Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
Ageing Res Rev. 2024 Nov;101:102532. doi: 10.1016/j.arr.2024.102532. Epub 2024 Oct 5.
Physical frailty, an age-related decline in the physiological capacity and function of various organs, is associated with higher vulnerability to unfavorable health outcomes. The mechanisms proposed for physical frailty including increased inflammation and oxidative stress are closely related to nutritional status. In addition to traditional nutritional factors such as protein malnutrition and nutrient deficiencies, emerging evidence has focused on the role of functional nutrients including polyphenols, carotenoids, probiotics, prebiotics, omega-3 long-chain polyunsaturated fatty acids (n-3 PUFAs), β-hydroxy-β-methylbutyrate (HMB), coenzyme Q10 (CoQ10), and L-carnitine in modifying the risk of physical frailty syndrome. Although several clinical trials have suggested the beneficial effects of supplementation with polyphenols, HMB, and prebiotics on frailty indices, the current evidence is still not robust to support recommendations on the routine clinical use of such functional nutrients for the management of frailty. Similarly, the association between CoQ10 and frailty was mainly assessed in observational studies, and more randomized controlled trials are needed in this regard. A limited number of studies have reported the beneficial effect of L-carnitine supplementation on frailty indices. Since carnitine is mainly found in skeletal muscle and its measurement is thus challenging due to ethical constraints, it is necessary to examine the effect of different doses of L-carnitine on frailty and its indices in future studies. A large number of interventional studies evaluated the impact of n-3 PUFA supplementation on physical frailty in the elderly and many of them reported improved physical performance following supplementation, especially when combined with resistance training programs. Although promising findings from experimental and observational studies have been reported on functional nutrients, high-quality evidence from randomized controlled trials as well as detailed mechanistic studies are still required to affirm their role in the prevention and/or treatment of physical frailty. This review aims to describe the current state of research on functional nutrients that may modify the development or prognosis of frailty syndrome.
身体虚弱是一种与年龄相关的各器官生理功能和容量下降，与对不良健康结果的更高易感性相关。提出的身体虚弱机制包括炎症和氧化应激增加，与营养状况密切相关。除了蛋白质营养不良和营养缺乏等传统营养因素外，新出现的证据还集中在功能性营养素的作用上，包括多酚、类胡萝卜素、益生菌、益生元、ω-3 长链多不饱和脂肪酸（n-3 PUFA）、β-羟基-β-甲基丁酸（HMB）、辅酶 Q10（CoQ10）和左旋肉碱，这些营养素可以改变身体虚弱综合征的风险。尽管几项临床试验表明多酚、HMB 和益生元补充剂对虚弱指数有益，但目前的证据还不够有力，无法支持常规临床使用这些功能性营养素来管理虚弱。同样，CoQ10 与虚弱的关系主要是在观察性研究中评估的，在这方面需要更多的随机对照试验。有限的研究报告了左旋肉碱补充剂对虚弱指数的有益影响。由于肉碱主要存在于骨骼肌中，由于伦理限制，其测量具有挑战性，因此有必要在未来的研究中检查不同剂量的左旋肉碱对虚弱及其指数的影响。大量干预性研究评估了 n-3 PUFA 补充剂对老年人身体虚弱的影响，其中许多研究报告补充后身体机能得到改善，尤其是与阻力训练计划相结合时。尽管实验和观察性研究报告了功能性营养素有希望的发现，但仍需要高质量的随机对照试验证据以及详细的机制研究来证实它们在预防和/或治疗身体虚弱中的作用。本综述旨在描述可能改变虚弱综合征发展或预后的功能性营养素的研究现状。
