Roberts Susan B, Silver Rachel E, Das Sai Krupa, Fielding Roger A, Gilhooly Cheryl H, Jacques Paul F, Kelly Jennifer M, Mason Joel B, McKeown Nicola M, Reardon Meaghan A, Rowan Sheldon, Saltzman Edward, Shukitt-Hale Barbara, Smith Caren E, Taylor Allen A, Wu Dayong, Zhang Fang Fang, Panetta Karen, Booth Sarah
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Adv Nutr. 2021 Jul 30;12(4):1438-1448. doi: 10.1093/advances/nmab032.
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.
生命末期健康状况不佳的时间正在增加。这篇叙述性综述总结了一致的证据，表明在步入老年的岁月里，健康的饮食模式和保持健康体重与广泛预防所有与衰老相关的典型疾病和损伤有关，包括：非传染性疾病、肌肉减少症、认知衰退和痴呆、骨质疏松症、年龄相关性黄斑变性、糖尿病视网膜病变、听力损失、阻塞性睡眠呼吸暂停、尿失禁和便秘。此外，随机临床试验表明，针对特定疾病的营养干预可以减缓许多已确诊的与衰老相关疾病的进展，在某些情况下还能有效治疗这些疾病。然而，中年人和老年人容易养成不健康的饮食模式，通常食用的饮食中健康食物组和必需营养素的摄入量不足，同时还大量摄入导致肥胖症的能量密集但营养匮乏的食物。不过，根据菜单示例，与美国膳食指南中的现行建议相比，营养密集、以植物为基础且血糖负荷适度较低的饮食更能满足许多老年人的营养需求。这些总结性发现表明，健康营养对健康衰老的重要性比普遍认知的更高。改善关于营养与衰老的公共卫生宣传，结合针对可通过营养处方治疗的与年龄相关疾病的常规筛查和医疗转诊，应成为国家营养路线图的核心组成部分，以减少不健康衰老的流行。
