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Nutrients
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Frailty: Role of Nutrition and Exercise
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Frailty: Role of Nutrition and Exercise

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (28 June 2019) | Viewed by 93810

Special Issue Editors

Prof. Dr. Marc Bonnefoy

E-Mail Website
Guest Editor
INSERM 1060 CarMeN , Université Claude Bernard Lyon1, Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France
Interests: geriatric evaluation; memory; management of falls; nutrition; sarcopenia; frailty; prevention of loss of mobility
Special Issues, Collections and Topics in MDPI journals
Prof. Mylène Aubertin-Leheudre

E-Mail Website
Guest Editor
Universite du Quebec a Montreal, Departement des sciences de l'activite physique; GRAPA, Montreal, Canada
Interests: physiological aspects of aging and exercise; body composition; functional profile; food; aging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Frailty is a common syndrome in older adults and considered as the stage that precedes dependency. Sarcopenia, low muscle quality, physical inactivity, and poor nutritional status are generally considered as major components for frailty. Nevertheless, there is no clear consensus about the definition of frailty and the type of intervention to prevent it.

The purpose of this special issue is an update on the role of exercise and nutritional interventions (combined or separated) on muscle function and physical performances in older patients at risk of frailty or with frailty living in the community, in nursing home or hospitalized.

Topics may include, but not be limited to, those listed below:

1) Influence of proteins (quantity, type, distribution) with or without exercise intervention

2) Influence of specific amino acids (EAA, leucine, casein, citrulline, etc.)  with or without exercise intervention

3) Influence of other nutrients (vitamin D, Omega 3, etc.) with or without exercise intervention

4) Influence of energy needs/ undernourished state.

Overall, this special issue will focus on addressing existing evidence gaps in this field with a view to finding the tracks for future care and toincreasing clinician awareness and knowledge of sarcopenia/frailty.

Your participation to share your expertise with the scientific and medical community is important and will be appreciated.

Prof. Marc Bonnefoy
Prof. Mylène Aubertin-Leheudre
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Frailty
  • Sarcopenia
  • Muscle function
  • Muscle quality
  • Nutrition
  • Supplementation
  • Exercise
  • Physical activity
  • Intervention
  • Lifestyle habits
  • Elderly
  • Energy needs and energy expenditure
  • Proteins
  • Essential amino acids
  • Vitamin D and omega-3

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Published Papers (6 papers)

