Novel approaches to optimize nutrition in the elderly patients

Abstract

BACKGROUND: The current dietary advice for the elderly is not in line with contemporary understanding of the effects that nutrition produces on the universal mechanisms of age-related diseases. AIM: This review is designed to consider modern concepts on the impact of nutrition on the development of age-related diseases and compare them with the current dietary advice for the elderly, with special focus on prevention of frailty and sarcopenia, the key factors of longevity and health quality. METHODS: Search in Google Scholar and PubMed for reviews and clinical trials using the keywords nutrition, frailty, and sarcopenia. RESULTS: Frailty is affected by several biopsychosocial factors, with nutrition having the paramount role. It dominates the onset and progression of the key mechanisms of accelerated aging: most importantly, chronic systemic inflammation, insulin resistance, and gut dysbiosis. There is strong evidence that frailty is promoted by malnutrition (insufficiency of energy and nutrients), obesity (insulin resistance), protein deficit, high dietary inflammatory index, easily digested carbohydrates (including fructose and starch), highly processed food, and trans fats and indirectly by gluten. Frailty and sarcopenia can be prevented through the consumption of high-quality (animal) protein, vegetables and fruit (the source of dietary fiber, vitamins, minerals, and phytonutrients), fats, nutrients with antioxidant properties (including vitamins A and E, zinc, selenium, and omega-3 fatty acids), correction of vitamin D status, support of gut microbial diversity, correction of hyperinsulinemia, and increased intestinal permeability. CONCLUSION: The dietary advice for elderly patients requires revision in line with the contemporary understanding of mechanisms behind age-related diseases and the recent evidence base. This review covers the basics of nutrition essential to prevent frailty and sarcopenia.