the incidence of major mobility disability among mobility-limited older adults.…”

Potential Nutrition Support for Age-Related Muscular Conditions

“…Cross-sectional data have reported high prevalence of sarcopenia is associated with alcohol intake, low dietary diversity, and insufficient intakes of fruit, vegetables and dairy food [3,[13][14][15]. In particular, high adherence to a Mediterranean diet is associated with slower decline in muscle and physical functioning and a lower risk of sarcopenia among the elderly [16][17][18]. Unfortunately, these findings are largely based on observational data and there are limited welldesigned Randomized Controlled Trials (RCTs) investigating the efficacy of nutrition interventions on age-related muscular conditions [11].…”