Nutrition is a modifiable factor potentially related to aging. Milk and other dairy products may contribute to the prevention of physical and cognitive impairment. We conducted a systematic review to ...investigate the effectiveness of dairy product intake for preventing cognitive decline, sarcopenia, and frailty in the elderly population. A systematic search for publications in electronic databases MEDLINE via PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews from 2009 to 2018 identified observational and interventional studies in English and Spanish that tested the relation between dairy product consumption and cognitive decline, sarcopenia, and frailty in community-dwelling older people. We assessed the participants, the type of exposure or intervention, the outcomes, and the quality of evidence. We screened a total of 661 records and included 6 studies (5 observational prospective cohort studies and 1 randomized controlled trial). Regarding cognitive impairment, the relation cannot be firmly established. Consumption of milk at midlife may be negatively associated with verbal memory performance. In older women, high intakes of dairy desserts and ice cream were associated with cognitive decline. On the other hand, 1 study demonstrated a significant inverse relation between dairy intake and development of Alzheimer disease among older Japanese subjects. The consumption of dairy products by older people may reduce the risk of frailty, especially with high consumption of low-fat milk and yogurt, and may also reduce the risk of sarcopenia by improving skeletal muscle mass through the addition of nutrient-rich dairy proteins (ricotta cheese) to the habitual diet. Despite the scarcity of evidence on the topic, our systematic review shows that there are some positive effects of dairy products on frailty and sarcopenia, whereas studies concerning cognitive decline have contradictory findings.
Resumen La incidencia de cáncer aumenta a medida que avanza la edad. Con el envejecimiento, y con una enfermedad crónica como el cáncer, crece la prevalencia de desnutrición relacionada con la ...enfermedad (DRE), de sarcopenia, de caquexia y de fragilidad. Estas se asocian a mortalidad, a toxicidad por tratamiento antineoplásico y a complicaciones posquirúrgicas. En este artículo se repasan, de forma diferencial en mayores, la prevalencia de DRE, sarcopenia y caquexia, la manera de diagnosticar estas situaciones en la clínica diaria, su fisiopatología, su relación con el pronóstico clínico y las evidencias sobre la eficacia del tratamiento médico nutricional y multimodal, con el ejercicio físico como principal aliado. Por el momento, son escasas las guías que se refieren únicamente al paciente mayor y, hasta que se generen más estudios en este grupo de enfermos, las actuaciones en materia de nutrición deberán basarse en las ya publicadas de forma general en oncología. Si el paciente mayor presenta desnutrición, y esta puede condicionar la calidad de vida o el pronóstico clínico, el tratamiento médico nutricional debe progresar, de forma individualizada, desde el consejo dietético hasta las formas más complejas de tratamiento como la suplementación oral, la nutrición enteral o la nutrición parenteral.
Nutrition plays an important role in bone health. The aim of our study was to update the evidence regarding dairy intake, osteoporotic fracture (OF) risk, and prospective bone mass density (BMD) ...evolution assessed by dual-energy X-ray absorptiometry in Europeans and non-Hispanic whites from North America. A systematic search was conducted in MEDLINE, EMBASE, and Scopus for papers published from 1 January, 2000 to 30 April, 2018. The eligibility criteria were as follows: healthy adults; measurable dairy exposure; hip, vertebral, wrist or OF as outcomes; and cohort or case-control studies. Two independent investigators conducted the search and the data extraction. A pooled analysis was conducted with random-effects models. Publication bias and meta-regression were considered. Ten cohort studies relating to OF risk were selected for meta-analysis. Three papers reporting BMD changes associated with dairy intake could not be aggregated in the meta-analysis. The pooled HRs of the highest compared with the lowest levels of dairy intake were 0.95 (95% CI: 0.87, 1.03; I2 = 82.9%; P-heterogeneity < 0.001) for OF at any site; 0.87 (95% CI: 0.75, 1.01; I2 = 86.7%; P-heterogeneity < 0.001) for hip fractures; and 0.82 (95% CI: 0.68, 0.99; I2 = 0.0%; P-heterogeneity = 0.512) for vertebral fractures. Concerning BMD, the selected studies described a 1.7–3% lower hip BMD in young and postmenopausal women with poor intake of milk in their youth, a positive relationship between baseline milk ingestion and the percentage of trochanter BMD change in elderly people, and a positive correlation between milk consumption and BMD change at the radius in women aged >65 y. In conclusion, in the studied population, the highest consumption of dairy products did not show a clear association with the total OF or hip fracture risks; however, a diminished risk of vertebral fracture could be described. The results regarding BMD change were heterogeneous and did not allow for a definitive conclusion.
Editorial Cuesta Triana, Federico
Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral,
2019
Journal Article
The incidence of cancer increases as age progresses. With aging, and with a chronic disease such as cancer, the prevalence of disease-related malnutrition (DRE), sarcopenia, cachexia and frailty ...increases. These are associated with mortality, toxicity due to antineoplastic treatment and post-surgical complications. In this article, the prevalence of DRE, sarcopenia and cachexia, the way to diagnose these situations in the daily clinic, their pathophysiology, their relationship with clinical prognosis, and the evidence on the effectiveness of medical nutrition treatment and multimodal therapy, with physical exercise as the main ally, are reviewed differentially in older patients. At the moment, there are few guidelines that refer only to the elderly patient, and until more studies are generated in this group of patients, the actions, in matters of nutrition, should be based on those already published in general oncology. If the elderly patient has malnutrition, and this can condition quality of life or clinical prognosis, medical nutrition therapy should progress, individually, from dietary advice to more complex forms of treatment such as oral supplementation, enteral nutrition or parenteral nutrition.
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