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

Deadline for manuscript submissions: closed (29 February 2020) | Viewed by 80220

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Prof. Dr. Siân Robinson

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AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University
Interests: Lifecourse influences of diet and lifestyle on health in later life; Focusing particularly on inequalities in health in older age; Interests in nutrition policy
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ailsa Welch

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Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
Interests: Diet and aging; Dietary fat and protein composition; Micronutrients; Dietary patterns and acid-base load; Malnutrition; Dietary methodology; Public health nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As increases in healthy life expectancy have not kept pace with improvements in life expectancy, today’s older adults may face greater time spent in poor health, with greater likelihood of having multiple chronic and complex health conditions and disability. Recognition of the challenges that ageing populations face has focused attention on health trajectories in later life. Understanding the determinants of differences in the rate and pace of ageing across the population will be central both to the provision of effective support to promote health and to help to maintain independence in older age, as well as predicting the healthcare needs of older people in the future. Lifestyle factors (diet, physical activity, sleep, smoking, alcohol) are known determinants of health, and may also be key influences on healthy ageing.

This Special Issue of Nutrients, entitled "Diet, Lifestyle and Healthy Ageing", welcomes the submission of manuscripts describing either original research or systematic reviews and meta-analyses.

Potential topics may include, but are not limited to:

influences on diet and lifestyle in older age: psychosocial and age-related factors;
diet, lifestyle and retirement transition;
inequalities in diet and lifestyle among older populations;
diet, lifestyle and healthy ageing;
systematic reviews and meta-analyses of studies of diet, lifestyle and health outcomes in older age; and
systematic reviews and meta-analyses of interventions to support diet and lifestyle in older populations.

Prof. Dr. Siân Robinson
Prof. Dr. Ailsa Welch
Guest Editors

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Keywords

diet
lifestyle
ageing
health

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Published Papers (11 papers)

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Research

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15 pages, 1667 KiB

Open AccessArticle

A Mediterranean Diet Is Positively Associated with Bone and Muscle Health in a Non-Mediterranean Region in 25,450 Men and Women from EPIC-Norfolk

by Amy Jennings, Angela A. Mulligan, Kay-Tee Khaw, Robert N. Luben and Ailsa A. Welch

Nutrients 2020, 12(4), 1154; https://doi.org/10.3390/nu12041154 - 21 Apr 2020

Cited by 26 | Viewed by 4810

Abstract

Research on Mediterranean diet (MD) adherence and musculoskeletal health is limited. The current study determined if adherence to the alternative MD score (aMED) and MD score (MDS), quantified from 7-d food diaries, was associated with fracture incidence, bone density (calcaneal broadband ultrasound attenuation (BUA)) and fat free mass (expressed over BMI (FFM^BMI) using bioelectrical impedance) in 25,450 men and women recruited to the European Prospective Investigation into Cancer study in Norfolk, UK. During 17.4 years of follow up (443,178 total person years) 2195 incident fractures occurred. Higher aMED adherence was associated with 23% reduced total (Q5–Q1 HR 0.77; 95% CI 0.67, 0.88; p-trend < 0.01) and 21% reduced hip (Q5–Q1 HR 0.79; 95% CI 0.65, 0.96; p-trend = 0.01) fracture incidence, and significantly higher BUA (Q5–Q1 1.0 dB/MHz 95% CI 0.2, 1.9; p-trend < 0.01) and FFM^BMI (Q5–Q1 0.05 kg/(kg/m²) 95% CI 0.04, 0.06; p-trend < 0.01), comparing extreme adherence quintiles. Higher MDS was also associated with reduced total fractures (Q5–Q1 HR 0.83; 95% CI 0.71, 0.96; p-trend = 0.03) and significantly higher BUA (Q5–Q1 1.4 dB/MHz 95% CI 0.5, 2.3; p-trend < 0.01) and FFM^BMI (Q5–Q1 0.03 kg/(kg/m²) 95% CI 0.01, 0.04; p-trend < 0.01). This evidence supports the need to develop interventions to enhance MD adherence, particularly in women, where evidence for associations was stronger. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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14 pages, 1276 KiB

