Nutrition and Frailty: Opportunities for Prevention and Treatment

Abstract

Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future.

Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction

“…The two largest loadings in DP6 were closely related as carotenoids, β-carotene (provitamin A), and its downstream product, vitamin A. In line with prior studies that have suggested a link between oxidative stress and frailty, higher β-carotene intake may be protective due to its antioxidant activity [ 36 , 37 ]. Kochlik et al found that compared with frail subjects, healthy participants had significantly higher levels of several antioxidants, including γ-tocopherol, α-carotene, β-carotene, and lycopene, while frail individuals had significantly higher concentrations of oxidative stress biomarkers [ 38 ].…”

The Nutritional Status of Long-Term Institutionalized Older Adults Is Associated with Functional Status, Physical Performance and Activity, and Frailty

“…The MNA provides important information for predicting frailty in older adults [69] and the relationship we found between nutrition and frailty, as measured by different tools, is well-established [24,25,[70][71][72]. Nutritional frailty has been proposed to be an independent phenotype of frailty, underscoring the close relationship between these two variables [73].…”

“…Malnutrition may also increase the risk of frailty. Two recent reviews highlighted the relative lack of studies conducted on frail patients, particularly the lack of nutritional intervention studies especially clinical trials [24,25]. Reflecting this lack, two of the few clinical trials with a nutritional intervention performed in frail older individuals living in LTNHs are the one published by Fiatarone et al and Smoliner et al [26,27].…”

Frailty Syndrome—Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature

“…The incidence of FS has also been linked to individual nutritional habits; low intake of protein and macro- and micronutrients in the daily diet being the acknowledged predisposing factors [ 16 , 17 ]. Reduced appetite in older adults may well lead to malnutrition and is generally associated with a loss of nutrients essential for the body functions [ 18 ]. In line with the recommendations of the European Society of Clinical Nutrition and Metabolism (ESPEN), older adults should consume 1.0 to 1.2 g protein/kg/d, whereas all malnourished seniors, or any individuals at risk of malnutrition, e.g., due to a specific medical condition, should consume 1.2 to 1.5 g protein/kg/d [ 19 ].…”