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Schultz TJ, Roupas P, Wiechula R. Nutritional interventions for optimizing healthy body composition in older adults in the community: An umbrella review of systematic reviews JBI Database System Rev Implement Rep. 2016;14:257-308.
What are the effects of nutritional strategies on improving body composition in community-dwelling older adults? How are these strategies viewed and experienced by older adults?
Nutrition is a significant factor in the discussion around healthy aging. In older people, being obese, overweight, or underweight are considered important health risks. Obesity and overweight are linked to a variety of chronic illnesses, while being underweight or malnourished is linked to frailty and muscle loss. Measurements of body composition—including fat, lean mass, bone mineral density, and muscle mass—have been suggested as useful indicators of health risks and nutrition status. Many systematic reviews assessing strategies aimed at enhancing nutrition status exist, highlighting the need for an umbrella review.
This is an umbrella review of 13 systematic reviews and meta-analyses published between 2006 and 2014.
None of the reviews included in the umbrella review reported on hydration status, while no reviews were identified that assessed food delivery, meal replacements, food groups, or how nutritional strategies were viewed or experienced by older adults. Overall, the umbrella review showed that several nutritional strategies worked to improve measures of body composition in underweight and overweight community-dwelling older adults aged 60 years and overs. The results were mixed depending on the type of strategy used, the outcome being looked at, and the population.
Strategies for weight gain in underweight older adults:
Strategies for weight loss in overweight older adults:
The quality of the evidence ranged from low to high depending on each outcome. In addition to decreased bone mineral density, negative side effects such as nausea, and stomach/intestinal problems were reported in some reviews. It also appeared that strategies that had multiple components may be more beneficial.
In older adults aged 60 years and older, body composition can be improved in underweight individuals through nutritional strategies such as oral supplements alone or in combination with resistance training, and nutritional counselling alone or in combination with oral supplements. Meanwhile, body composition can be improved in overweight individuals though nutritional counselling, diet combined with exercise, and nutritional counselling plus diet and exercise.