Nutritional considerations for healthy aging and reduction in age-related chronic disease
Integrating better nutrition into healthcare can help patients age healthily and may reduce the costs of the “silver tsunami” or the growing number of aging Americans, according to a paper published in Advances in Nutrition. The “Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease” paper outlines the issue of nutritional frailty in the aging American population. By 2050, the number of Americans over the age of 80 will reach 392 million, with nutritional frailty characterized by a loss in weight, muscle mass and strength becoming a greater risk and putting many in danger of disability. Despite obesity in older adults being on the rise, the risk of nutritional frailty is still high. The paper discusses the idea of dietary resilience, or the concept of the material, psychological, physical and social factors that operate behind food purchases, food preparation and diet consumption. Identifying individual patients’ needs through nutritional assessments that are tailored to older patients can help to tackle nutritional frailty while also taking into account aging factors. Incorporating older adults affected by disease and medication into clinical trials could help to identify how age affects nutritional needs, aiding with general healthcare provision. Increased education could also help those involved with providing care for elderly citizens, including family members who are caregivers, and reduce nutritional frailty.
Improving dietary resilience and better integration of nutrition in the health care system can promote healthy aging and may significantly reduce the financial and societal burden of the "silver tsunami." This is the key finding of a "Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease," a new paper initiated under the auspices of the Sackler Institute for Nutrition Science Working Group on Nutrition for Aging Population, and published in Advances in Nutrition.

By 2050, the number of persons aged 80 years old and over will reach 392 million, about three times the 2013 population. According to the report, an increasingly large portion of the population will be vulnerable to nutritional frailty, a state commonly seen in older adults, characterized by sudden significant weight-loss and loss of muscle mass and strength, or an essential loss of physiologic reserves, making the person susceptible to disability. Ironically, while increasing numbers of older adults are obese, many are also susceptible to nutritional frailty and, as a result, age-related diseases including sarcopenia, cognitive decline, and infectious disease.

The review concludes that exploring dietary resilience, defined as a conceptual model to describe material, physical, psychological and social factors that influence food purchase, preparation and consumption, is needed to better understand older adults' access to meal quality and mealtime experience. A recent model to frame food intake includes the addition of more randomized clinical trials that include older adults with disease and medication. This will help to identify their specific nutrient needs, biomarkers to understand the impact of advancing age on protein requirements, skeletal muscle turnover and a re-evaluation of how BMI guidelines are used.

"A nutritional assessment model that takes into consideration the effect of aging on muscle mass, weight loss and nutrient absorption is crucial to overall wellness in our elderly population," said Gilles Bergeron, Ph.D., executive director, The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, NY. "However, nutrition recommendations are usually based on that of a typical healthy adult, and fail to consider the effect of aging on muscle mass, weight loss, and nutrient absorption and utilization."

Simin Nikbin Meydani, D.V.M., Ph.D., director of the Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA concurs. "Much greater emphasis needs to be placed on prioritizing research that will fill the knowledge gaps and provide the kind of data needed by health and nutrition experts if we're going to address this problem," she said. "There also needs to be more education about on-going nutritional needs for those involved with elder-care - not only in a clinical setting, but also for family members who are responsible for aging adults."

More information: Julie Shlisky et al, Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease, Advances in Nutrition: An International Review Journal (2017). DOI: 10.3945/an.116.013474