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Nutrition, Diet and Exercise for the Prevention and Treatment of Frailty

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Sports Nutrition".

Deadline for manuscript submissions: closed (30 August 2023) | Viewed by 16748

Special Issue Editors


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Guest Editor
Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
Interests: neurodegeneration; exercise science; exercise performance; exercise physiology; nutrition; oxidative stress; reactive oxygen species; muscle contraction; antioxidants

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Guest Editor
Department of Physiology, Faculty of Medicine, University of Valencia, 46010 València, Valencia, Spain
Interests: aging; physical exercise; frailty; Alzheimer’s disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ageing is a major characteristic of societies in the Western world. Sometimes ageing is considered a problem, but it should be considered an opportunity because the average lifespan has increased enormously over the last hundred years, more than in any other period in recorded history. Additionally, older persons today have a chance of finding decades of productive and satisfactory life. However, the increase in lifespan must be accompanied by an increase in healthspan and this, in medical terms, means preventing the geriatric syndrome known as frailty. Research into frailty was spurred on enormously by the work of the team led by Linda Fried and Jeremy Walston, which characterised the phenotype of the frail individual. Frailty is associated with an increased risk of disability, hospitalization, and, finally, death. However, the good news is that frailty can be prevented. Moreover, it may be reversed by an adequate combination of diet, exercise, and, in some cases, nutritional supplements.

This Special Issue aims to provide cutting-edge information on the new developments in the frailty field as well as good reviews on the state of the art of this rapidly developing area.

Dr. Mari Carmen Gomez-Cabrera
Prof. Dr. José Viña
Guest Editors

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Keywords

  • diet
  • nutritional supplements
  • physical exercise
  • frailty
  • ageing

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Published Papers (6 papers)

