If only you could pop vitamin D and fish oil supplements to fight the frailty that often comes with aging, but new research delivers a disappointing message: Don't count on it.
In reaching that conclusion, the team used data from the VITAL study (Vitamin D and Omega-3 Trial), which included information from over 25,000 U.S. adults. Using questionnaires taken before the trial, six months after its start and annually through five years of follow-up, as well as frailty assessments, the researchers found the supplements made little difference.
The investigators studied the supplements in many different subgroups, including those whose vitamin D levels were low, those with and without healthy diets, and men and women, noted study author Dr. Ariela Orkaby. She is a geriatrician in the division of aging at Brigham and Women's Hospital in Boston.
“Our results stayed consistent. We really didn't see any benefits for either intervention or supplement,” Orkaby said.
Frailty has been defined as reduced physiological reserve. It might be that someone walks slower, loses weight and has a weaker grip. Frailty affects about half of adults over age 85, though it can happen at younger ages.
For the study, the researchers used the two leading definitions of frailty, one of which adds up all the different things that could be going wrong in the body, to figure out how many things a person has and then how frail they are on that spectrum, Orkaby explained. The other is a direct measure of how a person is walking, what their physical strength is, what their energy level is, their weight and whether they're losing weight.
“We tried to be as rigorous as we could and really use more than one definition so that we could capture as many types of frailty as are possible within the older adult population,” Orkaby explained.
With the exception of some research on inflammatory arthritis and in certain populations, studies on these supplements are not showing big benefits in a variety of health conditions, from heart disease to cancer to fractures, Orkaby noted.
The prevention of frailty seems to be no more magical than eating a balanced diet with whole foods, getting a small amount of natural vitamin D through exposure to sun, staying active, exercising daily and being engaged in the community.
“In fact, the Mediterranean diet has been shown — it's very promising data — to prevent frailty,” Orkaby said.
“Now, again, these are hard things to do. These are lifestyle changes and are not the same as just putting down some money and buying a pill,” Orkaby said.
The findings were published online Sept. 13 in JAMA Network Open.
Dr. Elizabeth Eckstrom, a professor of medicine in the division of general internal medicine and geriatrics at Oregon Health and Science University in Portland, wrote an editorial that accompanied the study.
“They really did a beautiful job thinking through all of the potential benefits and all of the ways to ensure fidelity to the intervention, all of the ways to ensure that they were eliminating bias from the trial,” Eckstrom said. “One of the good things that this study does for us is it has a high level of confidence in its ability to tell us how accurate these results are."
Eckstrom's editorial focuses on the benefits of eating a Mediterranean diet as an alternative to supplements for frailty prevention.
“The Mediterranean diet has really for many years now been shown to have health benefits for reducing heart attacks and strokes, cancer, dementia, all sorts of medical conditions,” Eckstrom said.
While it's not the go-to diet in the United States, where many people do not have gardens and where olive trees are not abundant, it did develop as a “poor man's diet,” Eckstrom explained, with a reliance on beans, legumes, vegetables and local plants. It also features fish, nuts and olive oil.
“Not becoming frail should be one of the primary goals of everybody in the population, because it leads to worse mobility, hospitalization, death, falls, all of these terrible things,” Eckstrom said.
“It's not just about food. It's about exercise. It's about maintaining our social engagement, maintaining our physical engagement, but diet is a huge piece of this,” Eckstrom added.
“This isn't something you should start when you're 80. Now, having said that, if you haven't done it before age 80, please do it now,” Eckstrom said. “It's never too late to start. And there are some really nice studies showing that even people who change their diet in their 80s and 90s were able to reduce their risk of dementia and some of these other outcomes.”
The Medical University of South Carolina has more on frailty.
SOURCES: Ariela Orkaby, MD, MPH, geriatrician, division of aging, Brigham and Women's Hospital, and assistant professor, medicine, Harvard Medical School, Boston; Elizabeth Eckstrom, MD, MPH, professor, medicine, division of general internal medicine and geriatrics, Oregon Health and Science University's School of Medicine, and co-director, OHSU Aging Alliance, Portland; JAMA Network Open, Sept. 13, 2022, online