Open AccessArticle

Feasibility of the AusMed Diet Program: Translating the Mediterranean Diet for Older Australians

by Karly Zacharia, Amanda J. Patterson, Coralie English and Lesley MacDonald-Wicks

Nutrients 2020, 12(4), 1044; https://doi.org/10.3390/nu12041044 - 10 Apr 2020

Cited by 15 | Viewed by 3698

Abstract

The Mediterranean diet pattern (MEDI) is associated with a lower risk of chronic conditions related to ageing. Adherence research mostly comes from Mediterranean countries with high cultural acceptability. This study examines the feasibility of a MEDI intervention designed specifically for older Australians (AusMed). Phase 1 involved a consumer research group (n = 17) presentation of program materials with surveys after each section. In-depth individual semi-structured interviews (n = 6) were then conducted. All participants reported increased knowledge and confidence in adherence to the MEDI, with the majority preferring a booklet format (70%) and group delivery (58%). Three themes emerged from interviews—1. barriers (complexity, perceived cost and food preferences), 2. additional support and 3. individualisation of materials. Program materials were modified accordingly. Phase 2 was a 2-week trial of the modified program (n = 15). Participants received a group counselling session, program manual and food hamper. Adherence to the MEDI was measured by the Mediterranean Diet Score (MDS). All participants increased their adherence after the 2-week trial, from a mean score of 5.4 ± 2.4 (low adherence) to a mean score of 9.6 ± 2.0 (moderate to high adherence). All found that text message support helped achieve their goals and were confident to continue the dietary change. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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14 pages, 5360 KiB

Open AccessArticle

Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

by Pilar Pérez-Ros, Rafael Vila-Candel, Lourdes López-Hernández and Francisco Miguel Martínez-Arnau

Nutrients 2020, 12(4), 1041; https://doi.org/10.3390/nu12041041 - 10 Apr 2020

Cited by 38 | Viewed by 6499

Abstract

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R² = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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10 pages, 258 KiB

Open AccessArticle

Effect of Calanus Oil Supplementation and 16 Week Exercise Program on Selected Fitness Parameters in Older Women

by Klára Daďová, Miroslav Petr, Michal Šteffl, Lenka Sontáková, Martin Chlumský, Miloš Matouš, Vladimír Štich, Marek Štěpán and Michaela Šiklová

Nutrients 2020, 12(2), 481; https://doi.org/10.3390/nu12020481 - 14 Feb 2020

Cited by 16 | Viewed by 3594

Abstract

We investigated changes in functional fitness after an exercise program in combination with Calanus oil supplementation, a novel source of bioactive lipids rich in wax esters with omega-3 polyunsaturated fatty acid (n-3 PUFA). Fifty-five healthy sedentary women aged 65–80 (mean age 70.9 ± 3.9 years, BMI 27.24 ± 3.9 kg m⁻², VO₂peak 19.46 ± 3.7 ml kg⁻¹ min⁻¹) were enrolled in the study. The participants were divided into two groups: exercise training plus Calanus Oil supplementation (n = 28) or exercise plus placebo (sunflower oil) supplementation (n = 27). The exercise intervention program was completed by 53 participants and contained functional circuit training (twice a week, 45 min plus 15 min of stretching and balance training) and Nordic walking (once a week, 60 min) for 16 weeks. Senior fitness test, exercise stress test on bicycle ergometer, hand-grip, and body composition were evaluated before and after the program. Our results show that functional fitness and body composition improved following the interventional exercise program, but for most of the parameters there was no synergic effect of supplementing n-3 PUFA-rich Calanus oil. In comparison to the placebo group, the group with Calanus supplementation experienced significantly higher improvement of functional strength of lower body which was evaluated by the chair stand test. Supplementation with Calanus may have a synergic effect with exercise on functional strength of the lower body in the elderly. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

11 pages, 273 KiB

Open AccessArticle

Independent and Joint Associations of Physical Activity and Dietary Behavior with Older Adults’ Lower Limb Strength

by Ting-Fu Lai, Chien-Yu Lin, Chien-Chih Chou, Wan-Chi Huang, Ming-Chun Hsueh, Jong-Hwan Park and Yung Liao