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Research

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10 pages, 418 KiB  
Article
Plant Protein but Not Animal Protein Consumption Is Associated with Frailty through Plasma Metabolites
by Toshiko Tanaka, Jayanta K. Das, Yichen Jin, Qu Tian, Ruin Moaddel, Ann Zenobia Moore, Katherine L. Tucker, Sameera A. Talegawkar and Luigi Ferrucci
Nutrients 2023, 15(19), 4193; https://doi.org/10.3390/nu15194193 - 28 Sep 2023
Cited by 2 | Viewed by 2198
Abstract
There is evidence that the association of protein intake and frailty may depend on the source of dietary protein. The mechanism underlying this association is not clear. In this study, we explore circulating metabolites as mediators of the relationship between dietary protein and [...] Read more.
There is evidence that the association of protein intake and frailty may depend on the source of dietary protein. The mechanism underlying this association is not clear. In this study, we explore circulating metabolites as mediators of the relationship between dietary protein and of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Cross-sectional analyses in 735 BLSA participants of associations between plant and animal protein intake and frailty. Usual protein intake from plant and animal sources were estimated with a Food Frequency Questionnaire (FFQ) and frailty was assessed with a 44-item Frailty Index (FI). Compared with the lowest quartile, higher quartiles of plant, but not animal, protein were associated with lower FI. Twenty-five plasma metabolites were associated with plant protein intake; of these, fifteen, including phosphatidylcholines, cholesterol esters, sphingomyelins, and indole metabolites, mediated the association between plant protein intake and FI. The protective association between plant protein consumption and FI is mediated by lower abundance of lipid metabolites and higher abundance of tryptophan-related metabolites. Full article
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13 pages, 998 KiB  
Article
Patterns of Dietary Blood Markers Are Related to Frailty Status in the FRAILOMIC Validation Phase
by Thorsten Henning, Bastian Kochlik, Ignacio Ara, Marcela González-Gross, Edoardo Fiorillo, Michele Marongiu, Francesco Cucca, Fernando Rodriguez-Artalejo, Jose Antonio Carnicero Carreño, Leocadio Rodriguez-Mañas, Tilman Grune and Daniela Weber
Nutrients 2023, 15(5), 1142; https://doi.org/10.3390/nu15051142 - 24 Feb 2023
Cited by 3 | Viewed by 1911
Abstract
The influence of nutritional factors on frailty syndrome is still poorly understood. Thus, we aimed to confirm cross-sectional associations of diet-related blood biomarker patterns with frailty and pre-frailty statuses in 1271 older adults from four European cohorts. Principal component analysis (PCA) was performed [...] Read more.
The influence of nutritional factors on frailty syndrome is still poorly understood. Thus, we aimed to confirm cross-sectional associations of diet-related blood biomarker patterns with frailty and pre-frailty statuses in 1271 older adults from four European cohorts. Principal component analysis (PCA) was performed based on plasma levels of α-carotene, β-carotene, lycopene, lutein + zeaxanthin, β-cryptoxanthin, α-tocopherol, γ-tocopherol and retinol. Cross-sectional associations between biomarker patterns and frailty status, according to Fried’s frailty criteria, were assessed by using general linear models and multinomial logistic regression models as appropriate with adjustments for the main potential confounders. Robust subjects had higher concentrations of total carotenoids, β-carotene and β-cryptoxanthin than frail and pre-frail subjects and had higher lutein + zeaxanthin concentrations than frail subjects. No associations between 25-Hydroxyvitamin D3 and frailty status were observed. Two distinct biomarker patterns were identified in the PCA results. The principal component 1 (PC1) pattern was characterized by overall higher plasma levels of carotenoids, tocopherols and retinol, and the PC2 pattern was characterized by higher loadings for tocopherols, retinol and lycopene together and lower loadings for other carotenoids. Analyses revealed inverse associations between PC1 and prevalent frailty. Compared to participants in the lowest quartile of PC1, those in the highest quartile were less likely to be frail (odds ratio: 0.45, 95% CI: 0.25–0.80, p = 0.006). In addition, those in the highest quartile of PC2 showed higher odds for prevalent frailty (2.48, 1.28–4.80, p = 0.007) than those in the lowest quartile. Our findings strengthen the results from the first phase of the FRAILOMIC project, indicating carotenoids are suitable components for future biomarker-based frailty indices. Full article
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17 pages, 3621 KiB  
Article
Real-Life Outcomes of a Multicomponent Exercise Intervention in Community-Dwelling Frail Older Adults and Its Association with Nutritional-Related Factors
by Fernando Millan-Domingo, Francisco Jose Tarazona-Santabalbina, Aitor Carretero, Gloria Olaso-Gonzalez, Jose Viña and Maria Carmen Gomez-Cabrera
Nutrients 2022, 14(23), 5147; https://doi.org/10.3390/nu14235147 - 3 Dec 2022
Cited by 2 | Viewed by 3305
Abstract
Most of the studies on physical exercise in older adults have been conducted through randomized clinical trials performed under tight experimental conditions. Data regarding Real-Life physical exercise intervention programs in older adults with different conditions and in different settings, are lacking. This is [...] Read more.
