Opportunities for prevention and treatment

Funding Information: Acknowledgments: M.N.L. is supported by an NIHR Doctoral Fellowship (grant code NIHR300159). D.W. is supported by a NIHR Clinical Lectureship. A.A.S., A.G., C.H., P.H., S.R. and M.D.W. acknowledge support from the NIHR Newcastle Biomedical Research Centre. C.J.S. receives funds from the M.R.C., Wellcome Trust, Chronic Disease Research Foundation. E.R.T. is supported by the Medical Research Council (MRC) and Versus Arthritis as part of the Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA) [MR/R502182/1]. Funding Information: Importantly, nutrition represents a modifiable risk factor for frailty, and as such, is a target for both prevention and treatment of this debilitating syndrome. However, to design effective dietary interventions, a clearer understanding of the key dietary components and underlying mechanisms of action are needed. Progress in understanding the role and importance of nutrition and to address how diet can be used for the prevention and treatment of frailty, requires a multi-disciplinary approach. This review evolved from a workshop held on 6 November 2020, which was attended by all authors. The workshop was one of a series funded by the Medical Research Council under the UK Nutrition Research Partnership (UK NRP) Call for Nutrition Hot Topic Workshops. It brought together a new group of experts from the fields of nutrition and frailty, from a variety of backgrounds, in order to promote dialogue to address the potential of diet within strategies to prevent and treat frailty. The workshop had two aims: firstly, to review the evidence and current understanding of the links between nutrition and frailty, and secondly, to consider the gaps in the evidence and identify unanswered questions. Funding Information: We would like to acknowledge the Medical Research Council for their support in funding the workshop which led to the production of this paper, as part of the UK Nutrition Research Part-nership (UK NRP) Call for Nutrition Hot Topic Workshops.Acknowledgments: M.N.L. is supported by an NIHR Doctoral Fellowship (grant code NIHR300159). D.W. is supported by a NIHR Clinical Lectureship. A.A.S., A.G., C.H., P.H., S.R. and M.D.W. acknowledge support from the NIHR Newcastle Biomedical Research Centre. C.J.S. re-ceives funds from the M.R.C., Wellcome Trust, Chronic Disease Research Foundation. E.R.T. is supported by the Medical Research Council (MRC) and Versus Arthritis as part of the Medical Research Council Versus Arthritis Centre for Integrated Research into Musculoskeletal Ageing (CIMA) [MR/R502182/1]. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved. Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its path-ophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November 2020, and synthesises current understanding of dietary influences on frailty, focusing on opportunities for prevention and treatment. Longer term prospective studies and well-designed trials are needed to determine the causal effects of nutrition on frailty risk and progression and how dietary change can be used to prevent and/or treat frailty in the future. publishersversion published