There is evidence that poor nutrition is related to frailty. Frailty is a clinical syndrome characterised by three or more of the following criteria: unintentional weight loss, exhaustion, weakness, slowness, and reduced physical activity.
Frailty is produced by two pathways: First, resulting from age-related musculoskeletal changes, loss of muscle mass, and anorexia of ageing; and second, as a result of the effect of diseases.
Anorexia of ageing, is a decrease in appetite and food intake. Frequently older people fail to ingest adequate amounts of good quality foods to meet their essential energy and nutrient requirements. In addition, physiological changes that occur with ageing in the gastrointestinal system, like alterations in taste and smell, gastric motility, and changes in gastrointestinal hormone, could modify dietary preferences, and impair absorption of vitamins, leading to vitamin deficiencies and malnutrition.
Frailty is characterised by the lack of functional reserve, it undermines the physiological response to new demands. In a previous study of our group (by Sandoval-Insausti H et al., 2017) we found that a diet rich in proteins could prevent frailty. Also, fruits and vegetables intake, and following a Mediterranean diet are believed to minimise frailty. So, it was of interest to know how specific nutrients from diet could influence frailty, and the association of vitamin intake with frailty has hardly being studied.
At the beginning of the study we obtained information about diet in participants without frailty, and three years later we obtained information about unintentional weight loss, exhaustion, weakness, slowness, and physical activity, that are the main elements to determinate frailty. Unsurprisingly, we found that poor vitamin intake, and the lack of adherence to the recommended daily allowances for vitamins, were strongly associated with frailty in older people. Conversely, a well-balanced diet, had lower risk of frailty than those with lower vitamin intake.
For the study analysis, we excluded individuals without baseline information on diet and participants who were taking vitamin supplements. We looked at vitamins obtained through ordinary food only. A balanced diet that contains plenty of vegetables, fruits, whole grains, and some sources of protein, offers nutrients that meet the body's requirements whereas there is little or no evidence of frailty prevention in those taking multi-supplements. We have to bear in mind that dietary and pharmacological vitamin doses could have different impact in health. On the other hand, a well-balanced diet is safe and can prevent other physical impairments.
Frailty syndrome is potentially preventable with specific strategies. When it appears, it could be reversed through physical activity and a healthy diet. The results of the study are important because the message for those aged 60 and older, is that having a healthy diet, in this case, with appropriate amounts of vitamins, can prevent frailty from manifesting. The recommendation is (1) to have a balanced diet with variety of foods like lean meat, fruits and vegetables, whole grains and low fat dairy, (2) eat less processed foods because they are low in nutritional value and vitamin density, and (3) engaging in regular physical activity.
Optimal nutrition is important to prevent diseases, improving quality of life, promoting healthy aging, and also avoiding dependence throughout the life cycle. Thus, being attentive to the diet of older adults who are close to us, could delay their deterioration associated with age.
Teresa Balboa Castillo
Department of Public Health
Universidad de La Frontera
Temuco, Chile
Read the Age and Ageing paper at https://academic.oup.com/ageing/advance-article-abstract/doi/10.1093/ageing/afy105/5058977?redirectedFrom=fulltext