Abstract
Chronic activation of the inflammatory response, defined as inflammaging, is the key physio-pathological substrate for anabolic resistance, sarcopenia and frailty in older individuals. Nutrients can theoretically modulate this phenomenon. The underlying molecular mechanisms reducing the synthesis of pro-inflammatory mediators have been elucidated, particularly for vitamin D, n-3 polyunsaturated fatty acids (PUFA) and whey proteins. In this paper, we review the current evidence emerging from observational and intervention studies, performed in older individuals, either community-dwelling or hospitalized with acute disease, and evaluating the effects of intake of vitamin D, n-3 PUFA and whey proteins on inflammatory markers, such as C-Reactive Protein (CRP), interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α). After the analysis, we conclude that there is sufficient evidence for an anti-inflammatory effect in aging only for n-3 PUFA intake, while the few existing intervention studies do not support a similar activity for vitamin D and whey supplements. There is need in the future of large, high-quality studies testing the effects of combined dietary interventions including the above mentioned nutrients on inflammation and health-related outcomes.
Highlights
Inflammaging and Its Relationship with NutritionIn both genders, aging is associated with a significant rise in serum levels of inflammatory markers, independently of comorbidities and cardiovascular risk factors [1]
Data from the InCHIANTI Study, a large population-based study carried out in Italy to identify the determinants of an healthy active aging, revealed that 25-OH-D is inversely associated with IL-6 and positively associated with soluble IL-6 receptors (sIL-6r), independently of a list of potential confounders including physical exercise, caloric intake, smoke, bone mineral density and Activities of
In two randomized controlled trials (RCTs), carried out in adult diabetic patients, supplementation with vitamin D and calcium was associated with a significant decrease in serum levels of C-Reactive Protein (CRP), IL-6, IL-1β and tumor necrosis factor α (TNF-α) [52,53]
Summary
In both genders, aging is associated with a significant rise in serum levels of inflammatory markers, independently of comorbidities and cardiovascular risk factors [1] Diminished food intake and increased energy needs create a vicious circle with unfavorable prognostic trajectory [17] This catabolic state is greatest during critical illness conditions characterized by poor response to nutritional intervention [18]. The low-grade catabolic state present outside the acute phase is strongly related to inflammaging This phenomenon, defined as “anabolic resistance”, implies suboptimal skeletal muscle protein synthesis in response to physiologic stimuli and is one of the main determinants of sarcopenia [20]. At the present moment sufficient clinical data in older individuals are present only for vitamin D, n-3 polyunsaturated fatty acids and whey proteins [31]
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