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Research

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14 pages, 238 KiB  
Communication
Dietary Protein, Exercise, and Frailty Domains
by Josje D. Schoufour, Elvera Overdevest, Peter J. M. Weijs and Michael Tieland
Nutrients 2019, 11(10), 2399; https://doi.org/10.3390/nu11102399 - 8 Oct 2019
Cited by 19 | Viewed by 5798
Abstract
Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty including nutrition and physical activity. Most effort so far has been spent on understanding the association between protein [...] Read more.
Increasing awareness of the impact of frailty on elderly people resulted in research focusing on factors that contribute to the development and persistence of frailty including nutrition and physical activity. Most effort so far has been spent on understanding the association between protein intake and the physical domain of frailty. Far less is known for other domains of frailty: cognition, mood, social health and comorbidity. Therefore, in the present narrative review, we elaborate on the evidence currently known on the association between protein and exercise as well as the broader concept of frailty. Most, but not all, identified studies concluded that low protein intake is associated with a higher prevalence and incidence of physical frailty. Far less is known on the broader concept of frailty. The few studies that do look into this association find a clear beneficial effect of physical activity but no conclusions regarding protein intake can be made yet. Similar, for other important aspects of frailty including mood, cognition, and comorbidity, the number of studies are limited and results are inconclusive. Future studies need to focus on the relation between dietary protein and the broader concept of frailty and should also consider the protein source, amount and timing. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
14 pages, 266 KiB  
Article
Effect of Long-Term Omega 3 Polyunsaturated Fatty Acid Supplementation with or without Multidomain Lifestyle Intervention on Muscle Strength in Older Adults: Secondary Analysis of the Multidomain Alzheimer Preventive Trial (MAPT)
by Yves Rolland, Philipe de Souto Barreto, Mathieu Maltais, Sophie Guyonnet, Christelle Cantet, Sandrine Andrieu and Bruno Vellas
Nutrients 2019, 11(8), 1931; https://doi.org/10.3390/nu11081931 - 16 Aug 2019
Cited by 44 | Viewed by 6919
Abstract
Background: The benefits of long-term omega 3 polyunsaturated fatty acid (ω3-PUFA) supplementation on muscle strength in older adults remains to be investigated. Objectives: We assessed the effect of ω3-PUFA supplementation and a multidomain (physical activity, cognitive training, and nutritional advice), alone or in [...] Read more.
Background: The benefits of long-term omega 3 polyunsaturated fatty acid (ω3-PUFA) supplementation on muscle strength in older adults remains to be investigated. Objectives: We assessed the effect of ω3-PUFA supplementation and a multidomain (physical activity, cognitive training, and nutritional advice), alone or in combination, compared with placebo, on muscle strength. We also hypothesized that ω3-PUFA supplementation resulted in additional benefit in participants with a low docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) erythrocyte level at baseline and high adherence to the multidomain intervention sessions. Design: We performed secondary analyses of the Multidomain Alzheimer Preventive Trial (MAPT), a 3-year, multicenter, randomized, placebo-controlled trial with four parallel groups. Participants were non-demented, aged 70 years or older. They were recruited in 13 memory clinics in France and Monaco between 30 May 2008 and 24 February 2011. Participants were randomly assigned to either ω3-PUFA alone (two capsules a day providing a total daily dose of 800 mg DHA and 225 mg EPA), ω3-PUFA plus the multidomain intervention (43 group sessions integrating advice for physical activity (PA), and nutrition, cognitive training, and three preventive consultations), the multidomain intervention plus placebo, or placebo alone. Our primary outcome was the change from baseline to 36 months of the muscle strength assessed with the repeated chair stand test and handgrip strength. Results: A total of 1680 participants (75.34 years ± 4.42) were randomized. In the modified intention-to-treat population (n = 1679), no significant differences at 3-year follow-up were observed in the repeated chair stand test score between any of the three intervention groups and the placebo group. The between-group differences compared with placebo were −0.05388 (−0.6800 to 0.5723; Standard Error, SE = 0.3192; p = 0.8660) for the ω3-PUFA group, −0.3936 (−1.0217 to 0.2345; SE = 0.3180; p = 0.2192) for the multidomain intervention plus placebo group, and −0.6017 (−1.2255 to 0.02222; SE = 0.2092; p = 0.3202) for the combined intervention group. No significant effect was also found for the handgrip strength. Sensitivity analyses performed among participants with low (DHA+EPA) erythrocyte level at baseline (first quartile vs. others) or highly adherent participants (≥75% of the multidomain intervention sessions) revealed similar results. Conclusion: Low dose ω3-PUFA supplementation, either alone or in combination with a multidomain lifestyle intervention comprising physical activity counselling, had no significant effects on muscle strength over 3 years in elderly people. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
