Volkert Dorothee
Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, 90408, Nürnberg, Deutschland.
Inn Med (Heidelb). 2025 Sep 4. doi: 10.1007/s00108-025-01977-3.
Nutrition is considered to play a key role in the multifactorial development of frailty. Conversely, frailty also affects nutrition. The aim of this article is to describe the interactions between these two entities in detail and to derive nutritional recommendations. On the one hand undernutrition and the resulting loss of body weight and muscle mass contribute to the development of sarcopenia and thus to the development of frailty. On the other hand obesity is associated with an increased risk of frailty even in middle age, presumably due to the accompanying chronic low-grade inflammation. At the nutrient level, protein is important as a building and regulatory substance: other nutrients appear to protect against frailty due to their antioxidant and anti-inflammatory properties, with the associations best documented for a Mediterranean-style diet, which is rich in these components. In the presence of existing frailty, the same recommendations generally apply: adequate energy and protein intake as part of a plant-based, varied diet, but the implementation requires more attention. Routine screening for malnutrition is recommended to detect corresponding warning signs as early as possible and subsequently eliminate the causes. As frailty is rarely solely related to nutrition, nutritional interventions should be part of an overall program that at least includes physical activation. In summary, nutrition as a modifiable factor, offers enormous preventive potential, ideally starting early in life but even in old age it is not too late for positive adjustments.
营养被认为在虚弱的多因素发展中起关键作用。相反,虚弱也会影响营养。本文旨在详细描述这两个实体之间的相互作用,并得出营养建议。一方面,营养不良以及由此导致的体重和肌肉量的减少会导致肌肉减少症的发展,进而导致虚弱的发展。另一方面,肥胖与虚弱风险增加有关,即使在中年也是如此,这可能是由于伴随的慢性低度炎症。在营养素层面,蛋白质作为一种构建和调节物质很重要:其他营养素似乎因其抗氧化和抗炎特性而能预防虚弱,其中与富含这些成分的地中海式饮食的关联记录最为充分。在已有虚弱的情况下,通常适用相同的建议:作为基于植物的多样化饮食的一部分,摄入足够的能量和蛋白质,但实施时需要更多关注。建议进行营养不良的常规筛查,以便尽早发现相应的警示信号并随后消除病因。由于虚弱很少仅与营养有关,营养干预应成为至少包括身体活动在内的整体计划的一部分。总之,营养作为一个可改变的因素具有巨大的预防潜力,理想情况下应从生命早期开始,但即使在老年进行积极调整也为时不晚。