Nutritional Management of Sarcopenia and Frailty-Shift from Metabolic Syndrome to Frailty

Older adults have physical and metabolic characteristics, and there are many differences in nutritional outcomes from middle-aged adults. In addition, there are many factors that cause malnutrition peculiar to the older adults, which are not seen in middle-aged adults, and it is easy for them to lose weight and become malnourished. Therefore, nutritional management needs to take into account the age of each subject. Uniform nutritional management can even cause poor health outcomes. The concept of frailty, especially phenotype frailty, and sarcopenia, which have been advocated with the aging of the population and the extension of life expectancy around the world, is very important in considering the extension of healthy life expectancy. In other words, in the super-aged society, frailty and sarcopenia have been emphasized as factors of functional decline, physical dysfunction, and the need for long-term care in addition to the well-known diseases such as cardiovascular disease, malignant tumors, and infectious disease. In fact, these two conditions are strongly associated with the increased risk of new disease development, falls, fractures, disability, hospitalization and death in the older adults. These two conditions are primarily associated with malnutrition and decreased dietary protein intake, and may recover to robustness again with appropriate interventions such as nutritional therapy. Therefore, undernutrition measures are more important for prevention of frailty and sarcopenia than measures for obesity against metabolic syndrome in the older adults, especially in the latestage older people.