19 pages, 957 KiB  
Article
Initial Dietary Protein Intake Influence Muscle Function Adaptations in Older Men and Women Following High-Intensity Interval Training Combined with Citrulline
by Fanny Buckinx, Vincent Marcangeli, Lívia Pinheiro Carvalho, Maude Dulac, Guy Hajj Boutros, Gilles Gouspillou, Pierrette Gaudreau, José Morais, Philippe Noirez and Mylène Aubertin-Leheudre
Nutrients 2019, 11(7), 1685; https://doi.org/10.3390/nu11071685 - 22 Jul 2019
Cited by 5 | Viewed by 5622
Abstract
Background: This study evaluates whether the initial amount of dietary protein intake could influence the combined effect of high-intensity interval training (HIIT) and citrulline (CIT), or HIIT alone, on body composition, muscle strength, and functional capacities in obese older adults. Methods: Seventy-three sedentary [...] Read more.
Background: This study evaluates whether the initial amount of dietary protein intake could influence the combined effect of high-intensity interval training (HIIT) and citrulline (CIT), or HIIT alone, on body composition, muscle strength, and functional capacities in obese older adults. Methods: Seventy-three sedentary obese older men and women who completed a 12-week elliptical HIIT program with double-blinded randomized supplementation of CIT or placebo (PLA) were divided into four groups according to their initial protein intake (CIT–PROT+: n = 21; CIT–PROT−: n = 19; PLA–PROT+: n = 19; PLA–PROT−: n = 14). Body composition (fat and fat-free masses), handgrip (HSr) strength, knee extensor (KESr) strength, muscle power, and functional capacities were measured pre-intervention and post-intervention. Results: Following the intervention, the four groups improved significantly regarding all the parameters measured. For the same initial amount of protein intake, the CIT–PROT− group decreased more gynoid fat mass (p = 0.04) than the PLA–PROT− group. The CIT–PROT+ group increased more KESr (p = 0.04) than the PLA–PROT+ group. In addition, the CIT–PROT− group decreased more gynoid FM (p = 0.02) and improved more leg FFM (p = 0.02) and HSr (p = 0.02) than the CIT–PROT+ group. Conclusion: HIIT combined with CIT induced greater positive changes than in the PLA groups. The combination seems more beneficial in participants consuming less than 1 g/kg/d of protein, since greater improvements on body composition and muscle strength were observed. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
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17 pages, 873 KiB  
Article
The Relationship between Dietary Habits and Frailty in Rural Japanese Community-Dwelling Older Adults: Cross-Sectional Observation Study Using a Brief Self-Administered Dietary History Questionnaire
by Kayoko Tamaki, Hiroshi Kusunoki, Shotaro Tsuji, Yosuke Wada, Koutatsu Nagai, Masako Itoh, Kyoko Sano, Manabu Amano, Hatsuo Maeda, Yoko Hasegawa, Hiromitsu Kishimoto, Sohji Shimomura and Ken Shinmura
Nutrients 2018, 10(12), 1982; https://doi.org/10.3390/nu10121982 - 14 Dec 2018
Cited by 29 | Viewed by 4899
Abstract
To develop effective nutritional interventions for preventing frailty, the specific problems associated with the dietary habits of individuals based on sex differences must be identified. The purpose of this study was to evaluate the association between dietary habits and frailty in rural Japanese [...] Read more.
To develop effective nutritional interventions for preventing frailty, the specific problems associated with the dietary habits of individuals based on sex differences must be identified. The purpose of this study was to evaluate the association between dietary habits and frailty in rural Japanese community-dwelling older adults. We recruited 800 participants, aged 65 and older, who underwent a comprehensive health examination between November 2015 and December 2017. Dietary habits were assessed by a brief self-administered dietary history questionnaire. Frailty was determined using either the Kihon Checklist (KCL) or the Japanese version of the Cardiovascular Health Study (J-CHS). The percentage of frail older adults was 8.4% according to KCL and 4.0% according to J-CHS. Various kinds of nutrient intakes, including three major nutrients, minerals, and vitamins in frail men, according to KCL, were the lowest. By contrast, there were no differences in nutrient intake between the robust, prefrail, and frail female groups according to KCL. We found significant associations of the intakes of soluble dietary fiber, potassium, folate, and vitamin C with a frail status in men (p = 0.035, 0.023. 0.012, and 0.007, respectively), and an association of the intake of vitamin C with a frail status in women (p = 0.027) according to J-CHS. Attention should be paid to the diagnostic criteria of frailty and to sex differences, when nutritional interventions for the prevention of frailty are planned. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
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Review

