Caries Experience in Elderly People Consuming a Milk-Based Drink Nutritional Supplement: A Cross-Sectional Study

Nutritional supplements have been recommended to cope with malnutrition in elderly persons. In Chile, the Supplementary Nutrition Program for the Elderly (PACAM, for its Spanish acronym) consists in a monthly distribution of a low-fat-milk-based drink that contains 8% sucrose. The aim of this study was to determine whether older persons consuming the milk-based drink have a higher caries experience when compared to those not receiving the supplement. A cross-sectional study was conducted in the Maule Region in Chile. The representative sample comprised two groups: (a) PACAM consumers (CS) (n = 60) and (b) nonconsumers (NCS) (n = 60). Participants received intraoral examination and coronal (DMFT/DMFS) and root caries (RCI index) experience were recorded. Additionally, questionnaires regarding acceptability and consumption habits of PACAM and a 24-h diet recall were applied. The influence of predictors was calculated using binary logistic regression for a dichotomized DMFS and Poisson Regression for root caries lesions. A p value <0.05 was considered significant. No differences were detected in food consumption patterns between study groups (p > 0.05). CS participants had increased dairy product consumption. Higher DMFS mean value was observed in the CS (85.35 ± 39.0) compared with NCS (77.28 ± 28.9) (p = 0.043). The multivariate analysis showed nonconsumers of the milk-based product (β = -0.41, p = 0.02) are less likely to have root surfaces affected by caries. Additionally, CS show higher RCI, compared to nonconsumers (β = -0.17, p = 0.02). Daily consumption of a PACAM's milk-based drink supplement seems to increase coronal and root caries risk. Based on these results, composition modification of milk-based drinks with added sucrose appears mandatory.

Dietary genistein increases microbiota-derived short chain fatty acid levels, modulates homeostasis of the aging gut, and extends healthspan and lifespan

Age-related gastrointestinal decline contributes to whole-organism frailty and mortality. Genistein is known to have beneficial effects on age-related diseases, but its precise role in homeostasis of the aging gut remains to be elucidated. Here, wild-type aging mice and Zmpste24^-/- progeroid mice were used to investigate the role of genistein in lifespan and homeostasis of the aging gut in mammals. A series of longitudinal, clinically relevant measurements were performed to evaluate the effect of genistein on healthspan. It was found that dietary genistein promoted a healthier and longer life and was associated with a decrease in the levels of systemic inflammatory cytokines in aging mice. Furthermore, dietary genistein ameliorated gut dysfunctions, such as intestinal inflammation, leaky gut, and impaired epithelial regeneration. A distinct genistein-mediated alteration in gut microbiota was observed by increasing Lachnospira abundance and short-chain fatty acid (SCFA) production. Further fecal microbiota transplantation and dirty cage sharing experiments indicated that the gut microbiota from genistein-fed mice rejuvenated the aging gut and extended the lifespan of progeroid mice. It was demonstrated that genistein-associated SCFAs alleviated tumor necrosis factor alpha-induced intestinal organoid damage. Moreover, genistein-associated propionate promoted regulatory T cell-derived interleukin 10 production, which alleviated macrophage-derived inflammation. This study provided the first data, to the authors' knowledge, indicating that dietary genistein modulates homeostasis in the aging gut and extends the healthspan and lifespan of aging mammals. Moreover, the existence of a link between genistein and the gut microbiota provides a rationale for dietary interventions against age-associated frailty.

Targeting AMPK signaling by polyphenols: a novel strategy for tackling aging

Aging is an inevitable biological process and is accompanied by a gradual decline of physiological functions, such as the incidence of age-related diseases. Aging becomes a major burden and challenge for society to prevent or delay the occurrence and development of these age-related diseases. AMPK is a key regulator of intracellular energy and participates in the adaptation of calorie restriction. It is also an important mediator of nutritionally sensitive pathways that regulate the biological effects of nutrient active ingredients. AMPK can limit proliferation and activate autophagy. Recent studies have shown that nutritional intervention can delay aging and lessen age-related diseases in many animal and even human models. Polyphenols function as a natural antidote and are important anti-inflammatory and antioxidant agents in human diets. Polyphenols can prevent age-related diseases because they regulate complex networks of cellular processes such as oxidative damage, inflammation, cellular aging, and autophagy, and have also attracted wide attention as a potential beneficial substance for longevity. In this review, we systemically summarized the progress of targeting AMPK signaling by dietary polyphenols in aging prevention. Polyphenols can reduce oxidative stress and inflammatory response, and maintain the steady state of energy. Polyphenols can also modulate sirtuins/NAD+, nutrient-sensing, proteostasis, mitochondrial function, autophagy and senescence via targeting AMPK signaling. Therefore, targeting the AMPK signaling pathway by dietary polyphenols may be a novel anti-aging strategy.

