Global populations are aging, changing the needs of healthcare systems with growing demands. The United Nations reports that the number of people aged 60 or older will reach 2.1 billion by 2050, double the number reported in 2017. As the population’s average age continues to rise, research efforts have begun to shift to include treatment and prevention strategies to support these aging groups.

Recent investigations exploring the use of omega-3 fatty acids on frailty have sparked conversation around the potential of these essential nutrients as a preventative or therapeutic strategy for aging populations. In this article, we will dive into the latest research on omega-3s and their impact on frailty in older adults, explore the mechanisms behind their effects, and provide practical recommendations for incorporating them into a healthy aging routine.

 

Frailty – A Brief Explanation

Frailty is a common clinical syndrome in older adults that can significantly impact quality of life. Although there is still some debate around the definition of frailty, it is generally accepted that it is a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems that compromise a person’s ability to deal with everyday stressors.

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Frailty can be defined as meeting three out of five criteria, including (1) weight loss, (2) exhaustion, (3) low physical activity, (4) slowness, and (5) weakness. These age-related deficits can lead to impaired balance, increased risk of falls and injuries, immobilization, disability, and dependency. The outcomes of frailty in older adults are associated with higher healthcare use and costs, as well as personal and financial burdens to the individuals affected, their caregivers, and society as a whole.

 

How Do Omega-3s Combat Frailty?

Although the underlying causes of frailty are complex, evidence indicates that nutrition should be considered a modifiable environmental factor that may prevent or reduce the risk of frailty. One of the pathophysiological processes involved in frailty that can be impacted by diet is chronic low-level inflammation.

Researchers have reported that frailty is associated with high levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin (IL)-6, and that levels of IL-6 are even more closely linked to frailty than age is. Omega-3 fatty acids could affect frailty outcomes by influencing inflammatory processes. Increasing the intake of omega-3s in the diet increases the content of omega-3s in cellular membranes. The increased membrane content of EPA and DHA results in increased production of anti-inflammatory compounds such as eicosanoids and resolvins. Several meta-analyses of clinical trials have reported that EPA and DHA reduce inflammatory cytokine levels, including molecules such as IL-6 and CRP.

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One way inflammation impacts frailty is through its effects on muscle mass. Sarcopenia, defined as the loss of skeletal muscle mass and function, is also associated with increased inflammation, which omega-3s can help resolve. Furthermore, growing evidence indicates that omega-3s may help retain muscle mass and function by mechanisms beyond inflammation control, such as increased nerve conduction and muscle activation, improved mitochondrial function, and increased muscle protein synthesis. Supporting the maintenance of muscle tissue through adequate omega-3 intake could potentially improve several frailty criteria.

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Research Evaluating Omega-3s and Frailty

Epidemiological studies worldwide have reported an inverse association between fish intake and the prevalence of frailty in older individuals (1, 2, 3, 4, 5, 6). Furthermore, a meta-analysis specifically evaluated the potential effects of omega-3 fatty acids on sarcopenia-related performances among older adults, which include several frailty criteria, including walking speed and muscular strength.

The researchers found that omega-3 supplementation was associated with increased muscle mass and walking speed, especially when supplementation was more than 2g daily and when administered for more than 24 weeks. This is in line with other studies that demonstrate lower doses of omega-3s (0.225g EPA and 0.8g DHA) resulted in no effect on measured frailty outcomes, while studies providing higher doses (1.8g EPA and 1.5g DHA) observed positive outcomes. The results of this study demonstrate that omega-3 intake, when consumed in appropriate quantities, can decrease the risk of frailty.

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Building on previous findings, in 2021, researchers aimed to determine if higher erythrocyte levels of omega-3 fats were associated with lower odds of frailty. A cross-sectional analysis was conducted using the Korean Frailty and Aging Cohort Study, and a total of 1,435 people aged 70-84 were included.

The results showed the likelihood of frailty was inversely associated with the erythrocyte levels of EPA and DHA. They concluded that frailty and frailty criterion were significantly associated with lower erythrocyte levels of omega-3 fats and that lower levels of omega-3s could be a marker for frailty risk. While the inverse association between omega-3 levels and frailty exists in this study, the population was particular, which got researchers wondering whether this association exists in Western populations.

 

New Evidence Confirms Relationship Between Omega-3s and Frailty

A study published this month in the Journals of Gerontology set out to determine if the prevalence of frailty in older adults in the UK was associated with plasma omega-3 levels. The cross-sectional study used data from 18,802 participants from the UK Biobank. During original data collection, questionnaires assessed dietary intake of oily fish and fish oil supplements, and total omega-3 and DHA levels were measured in plasma. Frailty was evaluated by a modified version of the Cardiovascular Health Study frailty index, where participants who met three or more of the five criteria were considered frail.

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The researchers discovered that intake of oily fish, fish oil supplementation, and plasma omega-3 levels were all inversely associated with the prevalence of frailty in UK older adults. Omega-3 intake appeared to affect the frailty criteria of weight loss, exhaustion, low grip strength, low physical activity, and slow walking pace. These findings align with the previous outcomes found in Korean older adults and further suggest that increased intake of omega-3 fatty acids could be beneficial for preventing frailty.

 

How To Get More Omega-3s

Omega-3 fatty acids are found naturally in foods, including:

  • Fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines)
  • Nuts and seeds (such as flaxseed, chia seeds, and walnuts)
  • Plant oils (such as flaxseed oil, soybean oil, and canola oil)
  • Fortified foods (such as certain brands of eggs, yogurt, juices, milk, soy beverages, and infant formulas)

However, EPA and DHA are found primarily in fatty fish. Therefore, to increase your blood levels of EPA and DHA, it’s important to increase fatty fish intake or follow a dietary lifestyle like the Mediterranean diet, which prioritizes fish and unsaturated fats. As an alternative, omega-3 supplements, including fish oil, krill oil, and algal oil, can be added regularly. The best way to know if EPA and DHA consumption is adequate is to test your Omega-3 Index.

 

Summary

As we age, maintaining strength and mobility becomes increasingly important. Frailty is a common issue among older adults that can significantly impact quality of life. Yet, increasing evidence shows that a greater intake of omega-3 fatty acids is associated with a lower risk of frailty in aging populations. Omega-3 fatty acids appear to impact frailty risk by affecting inflammation and muscle maintenance.

When considering nutrient interventions for health outcomes, it’s important to remember that dose matters. While no exact dose of EPA or DHA, or corresponding Omega-3 Index, to reduce the risk of frailty has been identified yet, the inverse association is clear. Current evidence indicates a daily intake >2g of EPA and DHA per day may be required to realize the benefits.

 

These statements have not been evaluated by the Food and Drug Administration. This test is not intended to diagnose, treat, cure, prevent or mitigate any disease. This site does not offer medical advice, and nothing contained herein is intended to establish a doctor/patient relationship. OmegaQuant, LLC is regulated under the Clinical Laboratory improvement Amendments of 1988 (CLIA) and is qualified to perform high complexity clinical testing. The performance characteristics of this test were determined by OmegaQuant, LLC. It has not been cleared or approved by the U.S. Food and Drug Administration.

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