Functional Medicine Nutrition and Exercise Protocol for Aging Populations: Enhancing Longevity and Well-Being

The World Health Organization estimates that the number of people aged 60 or older will reach 2 billion (22% of the global population) by 2050, highlighting the growing importance of health maintenance in aging populations. With aging comes an increased risk of chronic diseases, mobility challenges, dementia, cognitive decline, and other challenges that can seriously affect the quality of life for older adults. Functional medicine is a comprehensive approach to overall health and well-being that can be tailored to the needs of the aging population, combining nutrition and exercise protocols to help older adults stay active, independent, and healthy as long as possible.  

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The Challenges of Aging and Health

As we age, we accumulate a variety of cellular damage over time that ultimately leads to a higher risk of physical and mental challenges, including a higher risk of chronic disease, decreased mobility, and cognitive decline. Chronic diseases such as cardiovascular disease, type 2 diabetes, cancer, and arthritis all affect older adults more frequently than the younger population, and can negatively impact quality of life and independence if not treated.  Mobility also tends to decrease with age, putting older adults at risk for falls and loss of independence in everyday tasks. The risk of mortality after a fall affects the elderly population much more as well, making it a serious concern for older adults. Cognitive decline is another major challenge faced with aging, including not only self-reported issues with memory or confusion but also more severe challenges such as Alzheimer’s and other forms of dementia. 

Functional medicine is uniquely positioned to help address the aforementioned challenges, as functional medicine considers how to treat each individual based on their lifestyle and unique needs. Exercise recommendations, socialization, nutrition advice, chronic disease management, and mental health are all considerations in a functional medicine approach to enhance longevity and well-being.  

Principles of Functional Medicine in Aging Care

Functional medicine is a method of healthcare that is “root cause” focused, rather than being a set of specific treatment protocols to be applied to every case in the same way. Some of the core principles of functional medicine include:

• Every patient is unique and must be treated accordingly
• Diet, environmental, lifestyle, and social experiences are relevant to patient symptoms and presentations
• How well a person functions depends on interaction and communication between various physiological systems
• When assessing a patient, it’s important to look at antecedent, triggering, and mediating events and their relationship to patient symptoms. 

These core principles are important for the care of older adults because they help practitioners understand how each individual’s lifestyle, biology, and relationship to both self and others may be impacting how they age. Understanding individual health histories, the presence of support systems, self-efficacy, and lifestyle factors such as nutritional choices and ability to exercise are all key to helping reduce disease risk and enhance healthy aging. For example, addressing social isolation in the elderly is a key element of comprehensive health and wellness care as loneliness in older adults independently increases the risk of chronic disease and mental health problems to a greater extent than in younger adults.  

Nutritional Strategies for Healthy Aging

As we age, there are some specific nutritional strategies to be considered to support health and prevent disease. When it comes to general dietary patterns, a higher protein intake is generally recommended to combat age-related muscle loss, which is extremely important to help maintain mobility and strength. Older adults are also not as responsive to the anabolic stimulus of protein intake, making higher intake levels important to help offset this diminished response.  

A protein-forward Mediterranean diet is a good option, as the Mediterranean diet has been shown to help reduce disease risk for many conditions that affect older adults. This nutritional approach contains many of the key nutrients that are considered important risk nutrients in older adults, including adequate protein, omega-3 fats, dietary fiber, B vitamins, calcium, magnesium, potassium, zinc, and iron.  Hydration is also important for older adults, as the risk of dehydration rises in this population, particularly in warm climates and in those with chronic illnesses.  

When it comes to supplements that may be beneficial for aging populations, functional medicine lab testing that evaluates micronutrient status such as the Micronutrient Test by Spectracell can be helpful to guide supplementation of any vitamins and minerals on a case by case basis.  Decreased appetite and eating poor-quality foods are two risk factors in older adults that may lead to nutrient deficiencies in important nutrients, such as vitamin D, iron, magnesium, omega-3 fats, and zinc, amongst others.  

Exercise and Physical Activity Protocols

While exercise and physical activity protocols may vary individually depending on baseline health and needs, there are some general guidelines recommended by the CDC for adults 65 and older:

• 150 minutes per week of moderate-intensity activity, such as brisk walking, or 75 minutes per week of vigorous-intensity activity such as hiking, jogging, or running
• At least 2 days per week of exercise that strengthens muscles, such as resistance training
• Activities that improve balance

These recommendations cover different types of activity that help delay the physical decline that often comes with aging.  Strength training is important to help reduce age-related muscle loss, improve balance and coordination, and retain good motor function, and is an important component of any exercise plan that aims to support mobility and reduce the risk of falls.  

Balance training programs have been linked to higher rates of self-efficacy in balance control, walking speed, and physical function, while also lowering fear of falls. Cardiovascular exercise carries several benefits for older adults, including improving mobility and physical function, improving blood flow, supporting cognitive health, and reducing the risk of chronic disease. The benefits of cardiovascular disease increase when combined with a program that also includes strength training. For older adults who have physical limitations that may make walking or other types of exercise difficult, recumbent bikes or aquatic workouts are also good options for cardiovascular exercise.

