Added sugars increase the risk of frailty as you age

June 19, 2018 by Joel Fuhrman, MD

It is well-known that added sugars are bad for your health, and now research shows an even more important reason for seniors especially to shun sugar and pay heed to eating a nutrient-rich diet. Added sugars have been found to have a profound effect in causing frailty in older people leading to a greater risk of falls and early death.

Frailty is a condition defined by meeting three of five criteria: unintentional weight loss, exhaustion, low physical activity, slow walking, and weak grip strength. The consequences of frailty are an elevated vulnerability to falls, disability, and earlier death.1

According to a new study, excessive intake of added sugars was linked to a greater risk of frailty in adults over the age of 60. Study participants were divided into three groups based on their intake of added sugars. Three years later, those participants who consumed at least 36 g sugar per day (about the amount in one 12-ounce can of soda) had more than double the risk of becoming frail over the follow-up period compared to those who consumed less than 15 g per day. Even after adjusting the results for physical activity, the risk was still elevated more than two-fold in the high-sugar group. When separated out from different sources, the sugars in processed foods, such as pastries and cookies, were the most strongly associated with frailty.

Notably, naturally occurring sugars were not associated with an increase in risk (naturally occurring sugars in this study included those in fruits and vegetables, but not fruit juices). Naturally sweet fruits (especially berries and pomegranate) and vegetables (such as carrots and sweet potatoes) provide valuable phytochemicals, such as flavonoids and carotenoids, and – importantly – fiber, which slows the absorption of their sugars, minimizing their glycemic effect.

Since loss of muscle mass (sarcopenia) is the primary factor that drives frailty, muscle-building and cardiovascular fitness are, of course, important modes of prevention, however, the importance of a healthy diet cannot be overstated in maintaining muscle  quality and a fit body.

Insulin resistance impairs muscle function

Insulin, a hormone made by the pancreas, allows cells to absorb glucose so that it can be used as energy. The cells of individuals with insulin resistance are unable to use insulin effectively. When cells cannot absorb glucose, it builds up in the blood. Insulin resistance has been linked to frailty risk in previous studies.2 Skeletal muscle insulin resistance is an early precursor to type 2 diabetes. When muscle cells become insulin resistant, their ability to use glucose for energy is impaired. Skeletal muscle insulin resistance therefore results in both a higher blood glucose level and impaired energy metabolism in the muscle cells.

High sugar intake likely contributes to frailty by promoting insulin resistance and lipid accumulation in skeletal muscle. Lipid accumulation is also associated with impaired muscle function. These changes due to high sugar intake may diminish the body’s ability to maintain muscle mass with age, leading to sarcopenia and frailty.3

Nutrient-rich diet provides protection

In addition to the harms of sugar, a diet rich in sugar-sweetened beverages and processed foods crowds out nutrient-rich vegetables, fruits, beans, nuts and seeds, potentially leading to micronutrient deficiencies or insufficiencies.  In a systematic review of many studies, links to frailty were found when there was a low intake of several micronutrients including vitamin D, vitamin E, vitamin C, folate, vitamin A, vitamin B6, and carotenoids alpha-carotene, beta-carotene, and cryptoxanthin.

Similarly, biomarkers of nutrient inadequacy were also linked to frailty, such as MMA (a marker of B12 deficiency), and low levels of serum carotenoids, alpha-tocopherol (vitamin E), vitamin D, and vitamin B6. In contrast, a diet with higher antioxidant capacity was associated with a lower risk of frailty.4

Perhaps the most important benefit of a Nutritarian diet is that, coupled with exercise, it allows you to enjoy life in your 70s, 80sand 90s. This eating style not only promotes weight loss in the short term, it is designed for longevity:

A note on protein: The loss of muscle mass associated with frailty can be due in part to undernutrition, inadequate protein in particular. The elderly may have less efficient absorption and utilization of protein, which could lead to excessively low IGF-1 levels. Elderly people may require a higher and evenly distributed protein intake compared to younger and middle-aged adults to maintain muscle mass. Read more

  1. Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med 2011, 27:1-15.
  2. Barzilay JI, Blaum C, Moore T, et al. Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. Arch Intern Med 2007, 167:635-641.
  3. Cleasby ME, Jamieson PM, Atherton PJ. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J Endocrinol 2016, 229:R67-81.
  4. Lorenzo-Lopez L, Maseda A, de Labra C, et al. Nutritional determinants of frailty in older adults: A systematic review. BMC Geriatr 2017, 17:108.

Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.
For over 25 years, Dr. Fuhrman has shown that it is possible to achieve sustainable weight loss and reverse heart disease, diabetes and many other illnesses using smart nutrition. In his medical practice, and through his books and PBS television specials, he continues to bring this life-saving message to hundreds of thousands of people around the world.


Comments (0):



06/27/2018 11:56 AM

Another great reason to avoid sugar! Thank you Dr. Fuhrman. I notice that on your emergency diet for those with severe cardiovascular problems, even fruit is somewhat limited to about three per day, but I'm glad the rest of us can enjoy four or more fruits a day.