Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 349

This chapter has summarized nutritional approaches for preventing osteoporosis and fractures, sarcopenia and frailty, and cognitive decline and dementia. Epidemiological studies on nutrition and healthy ageing show that the guidelines for elderly people are very similar to those formulated for younger adults. However, in older adults, it may be imperative to consider dietary supplementation in cases where diet is inadequate and digestion and absorption issues are present (e.g. Celiac disease, Cohn’s disease; high‐quality multivitamin with breakfast). Maintaining a stable body weight and fat‐free mass by sufficient physical activity is important (20–45 minutes per day). The diet should contain higher consumption of green leafy vegetables, nuts and seeds, berries, beans and whole grains, fish, poultry, and olive oil and possibly one glass of wine with a meal. Reductions in red meats, butter and stick margarine, cheese, pastries, sweets, and fried or fast food are recommended.

A clinical laboratory can monitor nutritional status relevant to the promotion of healthy ageing. For instance, 25‐OH‐vitamin D, homocysteine and related B vitamins, and omega‐3 fatty acids are available to the clinician to rule out reversible causes of dementing and mobility illnesses. Frail elders with an inadequate energy intake may need enriched or fortified foods with vitamins, minerals, amino acids, and lipids added according to the healthcare provider recommendations.

In conclusion, many questions remain about how best to individualize nutritional approaches to sustain healthy ageing. However, new initiatives in precision nutrition are materializing to move from population recommendations that work only in subsets of the population to more personalized approaches that maximize individual benefit.⁶⁴ Companion diagnostics that reliability quantify and monitor nutritional status will play off the success of individualized nutrition in the future.⁶⁵