Social Determinants of the Non-Utilization of the Supplementary Feeding Program (PACAM) Aimed at Older Adults' Nutritional Support

Chile has implemented the PACAM program to support older people with nutrition and for the prevention of malnutrition and frailty. This work aims to identify the social determinants of older persons not withdrawing PACAM food in order to obtain helpful knowledge for improving the program. First, the CASEN Survey 2017 was used (960,498 observations); the inclusion criterion was PACAM recipients (Yes/No). Next, a probit model was performed with a dichotomous response to determine the marginal effects of each independent variable (e.g., demographic, health, and social). The model shows a good fit (64.4%) with an explained variance between 10.5% to 14.1%. Those variables with more significant marginal effects are people aged 70-75, having tertiary and secondary education, urban living, not participating in social organizations, immigrants, and living in the austral zone. On the other hand, a higher likelihood of consumption was found among people of greater vulnerability (lowest income, lowest education, low health insurance, and aged over 80) and, therefore, in greater fragility. To conclude, the program achieves effective targeting, although improvement actions are required to expand coverage in some groups (indigenous people, immigrants, and people with disabilities). Moreover, authorities should evaluate and reinforce the program with tailored strategies for the older adults who actually withdraw food.

Nutritional components as mitigators of cellular senescence in organismal aging: a comprehensive review

The process of cellular senescence is rapidly emerging as a modulator of organismal aging and disease. Targeting the development and removal of senescent cells is considered a viable approach to achieving improved organismal healthspan and lifespan. Nutrition and health are intimately linked and an appropriate dietary regimen can greatly impact organismal response to stress and diseases including during aging. With a renewed focus on cellular senescence, emerging studies demonstrate that both primary and secondary nutritional elements such as carbohydrates, proteins, fatty acids, vitamins, minerals, polyphenols, and probiotics can influence multiple aspects of cellular senescence. The present review describes the recent molecular aspects of cellular senescence-mediated understanding of aging and then studies available evidence of the cellular senescence modulatory attributes of major and minor dietary elements. Underlying pathways and future research directions are deliberated to promote a nutrition-centric approach for targeting cellular senescence and thus improving human health and longevity.

The Role of Immune Cells in Oxi-Inflamm-Aging

Aging is the result of the deterioration of the homeostatic systems (nervous, endocrine, and immune systems), which preserve the organism's health. We propose that the age-related impairment of these systems is due to the establishment of a chronic oxidative stress situation that leads to low-grade chronic inflammation throughout the immune system's activity. It is known that the immune system weakens with age, which increases morbidity and mortality. In this context, we describe how the function of immune cells can be used as an indicator of the rate of aging of an individual. In addition to this passive role as a marker, we describe how the immune system can work as a driver of aging by amplifying the oxidative-inflammatory stress associated with aging (oxi-inflamm-aging) and inducing senescence in far tissue cells. Further supporting our theory, we discuss how certain lifestyle conditions (such as social environment, nutrition, or exercise) can have an impact on longevity by affecting the oxidative and inflammatory state of immune cells, regulating immunosenescence and its contribution to oxi-inflamm-aging.

Anthropometric measurements and food consumption analysis of older people according to place of residence and gender: A cross-sectional study

BACKGROUND & AIMS

The older population across the world is rapidly increasing, raising the importance of a healthy and independent aging process and the factors affecting it. This study aimed to examine the food consumption habits and anthropometric measurements of older people according to their gender and the place of residence.

METHODS

A total of 121 healthy participants aged over 80 years who lived in rural (n:70) and urban (n:51) areas in the Aegean Region of Turkey were included in the study. A questionnaire was administered to determine the demographic data and nutritional status of the participants. Three-day food consumption was recorded and then analyzed using BeBiS 8.1. The participants' adherence to the Mediterranean diet and their Healthy Eating Index-2015 values were calculated based on their food consumption. The circumferences of the waist, hip, upper-mid arm and calf of the participants were measured by the researcher using an inelastic measuring tape. Weight, fat, muscle, water and basal metabolic rate were measured using the TANITA BC730 body impedance analyzer.