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21 pages, 458 KiB  
Review
The Role of the Anabolic Properties of Plant- versus Animal-Based Protein Sources in Supporting Muscle Mass Maintenance: A Critical Review
by Insaf Berrazaga, Valérie Micard, Marine Gueugneau and Stéphane Walrand
Nutrients 2019, 11(8), 1825; https://doi.org/10.3390/nu11081825 - 7 Aug 2019
Cited by 255 | Viewed by 46516
Abstract
Plant-sourced proteins offer environmental and health benefits, and research increasingly includes them in study formulas. However, plant-based proteins have less of an anabolic effect than animal proteins due to their lower digestibility, lower essential amino acid content (especially leucine), and deficiency in other [...] Read more.
Plant-sourced proteins offer environmental and health benefits, and research increasingly includes them in study formulas. However, plant-based proteins have less of an anabolic effect than animal proteins due to their lower digestibility, lower essential amino acid content (especially leucine), and deficiency in other essential amino acids, such as sulfur amino acids or lysine. Thus, plant amino acids are directed toward oxidation rather than used for muscle protein synthesis. In this review, we evaluate the ability of plant- versus animal-based proteins to help maintain skeletal muscle mass in healthy and especially older people and examine different nutritional strategies for improving the anabolic properties of plant-based proteins. Among these strategies, increasing protein intake has led to a positive acute postprandial muscle protein synthesis response and even positive long-term improvement in lean mass. Increasing the quality of protein intake by improving amino acid composition could also compensate for the lower anabolic potential of plant-based proteins. We evaluated and discussed four nutritional strategies for improving the amino acid composition of plant-based proteins: fortifying plant-based proteins with specific essential amino acids, selective breeding, blending several plant protein sources, and blending plant with animal-based protein sources. These nutritional approaches need to be profoundly examined in older individuals in order to optimize protein intake for this population who require a high-quality food protein intake to mitigate age-related muscle loss. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
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21 pages, 2115 KiB  
Review
Gut Microbiota, Muscle Mass and Function in Aging: A Focus on Physical Frailty and Sarcopenia
by Andrea Ticinesi, Antonio Nouvenne, Nicoletta Cerundolo, Pamela Catania, Beatrice Prati, Claudio Tana and Tiziana Meschi
Nutrients 2019, 11(7), 1633; https://doi.org/10.3390/nu11071633 - 17 Jul 2019
Cited by 249 | Viewed by 23116
Abstract
Human gut microbiota is able to influence the host physiology by regulating multiple processes, including nutrient absorption, inflammation, oxidative stress, immune function, and anabolic balance. Aging is associated with reduced microbiota biodiversity, increased inter-individual variability, and over-representation of pathobionts, and these phenomena may [...] Read more.
Human gut microbiota is able to influence the host physiology by regulating multiple processes, including nutrient absorption, inflammation, oxidative stress, immune function, and anabolic balance. Aging is associated with reduced microbiota biodiversity, increased inter-individual variability, and over-representation of pathobionts, and these phenomena may have great relevance for skeletal muscle mass and function. For this reason, the presence of a gut-muscle axis regulating the onset and progression of age-related physical frailty and sarcopenia has been recently hypothesized. In this narrative review, we summarize the studies supporting a possible association between gut microbiota-related parameters with measures of muscle mass, muscle function, and physical performance in animal models and humans. Reduced muscle mass has been associated with distinct microbiota composition and reduced fermentative capacity in mice, and the administration of probiotics or butyrate to mouse models of muscle wasting has been associated with improved muscle mass. However, no studies have targeted the human microbiome associated with sarcopenia. Limited evidence from human studies shows an association between microbiota composition, involving key taxa such as Faecalibacterium and Bifidobacterium, and grip strength. Similarly, few studies conducted on patients with parkinsonism showed a trend towards a different microbiota composition in those with reduced gait speed. No studies have assessed the association of fecal microbiota with other measures of physical performance. However, several studies, mainly with a cross-sectional design, suggest an association between microbiota composition and frailty, mostly assessed according to the deficit accumulation model. Namely, frailty was associated with reduced microbiota biodiversity, and lower representation of butyrate-producing bacteria. Therefore, we conclude that the causal link between microbiota and physical fitness is still uncertain due to the lack of targeted studies and the influence of a large number of covariates, including diet, exercise, multimorbidity, and polypharmacy, on both microbiota composition and physical function in older age. However, the relationship between gut microbiota and physical function remains a very promising area of research for the future. Full article
(This article belongs to the Special Issue Frailty: Role of Nutrition and Exercise)
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