Nutrients 2020, 12(2), 443; https://doi.org/10.3390/nu12020443 - 10 Feb 2020

Cited by 5 | Viewed by 2744

Abstract

Studies have indicated that sufficient physical activity levels and balanced dietary behavior are independently related to physical function in older populations; however, their joint association with physical function remain unclear. This study examined the independent and combined associations of sufficient physical activity and balanced selection of foods with lower limb strength among 122 older Taiwanese adults living in community (mean age: 69.9 ± 5.0 years). The assessments included accelerometer-measured moderate-to-vigorous physical activity (MVPA) and self-reported selection of foods. Lower limb strength performance was measured using the five times sit-to-stand test. Binary logistic regression analyses were performed to estimate the associations in question before and after adjusting for potential confounders. The results showed that in the adjusted model, lower limb strength had no significant independent association with either meeting the recommended level of MVPA or balanced selection of foods. Compared to older adults who neither met the recommended MVPA level nor reported a balanced selection of foods, those who conformed to both these criteria were more likely to have better lower limb strength (odds ratio = 6.28, 95% confidence interval = 1.36–29.01) after adjusting for covariates. Health promotion initiatives addressing disability prevention for older adults need to consider promoting both MVPA and food selection. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

16 pages, 829 KiB

Open AccessArticle

Comparison of the Acute Postprandial Circulating B-Vitamin and Vitamer Responses to Single Breakfast Meals in Young and Older Individuals: Preliminary Secondary Outcomes of a Randomized Controlled Trial

by Pankaja Sharma, Nicola Gillies, Shikha Pundir, Chantal A. Pileggi, James F. Markworth, Eric B. Thorstensen, David Cameron-Smith and Amber M. Milan

Nutrients 2019, 11(12), 2893; https://doi.org/10.3390/nu11122893 - 28 Nov 2019

Cited by 9 | Viewed by 3628

Abstract

B-vitamin deficiency is common in ageing populations either due to altered dietary habits or altered digestive and metabolic functions. There is limited data on the acute circulating concentrations of B-vitamins and their various forms (vitamers), following ingestion of realistic meals. This study compared the acute circulating B-vitamin and vitamer responses to either an energy-dense (ED) or a nutrient-dense (ND) breakfast meal, consumed in a randomized cross-over sequence, in older and younger adults (n = 15 and 15, aged 67.3 ± 1.5 and 22.7 ± 0.5 years (mean ± SEM), respectively). Eleven differing B-vitamins and vitamers were determined in plasma samples by ultra-high-performance liquid chromatography-tandem mass spectrometry, in the fasting and postprandial state (hourly for 5 h). While postprandial thiamine concentration increased following both meals, riboflavin increased only following a ND meal in both age groups. Many vitamins including nicotinic acid, pantothenic acid, pyridoxal, pyridoxamine, pyridoxal-5’phosphate, and 4-pyridoxic acid remained unaltered, and flavin mononucleotide (FMN), nicotinamide and nicotinuric acid concentrations reduced following both meals. Biological age and food composition had minimal impact on postprandial B-vitamin concentrations, yet the differences between the ED and ND meals for riboflavin highlight the importance of riboflavin intake to achieve adequacy. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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10 pages, 237 KiB

Open AccessArticle

Association between Food Store Availability and the Incidence of Functional Disability among Community-Dwelling Older Adults: Results from the Japanese Gerontological Evaluation Cohort Study

by Ryo Momosaki, Hidetaka Wakabayashi, Keisuke Maeda, Hiroshi Shamoto, Shinta Nishioka, Kaori Kojima, Yukako Tani, Norimichi Suzuki, Masamichi Hanazato and Katsunori Kondo

