Novel approaches to optimize nutrition in the elderly patients

Abstract

Background: The current dietary advice for the elderly are not in line with contemporary understanding of the effects that nutrition produces on the universal mechanisms of age-related diseases (ARD). The review is aimed at filling this gap, with special focus on prevention of frailty and sarcopenia, the key factors of longevity and health quality.
 Methods: Search in Google Scholar, PubMed for reviews and clinical trials with key words nutrition, frailty, and sarcopenia.
 Results: Frailty is affected by several biopsychosocial factors, with paramount role of nutrition. 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, trans-fats, and indirectly by gluten.
 Frailty and sarcopenia can be prevented through 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, 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 the elderly requires revision in line with the contemporary understanding of ARD mechanisms and the recent evidence base. The review covers the basics of nutrition essential to prevent frailty and sarcopenia.