Integrating Mind-Body Wellness Techniques

Mind-body wellness techniques such as yoga, tai chi, and meditation are used widely by older adults for both fitness and relaxation, as well as to enhance mental and emotional well-being. These practices offer a variety of benefits, including better stress management, improving sleep, helping with mobility and balance, and enhancing cognitive health.  

Tai chi is a popular form of mind-body exercise that is effective at improving the overall quality of life in older adults. Known for its slow, intentional movements, tai chi can positively influence muscle strength, flexibility, and balance as well.  

Yoga has been well-studied in older adults, with studies showing it may have positive impacts on cellular aging, mobility and balance, mental health, and prevention of cognitive decline. Yoga can improve predictors of longevity including walking speed and leg strength, and may also reduce symptoms of depression and support overall mental wellbeing in older adults.  

Meditation, done consistently, may help delay dementia and promote healthy aging. Mindfulness meditation has also been linked to improvements in sleep quality and can be an effective stress management tool as well.  

Addressing Common Age-Related Health Conditions

A functional medicine approach to managing common age-related health conditions such as arthritis, osteoporosis, and heart disease is an ideal option to help older adults better understand how to support healthy aging and manage their health in a way that’s personalized for their unique needs. Many chronic diseases are tied to lifestyle factors that can be changed using a functional medicine approach to help reduce symptom severity and slow disease progression. Using strategies that help patients understand how regular exercise, good nutrition choices, supportive social networks, and prioritizing sleep can lead to lifestyle changes that can massively impact the quality of life in older adults with chronic disease.

Almost half of adults aged 65 and older have an arthritis diagnosis, which can negatively impact mobility and quality of life for older adults. Exercise recommendations can help to keep muscles strong without a high impact on joints, and can help to maintain mobility. Specific rehabilitation exercises may also be recommended depending on which joints are affected by arthritis, helping to ease symptoms of pain and inflammation. Nutritional recommendations also play a role in a functional medicine approach to arthritis; for example, the Mediterranean diet has been shown to reduce inflammation and slow the progression of osteoarthritis.

Osteoporosis is also a concern for older adults, especially for women, as bone density begins to break down with aging. Osteoporosis carries with it a higher risk of fractures and oftentimes doesn’t have any symptoms, making it important to get regular checks later in life. Ensuring adequate intake of protein, calcium vitamin D, minerals, vitamin K and omega-3 fats is an important component of nutrition in older adults to help reduce the risk of osteopenia, while including plenty of weight-bearing exercises and strength training to help keep bones and joints strong and healthy. 

Diets like the Mediterranean diet are also linked to better heart health, making it an ideal choice for older adults dealing with heart disease. Walking and other forms of cardiovascular exercise also help support heart health and circulation and can help the heart work better in those with heart disease.  

Monitoring and Adjusting Protocols

Functional decline in older adults often increases the necessity to be able to regularly monitor and adjust their care plans as their needs and health statuses change. Older adults may need more reminders about various treatments, like medication or doctor’s appointments. Sometimes the need for remote monitoring may also arise to reduce the risk of falls or adverse events and keep regular tabs on health biometrics to be able to adjust care plans accordingly.  

Healthcare professionals can ensure regular monitoring occurs in a variety of ways. Having regular check-ins scheduled, whether that be through appointments or a patient messaging system, can help with regular evaluation of health status and to see if patients’ needs are being met. This allows for adjustments in nutrition and exercise protocols to be made sooner rather than later, helping ensure older adults continue to take actionable steps to improve their well-being. Additionally, the use of wearable technology and home automation may help practitioners monitor the functional capacity of older adults, helping them adjust their plans based on performance. Lastly, communicating with family members or caregivers, particularly in cases where cognitive decline is a concern, can also ensure that older adults are adhering to a care plan and are supported at home.  

Educating and Empowering Older Adults

An important component of enhancing longevity and well-being in aging populations is the education and empowerment of older adults in managing their own health, including understanding their treatment plans and making informed lifestyle choices around nutrition and exercise. Older adults are at risk of losing their independence over time as their physical and mental health starts to decline, and bringing awareness to the resources and knowledge they need to improve self-efficacy and adherence to their treatment plans can help them maintain their independence for as long as possible.  

Practitioners can use different strategies to encourage the active participation of older adults in their health and wellness journey. Communication methods need to consider each patient’s digital literacy, as many older adults are not as at ease with technology as the younger population. Having options to communicate and ask questions beyond digital platforms can be a helpful option. Alternatively, practitioners or a member of their team can make the time to show older adults how to use any necessary apps or other technology needed to communicate with their providers and be available to answer questions as they come up. Another strategy to consider using programs aimed at improving self-efficacy and patient morale. Such programs often include components such as creating a social network for members and encouraging physical activity in fun and interesting ways. Group programs may be a particularly good fit for older adults who do not have a supportive family network at home or who may live alone.

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Nutrition and Exercise Guidelines for Aging Populations: Final Thoughts

A functional medicine approach to enhanced longevity and well-being will include nutrition and exercise protocols to help minimize the risk of challenges often faced by the aging population, including decreased mobility, chronic disease management, and cognitive decline. Encouraging self-efficacy and active participation in health and wellness plans is an integral part of healthcare for older adults, as with aging can come a loss of independence. Encouraging a variety of exercises and mind-body wellness techniques, while also focusing on quality protein-forward anti-inflammatory nutrition, are central to functional medicine approaches to caring for aging populations.