Nutrients 2019, 11(10), 2369; https://doi.org/10.3390/nu11102369 - 4 Oct 2019

Cited by 10 | Viewed by 5345

Abstract

This study sought to clarify the association between food store availability and the incidence of disability in older adults. This study utilized a population-based cohort study of independent Japanese adults aged ≥65 years, which was a 6 year follow-up of participants in the Japan Gerontological Evaluation Study. A total of 31,273 respondents were extracted. Food store availability was evaluated based on the existence of food stores within 500/1000 m of the home. We utilized participant-reported subjective measurement as well as geographic information system-based objective measurement for the evaluation. The incidence of disability was determined using municipal data on eligibility for long-term care insurance benefits. There were 7643 (24.4%) community-dwelling participants with low subjective food store availability and 5673 (18.1%) with low objective food store availability. During the follow-up period of 6 years, the cumulative incidence of disability was 20.9%, with a significant association between low subjective food store availability and increased disability. Participants who reported low subjective food store availability had a significantly higher likelihood of developing disability (hazard ratio = 1.18, 95% confidence interval: 1.11–1.25) than those who reported high subjective food store availability after adjusting for age, sex, sociodemographic status, environmental status, walking and going out, dietary food intake, body mass index, and comorbidities. Low subjective food store availability was associated with early onset of disability. Accessibility of food stores might contribute to maintaining a disability-free life. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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32 pages, 1981 KiB

Open AccessReview

Myoprotective Whole Foods, Muscle Health and Sarcopenia: A Systematic Review of Observational and Intervention Studies in Older Adults

by Antoneta Granic, Lorelle Dismore, Christopher Hurst, Sian M. Robinson and Avan A. Sayer

Nutrients 2020, 12(8), 2257; https://doi.org/10.3390/nu12082257 - 28 Jul 2020

Cited by 35 | Viewed by 12353

Abstract

Decline in skeletal muscle strength and mass (sarcopenia) accelerates with age, leading to adverse health outcomes and poor quality of life. Diet plays a crucial role in muscle ageing being an important element of a healthy lifestyle. However, unlike single nutrients, such as dietary protein, or dietary patterns, such as the Mediterranean diet, the relationship between individual whole foods and muscle health has not been systematically evaluated. We aimed to investigate which whole foods (meat, fish, eggs, fruit and vegetables, and non-liquid dairy) may be beneficial (myoprotective) for ageing muscle and sarcopenia in adults aged ≥ 50 years. Nineteen observational and nine intervention studies were identified through systematic searches of the four electronic databases (last search: March 2020). The synthesis of findings showed strong and consistent evidence for a beneficial effect of lean red meat on muscle mass or lean tissue mass in both observational and intervention studies. Higher intake of fruit and vegetables was associated with better muscle function in observational studies, but the evidence from intervention studies was scarce. Non-liquid dairy foods were beneficial for muscle mass in both observational and intervention studies. There was moderate evidence for the role of these foods in muscle strength and sarcopenia, and limited or inconclusive evidence for the benefits of other whole foods (e.g., fish, eggs) for muscle health in older adults. Although current nutritional recommendations are often based on a single nutrient approach, further research about the role of protein-rich and other foods in muscle health will allow for the development of guidelines that are based on whole foods, also highlighting the potential importance of non-protein nutrients within these foods for myoprotection in older adults. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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21 pages, 1604 KiB

Open AccessReview

Effects of Dietary or Supplementary Micronutrients on Sex Hormones and IGF-1 in Middle and Older Age: A Systematic Review and Meta-Analysis

by Ryan Janjuha, Diane Bunn, Richard Hayhoe, Lee Hooper, Asmaa Abdelhamid, Shaan Mahmood, Joseph Hayden-Case, Will Appleyard, Sophie Morris and Ailsa Welch

