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Chen H, Avgerinou C. Association of Alternative Dietary Patterns with Osteoporosis and Fracture Risk in Older People: A Scoping Review. Nutrients 2023; 15:4255. [PMID: 37836538 PMCID: PMC10574803 DOI: 10.3390/nu15194255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
PURPOSE Although the Mediterranean diet has been associated with a lower risk of hip fracture, the effect of other dietary patterns on bone density and risk of fracture is unknown. This scoping review aims to investigate the association between adherence to alternative dietary patterns (other than the traditional Mediterranean diet) and osteoporosis or osteoporotic fracture risk in older people. METHODS A systematic search was carried out on three electronic databases (Medline, EMBASE, and Scopus) to identify original papers studying the association between alternative dietary patterns (e.g., Baltic Sea Diet (BSD), modified/alternative Mediterranean diet in non-Mediterranean populations, Dietary Approaches to Stop Hypertension (DASH)) assessed using 'prior' methods (validated scores) and the risk of osteoporotic fracture or Bone Mineral Density (BMD) in people aged ≥50 (or reported average age of participants ≥ 60). Results from the included studies were presented in a narrative way. RESULTS Six observational (four prospective cohort and two cross-sectional) studies were included. There was no significant association between BMD and BSD or DASH scores. Higher adherence to DASH was associated with a lower risk of lumbar spine osteoporosis in women in one study, although it was not associated with the risk of hip fracture in another study with men and women. Higher adherence to aMED (alternative Mediterranean diet) was associated with a lower risk of hip fracture in one study, whereas higher adherence to mMED (modified Mediterranean diet) was associated with a lower risk of hip fracture in one study and had no significant result in another study. However, diet scores were heterogeneous across cohort studies. CONCLUSIONS There is some evidence that a modified and alternative Mediterranean diet may reduce the risk of hip fracture, and DASH may improve lumbar spine BMD. Larger cohort studies are needed to validate these findings.
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Affiliation(s)
- Huiyu Chen
- Division of Medicine, University College London, London WC1E 6BT, UK;
| | - Christina Avgerinou
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
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Aihemaitijiang S, Zhang L, Ye C, Halimulati M, Huang X, Wang R, Zhang Z. Long-Term High Dietary Diversity Maintains Good Physical Function in Chinese Elderly: A Cohort Study Based on CLHLS from 2011 to 2018. Nutrients 2022; 14:1730. [PMID: 35565697 PMCID: PMC9105097 DOI: 10.3390/nu14091730] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Objective: This study aimed to explore the correlation between dietary factors and physical function in Chinese elderly. (2) Methods: A cohort study was conducted on the association of long-term dietary intake status with physical function in older people based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018. The physical function of the subjects was judged according to the scores of basic activities of daily living (BADL) and instrumental activities of daily living (IADL). The dietary diversity score was established according to the intake frequency of the food groups, and the dietary pattern score was obtained by factor analysis. The associations between dietary factors and functional impairment was investigated by logistic regressions. (3) Results: A total of 2282 subjects were included in our cohort study, 458 and 1439 of whom had BADL limitation and IADL limitation, respectively. The risk of functional impairment decreased in the consistent high dietary diversity groups compared with the consistent low dietary diversity group (p < 0.05). The fruit-egg-milk pattern, vegetable-meat-fish pattern, and condiment and tea pattern reduced the risk of functional impairment (p < 0.05). (4) Conclusions: Long-term maintenance of high dietary diversity and increasing total dietary intake can help maintain good physical function of Chinese elderly.
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Affiliation(s)
- Sumiya Aihemaitijiang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
| | - Li Zhang
- Department of Population Health Sciences, School of Population Health & Environmental Sciences, King’s College London, London SE1 1UL, UK;
| | - Chen Ye
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
| | - Mairepaiti Halimulati
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
| | - Xiaojie Huang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
| | - Ruoyu Wang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
| | - Zhaofeng Zhang
- Department of Nutrition & Food Hygiene, School of Public Health, Peking University Health Science Center, Haidian District, Beijing 100191, China; (S.A.); (C.Y.); (M.H.); (X.H.); (R.W.)
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O'Halloran AM, Laird EJ, Feeney J, Healy M, Moran R, Beatty S, Nolan JM, Molloy AM, Kenny RA. Circulating Micronutrient Biomarkers Are Associated With 3 Measures of Frailty: Evidence From the Irish Longitudinal Study on Ageing. J Am Med Dir Assoc 2019; 21:240-247.e5. [PMID: 31401047 DOI: 10.1016/j.jamda.2019.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 06/10/2019] [Accepted: 06/13/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To examine the associations between 3 frailty instruments and circulating micronutrients in a large representative sample of older adults. DESIGN Cross-sectional data from a nationally representative cohort study conducted between October 2009 and July 2011. PARTICIPANTS AND SETTING Adults age ≥50 years (n = 4068) living in the community in Ireland. MEASUREMENTS Circulating micronutrients (lutein, zeaxanthin, folate, vitamin B-12, and vitamin D) were measured, transformed, and standardized. Frailty was assessed using the Frailty Phenotype, the Frailty Index, and the FRAIL Scale (fatigue, resistance, ambulation, illnesses, and loss of weight), instruments. Multinomial logistic regression determined associations between micronutrients and prefrailty or frailty. Models were adjusted for sociodemographic, lifestyle, health, and seasonal factors. RESULTS Adjusting for age, sex, and educational attainment, all 3 measures of frailty were associated with lower levels of lutein [relative risk ratios (RRRs): 0.43‒0.63], zeaxanthin (RRRs: 0.49‒0.63), and vitamin D (RRRs: 0.51‒0.75), and with the accumulation of micronutrient insufficiencies (RRRs: 1.42‒1.90). Attenuated but significant associations were also observed with all measures of prefrailty for lutein, vitamin D, and number of micronutrient insufficiencies. The associations with frailty persisted following additional adjustment for social, lifestyle, and health and seasonal factors, and following multiple test correction. CONCLUSIONS AND IMPLICATIONS We have presented the most consistent evidence in the largest study to date that micronutrient concentrations are associated with prefrailty and frailty in older adults. Our data suggest that low micronutrient status has potential as an easily modifiable marker and intervention target for frailty and supports further investigation into micronutrient supplementation and fortification to prevent frailty and disability among older adults.