RESULTS

The mean weight, body mass index, circumferences of waist, hip and upper-mid arm,fat-free mass and basal metabolic rate were higher in the rural men than the urban ones (p < 0.05). The urban women had a higher waist-to-hip ratio than the rural ones (p < 0.05). There were no significant differences in the participants' adherence to the Mediterranean diet and their Healthy Eating Index values according to gender or the region they lived in. Nutrient intake was compared with the daily recommendations in the Turkish Nutrition Guide. It was found that the urban men consumed more carbohydrates, fats, vitamins A and C, and sodium. In contrast, energy, protein, fiber, vitamins E, D, B₁, B₂, B₆ and B₁₂, folic acid, magnesium, calcium, iron and zinc were consumed at lower amounts than recommendations. On the other hand, the rural men consumed more carbohydrates, fats, vitamins A, C and B₂, folic acid, sodium and zinc. Similarly, the urban and rural women were found to have a higher intake of carbohydrates, fats, vitamins A and B₂ and sodium and lower intake of other nutrients than recommendations.

CONCLUSION

Old age is one of the most sensitive periods in a person's life cycle. Place of residence during this period may physiologically affect food intake, physical activity, and therefore, anthropometric measurements. Healthcare providers should take into account that place of residence may alter older individuals' nutritional status and anthropometric measurements.

Healthy Aging-Nutrition Matters: Start Early and Screen Often

The amount of time spent in poor health at the end of life is increasing. This narrative review summarizes consistent evidence indicating that healthy dietary patterns and maintenance of a healthy weight in the years leading to old age are associated with broad prevention of all the archetypal diseases and impairments associated with aging including: noncommunicable diseases, sarcopenia, cognitive decline and dementia, osteoporosis, age-related macular degeneration, diabetic retinopathy, hearing loss, obstructive sleep apnea, urinary incontinence, and constipation. In addition, randomized clinical trials show that disease-specific nutrition interventions can attenuate progression-and in some cases effectively treat-many established aging-associated conditions. However, middle-aged and older adults are vulnerable to unhealthy dietary patterns, and typically consume diets with inadequate servings of healthy food groups and essential nutrients, along with an abundance of energy-dense but nutrient-weak foods that contribute to obesity. However, based on menu examples, diets that are nutrient-dense, plant-based, and with a moderately low glycemic load are better equipped to meet the nutritional needs of many older adults than current recommendations in US Dietary Guidelines. These summary findings indicate that healthy nutrition is more important for healthy aging than generally recognized. Improved public health messaging about nutrition and aging, combined with routine screening and medical referrals for age-related conditions that can be treated with a nutrition prescription, should form core components of a national nutrition roadmap to reduce the epidemic of unhealthy aging.

High relative consumption of vegetable protein is associated with faster walking speed in well-functioning older adults

BACKGROUND

Adequate nutrition and, especially, optimal protein intake are necessary to preserve physical function during aging. Increased consumption of animal-derived protein is often advocated as a strategy to support physical performance in old age. However, there is a lack of empirical evidence to support this claim.

AIMS

To assess the relationship of protein consumption and specific protein sources with physical function in older adults.

METHODS

Participants were community dwellers aged 60 years and older recruited in São Paulo, Brazil. Enrollees had their medical books reviewed and were evaluated for anthropometry, physical performance, and diet. Physical performance was evaluated by isometric handgrip strength and walking speed (WS) tests. Diet was assessed using a 24-h recall diary.

RESULTS

Ninety older adults were recruited (mean age: 68.0 ± 6.7 years; 87.0% women). Body weight-adjusted protein consumption was significantly associated with upper-limb muscle strength (r = 0.21; p < 0.05), but not with usual (r = 0.09; p > 0.05) or fast WS (r = 0.08; p > 0.05). Conversely, relative protein consumption was correlated with usual WS (r = 0.13; p < 0.05), while fast WS was negatively associated with relative animal protein intake (r = - 0.18; p < 0.05) and positively associated with relative plant-based protein ingestion (r = 0.15; p < 0.05).

DISCUSSION

Findings of the present study indicate that different measures of protein intake are associated with distinct components of physical function. In addition, high relative ingestion of vegetable protein is associated with faster WS.

CONCLUSIONS

A comprehensive dietary evaluation is necessary to appreciate the impact of specific nutrients on physical performance in older people. Future interventional studies are needed to establish the optimal blend of protein sources to support physical performance in old age.