Nutrients 2020, 12(5), 1457; https://doi.org/10.3390/nu12051457 - 18 May 2020

Cited by 9 | Viewed by 7297

Abstract

Observational research suggests that micronutrients may be protective for sarcopenia, a key health issue during ageing, potentially via effects on hormone synthesis and metabolism. We aimed to carry out a systematic review of RCTs investigating effects of increasing dietary or supplemental micronutrient intake on sex hormones and IGF-1 in individuals aged 45 years or older. We searched MEDLINE, EMBASE and Cochrane databases for RCTs reporting the effects of different micronutrients (vitamins A, C, D, or E; carotenoids; iron; copper; zinc; magnesium; selenium; and potassium) on sex hormones or IGF-1. Of the 26 RCTs identified, nine examined effects of vitamin D, nine of multi-nutrients, four of carotenoids, two of selenium, one of zinc, and one of vitamin E. For IGF-1 increasing vitamin D (MD: −0.53 nmol/L, 95% CI: −1.58, 0.52), multi-nutrients (MD: 0.60 nmol/L, 95% CI −1.12 to 2.33) and carotenoids (MD −1.32 nmol/L; 95% CI −2.76 to 0.11) had no significant effect on circulating concentrations. No significant effects on sex hormones of other micronutrients were found, but data were very limited. All trials had significant methodological limitations making effects of micronutrient supplementation on sex hormones unclear. Further high quality RCTs with physiological doses of micronutrients in people with low baseline intakes or circulating concentrations, using robust methodology, are required to assess effects of supplementation adequately. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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16 pages, 1119 KiB

Open AccessReview

Social and Economic Factors and Malnutrition or the Risk of Malnutrition in the Elderly: A Systematic Review and Meta-Analysis of Observational Studies

by Maria Besora-Moreno, Elisabet Llauradó, Lucia Tarro and Rosa Solà

Nutrients 2020, 12(3), 737; https://doi.org/10.3390/nu12030737 - 11 Mar 2020

Cited by 118 | Viewed by 19617

Abstract

Malnutrition in the elderly could be tackled by addressing socioeconomic factors. This study aimed to determine the magnitude of the relationship between socioeconomic factors and the malnutrition or malnutrition risk (MR) in the elderly. The PubMed and SCOPUS databases were searched for observational studies that included assessment of malnutrition or/and MR and socioeconomic variables (educational level, living alone, marital status, income and occupational level, feeling of loneliness, place of residence, and food expenditure) in ≥60-year-old subjects, published in English among 2000–2018 (PROSPERO: CRD42019137097). The systematic review included 40 observational studies (34 cross-sectional and 4 cohort studies) and 16 cross-sectional studies in the meta-analysis (34,703 individuals) of malnutrition and MR in relation to low educational level (Odds Ratio (OR): 1.48; 95% Confidence Interval (CI): 1.33–1.64; p < 0.001), living alone (OR: 1.92; 95% CI: 1.73–2.14; p < 0.001), being single, widowed, or divorced (OR: 1.73; 95% CI: 1.57–1.90; p < 0.001), and low income level (OR: 2.69; 95% CI: 2.35–3.08; p < 0.001), and considering these four socioeconomic factors, malnutrition and MR is associated with them (OR: 1.83; 95% CI: 1.73–1.93; p < 0.001). Malnutrition and MR could be reduced by increasing economic level, supporting people living alone or being single, widowed, and divorced, and improving lifelong learning. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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17 pages, 611 KiB

Open AccessReview

Nutrition and Muscle Strength, As the Key Component of Sarcopenia: An Overview of Current Evidence

by Sian Robinson, Antoneta Granic and Avan Aihie Sayer

Nutrients 2019, 11(12), 2942; https://doi.org/10.3390/nu11122942 - 3 Dec 2019

Cited by 59 | Viewed by 9752

Abstract

Much has been achieved by recent research to increase understanding of the links between nutrition and muscle health. Focusing on muscle strength as the key component of sarcopenia, the aim of this overview was to evaluate its links to nutrition, both to variation in habitual diets in older populations, as well as considering supplementation effects in trials. A main message from the reviewed studies is that while many provide suggestive evidence of benefits of higher nutrient intakes and diets of higher quality, findings are inconsistent, and data on muscle strength are often lacking. To assess the potential of optimising diets as a strategy to promote and maintain muscle strength, gaps in current evidence need to be addressed. These include the need for (i) better understanding of individual differences in responsiveness to dietary change, and the need for targeted nutritional support; (ii) clearer distinction between protective and therapeutic actions of diet; and (iii) definition of the role of dietary patterns and their influence on muscle strength, to allow effects of changes in food consumption to be evaluated—particularly when combined with physical activity. Development of this evidence is needed to enable translation into appropriate dietary recommendations for older populations. Full article

(This article belongs to the Special Issue Diet, Lifestyle and Healthy Ageing)

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