Service de Médecine du Vieillissement, Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France.
Programme «Bien sur ses Jambes», Hôpital Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France.
Nutrients. 2023 Sep 22;15(19):4100. doi: 10.3390/nu15194100.
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
提高无残疾预期寿命是优化积极老龄化和降低可避免医疗费用负担的关键问题。其中一个主要挑战是制定实用和个性化的预防策略，以预防虚弱，抵消跌倒和行动障碍等不良后果，并提高生活质量。强有力的证据报告了运动干预在改善各种身体参数和肌肉功能方面的有效性，这些都是虚弱的基石。其他研究结果还表明，营养与身体活动的相互作用，无论是单独进行还是与健康行为促进相结合，都可以预防虚弱的发生。多模式方案，包括结构化运动、适当的饮食干预和健康行为促进，越来越得到共识。然而，为了在现实生活环境中实施，需要解决一些陷阱。从这个角度来看，构建和调整可行、可接受和可持续的干预措施，以优化运动训练反应，是保证短期、中期和长期个体获益的必要条件。运动方案的不同组成部分似乎相当一致且有效。然而，为了提高运动反应，方案中提出的（频率、强度、类型、时间、量和渐进性）具体组成部分必须根据个体特点和目标进行调整。这些方案的干预方法、行为策略和适应证也需要加以完善和阐述。这项工作的主要目标是指导医疗保健专业人员的行动，使他们能够在现实生活环境中广泛有效地实施多模式方案，包括运动、营养和行为策略。