Most of the studies on physical exercise in older adults have been conducted through randomized clinical trials performed under tight experimental conditions. Data regarding Real-Life physical exercise intervention programs in older adults with different conditions and in different settings, are lacking. This is an interventional, prospective and pragmatic Real-Life study in which fifty sedentary and frail individuals were enrolled. We aimed at determining if a Real-Life exercise intervention outweighs previously reported improvements in a Clinical Trial (NCT02331459). We found higher improvements in the Real-Life exercise intervention vs. the Clinical Trial in functional parameters, such as Fried’s frailty criteria, Tinetti, Barthel and Lawton & Brody scales. Similar results were found in the dietary habits, emotional and social networking outcomes determined through the Short-MNA, Yesavage, EuroQol and Duke scales. The Real-Life intervention led to a significant reduction in the number of falls, visits to the primary care centers and emergency visits when compared to the results of our previously published Clinical Trial. The implementation of a Real-Life exercise intervention is feasible and should be a major priority to improve health-span in the older population. Full article
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18 pages, 5006 KiB  
Article
Sex Specific Differences in Response to Calorie Restriction in Skeletal Muscle of Young Rats
by Margalida Torrens-Mas, Cayetano Navas-Enamorado, Devin Wahl, Andres Sanchez-Polo, Anna Picca, Jordi Oliver, Pilar Roca and Marta Gonzalez-Freire
Nutrients 2022, 14(21), 4535; https://doi.org/10.3390/nu14214535 - 28 Oct 2022
Cited by 3 | Viewed by 2595
Abstract
Calorie restriction (CR), defined as a reduction of the total calorie intake of 30% to 60% without malnutrition, is the only nutritional strategy that has been shown to extend lifespan, prevent or delay the onset of age-associated diseases, and delay the functional decline [...] Read more.
Calorie restriction (CR), defined as a reduction of the total calorie intake of 30% to 60% without malnutrition, is the only nutritional strategy that has been shown to extend lifespan, prevent or delay the onset of age-associated diseases, and delay the functional decline in a wide range of species. However, little is known about the effects of CR when started early in life. We sought to analyze the effects of CR in the skeletal muscle of young Wistar rats. For this, 3-month-old male and female rats were subjected to 40% CR or fed ad libitum for 3 months. Gastrocnemius muscles were used to extract RNA and total protein. Western blot and RT-qPCR were performed to evaluate the expression of key markers/pathways modulated by CR and affected by aging. CR decreased body and skeletal muscle weight in both sexes. No differences were found in most senescence, antioxidant, and nutrient sensing pathways analyzed. However, we found a sexual dimorphism in markers of oxidative stress, inflammation, apoptosis, and mitochondrial function in response to CR. Our data show that young female rats treated with CR exhibit similar expression patterns of key genes/pathways associated with healthy aging when compared to old animals treated with CR, while in male rats these effects are reduced. Additional studies are needed to understand how early or later life CR exerts positive effects on healthspan and lifespan. Full article
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11 pages, 284 KiB  
Article
Associations of Nutrition-Related, Physical, and Social Factors and Their Combinations with Sarcopenia in Community-Dwelling Older Adults: Kashiwa Cohort Study
by Weida Lyu, Tomoki Tanaka, Bo-Kyung Son, Yasuyo Yoshizawa, Masahiro Akishita and Katsuya Iijima
Nutrients 2022, 14(17), 3544; https://doi.org/10.3390/nu14173544 - 27 Aug 2022
Cited by 9 | Viewed by 2932
Abstract
Background: Sarcopenia is a major cause of frailty, which relates to nutrition-related, physical, and social factors. In this study, we aimed to discuss the cross-sectional association of sarcopenia with the above three factors both individually and comprehensively. Methods: Overall, 1257 older adults (≥65 [...] Read more.
Background: Sarcopenia is a major cause of frailty, which relates to nutrition-related, physical, and social factors. In this study, we aimed to discuss the cross-sectional association of sarcopenia with the above three factors both individually and comprehensively. Methods: Overall, 1257 older adults (≥65 years old) participated in this study. Sarcopenia was determined via the Asian Working Group for Sarcopenia 2019 criteria. The independent variables for nutrition-related, physical, and social factors and especially their criteria for health condition were defined separately. Binomial logistic regression analysis was carried out to testify the associations of sarcopenia with three factors individually and in combination. Results: The mean age was 74.6 (±5.5), and women were 47.7%. Sarcopenia prevalence was 7.5%. Participants who did not meet the criteria of nutritional health, physical fitness, or social robustness independently had significant associations with a higher adjusted odds ratio (aOR) of sarcopenia or its indices of lower grip strength, muscle mass, or gait speed. In comparison to participants meeting three criteria, those who met two, one, or none showed (marginally) significant association with increased aOR for sarcopenia (aOR (95% confidence interval)): two: 1.97 (0.84–4.64); one: 2.35 (1.00–5.23); none: 5.52 (2.30–13.23). Conclusions: Comprehensive countermeasures with the above three factors are indispensable for sarcopenia prevention. Full article

Review

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37 pages, 678 KiB  
Review
Implementation and Core Components of a Multimodal Program including Exercise and Nutrition in Prevention and Treatment of Frailty in Community-Dwelling Older Adults: A Narrative Review
by Leo Delaire, Aymeric Courtay, Joannès Humblot, Mylène Aubertin-Leheudre, France Mourey, Antoine Noël Racine, Thomas Gilbert, Zeinabou Niasse-Sy and Marc Bonnefoy
Nutrients 2023, 15(19), 4100; https://doi.org/10.3390/nu15194100 - 22 Sep 2023
Cited by 2 | Viewed by 2856
Abstract
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such [...] Read more.
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings. Full article
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