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Affiliation(s)
- Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing, Medical Gerontology, Trinity College, Dublin, Ireland.
| | - Eamon J Laird
- The Irish Longitudinal Study on Ageing, Medical Gerontology, Trinity College, Dublin, Ireland
| | - Joanne Feeney
- The Irish Longitudinal Study on Ageing, Medical Gerontology, Trinity College, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, Laboratory Medicine and Molecular Pathology, St James's Hospital, Dublin, Ireland
| | - Rachel Moran
- Macular Pigment Research Group, Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - Stephen Beatty
- Macular Pigment Research Group, Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - John M Nolan
- Macular Pigment Research Group, Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | | | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Medical Gerontology, Trinity College, Dublin, Ireland; Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
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Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr 2017; 17:108. [PMID: 28506216 PMCID: PMC5433026 DOI: 10.1186/s12877-017-0496-2] [Citation(s) in RCA: 306] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/04/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults. METHODS PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles. RESULTS Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty. CONCLUSIONS This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.
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Affiliation(s)
- Laura Lorenzo-López
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain
| | - Ana Maseda
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain
| | - Carmen de Labra
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain
| | - Laura Regueiro-Folgueira
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain
| | - José L Rodríguez-Villamil
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain
| | - José C Millán-Calenti
- Universidade da Coruña, Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15071, A Coruña, Spain. .,Gerontology Research Group, Department of Biomedical Sciences, Medicine and Physiotherapy, Faculty of Health Sciences, Universidade da Coruña, Campus de Oza, 15071, A Coruña, Spain.
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Samaras N, Samaras D, Frangos E, Forster A, Philippe J. A review of age-related dehydroepiandrosterone decline and its association with well-known geriatric syndromes: is treatment beneficial? Rejuvenation Res 2014; 16:285-94. [PMID: 23647054 DOI: 10.1089/rej.2013.1425] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate ester are the most abundant steroids in humans. DHEA levels fall with age in men and women, reaching values sometimes as low as 10%-20% of those encountered in young individuals. This age-related decrease suggests an "adrenopause" phenomenon. Studies point toward several potential roles of DHEA, mainly through its hormonal end products, making this decline clinically relevant. Unfortunately, even if positive effects of DHEA on muscle, bone, cardiovascular disease, and sexual function seem rather robust, extremely few studies are large enough and/or long enough for conclusions regarding its effects on aging. Moreover, because it has been publically presented as a "fountain of youth" equivalent, over-the-counter preparations lacking pharmacokinetic and pharmacodynamic data are widely used worldwide. Conceptually, supplementing a pre-hormone is extremely interesting, because it would permit the human organism to adequately use it throughout long periods, increasing or decreasing end products according to his needs. Nevertheless, data on the safety profile of long-term DHEA supplementation are still lacking. In this article, we examine the potential relation between low DHEA levels and well-known age-related diseases, such as sarcopenia, osteoporosis, dementia, sexual disorders, and cardiovascular disease. We also review risks and benefits of existing protocols of DHEA supplementation.
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Affiliation(s)
- Nikolaos Samaras
- Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
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Vitamin D depletion in hip fracture women is associated with the occurrence of simultaneous upper limb fractures independently of bone mineral density. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2013.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Marañón E, Omonte J, Alvarez ML, Serra JA. [Vitamin D and fractures in the elderly]. Rev Esp Geriatr Gerontol 2011; 46:151-162. [PMID: 21497954 DOI: 10.1016/j.regg.2011.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 05/30/2023]
Abstract
Osteoporosis and the subsequent fractures caused by this are a source of morbidity and mortality in the elderly population. It is also often the start of the cascade that culminates in frailty and dependence. Vitamin D has a direct relationship with the appearance of osteoporosis and with the risk of fractures. Receptors of this vitamin have also recently been described in other organs and systems of the body that are associated with muscle strength, cancer and overall mortality. Deficiency of this vitamin in the elderly population in Spain is very prevalent, both in the community and the hospitalised elderly. The diagnosis and treatment are straightforward and cheap. Its efficacy in the prevention of osteoporosis and in the appearance of fractures is perfectly demonstrated. In this review, we will look at the physiology and actions of this vitamin, as well as the principal studies that have demonstrated its effectiveness in the elderly population.
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Affiliation(s)
- Eugenio Marañón
- Servicio de Geriatría, Hospital General Universitario Gregorio Marañón, Madrid, España.
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