These Three Nutrients Can Prevent Frailty at Any Age

Dr. Janet Zand
November 25, 2018


Nobody wants to get weaker as they grow older. But it happens. One day you’re strong and vital. Then suddenly it’s difficult to get out of a chair or walk up stairs. If you want to be strong in your later years, you need to begin today to strengthen your body.

When most people think about staying strong, they think about weight training. While I’m a huge fan of weight training and exercise, there is a remarkable key to avoiding frailty that enhances an exercised body and goes beyond exercise. And it works regardless of your age. The secret is to have enough of certain nutrients.

Not many people know this, but particular nutrients can help you get and remain strong and vital. They’re key to staying strong. Don’t wait. The time to evaluate your need for them is now.

This may surprise you. Frailty comes in many shapes and sizes. It doesn’t just hit those who are thin and wispy.

Take Sandy, for instance. She’s in her 60s, overweight, and doesn’t look frail at all. But she is. She meets four out of the five criteria for frailty syndrome: weakness, walking slowly, feeling exhausted, having a low level of activity, and unintentional weight loss. Sandy has all of these frailty markers except the weight loss. If she doesn’t make any changes, she’s likely to wind up with poor balance, brittle bones, and weak muscles.

Frailty is a common result of aging. In fact, 30% of people 80 years old or older are frail. So are a surprising number of younger adults. All have three or more out of the five frailty symptoms.

Low hormones and low immunity contribute to frailty as we get older. But low levels of some nutrients can cause weakness at any age. Begin today by evaluating these nutrients in your diet and supplements. If they are low, boost their levels, especially if you’re already frail or feeling weak.

Balance” Begins With a “D”

Vitamin D: Along with its many benefits, vitamin D improves your balance. This reduces your risk for falls and broken bones. It also makes you stronger. In one study of adults over 60, those with low vitamin D levels (serum 25-hydroxyvitamin D below 60 nmol/L) took longer to get up out of a chair, and walked more slowly than those with the highest levels.

Some researchers say that 90% of older adults are deficient in vitamin D. Even those who live in sunny places. I agree. Many people don’t go outdoors enough to absorb sufficient vitamin D from the sun. And we’ve been told for years to slather ourselves with sunscreen before stepping outside — even on cloudy days. But using a lot of sunscreen almost guarantees you’ll be low in vitamin D. And more likely to be frail.

In a study out of Johns Hopkins, vitamin D was significantly lower in older frail women. Another study of 1,300 adults found that higher amounts of D meant better performance in a number of neuromuscular activities.

The researchers of another study found similar results. When they gave several hundred healthy older adults 800 IU of vitamin D along with calcium, their posture improved and their thigh muscles became stronger.

There’s more. Studies found that 800 IU of vitamin D a day taken for three years could reduce broken bones by 32% to 68%.

Most dietary sources of vitamin D are oily fish and cod liver oil, or fortified foods. Cod liver oil often contains too much vitamin A for daily use, and fortified foods (like milk), don’t contain enough vitamin D to raise your levels. Commonly, I recommend between 2500-5,000 IU of vitamin D a day for people over 60, and 1,000 IU daily for other adults. It’s safe and inexpensive.

Sweet Potatoes and Carrots Hold the Answer

Carotenoids are antioxidants found in vitamin A. People with low levels of carotenoids walk slowly and have less knee, hip, and grip strength. The Johns Hopkins study found that frail women tended to have two or more deficiencies of these nutrients: carotenoids, vitamin E, vitamin D, and vitamin B6. The lower their concentrations, the weaker they were.

The carotenoids that most affect frailty are beta-carotene, lutein, zeaxanthin, and total carotenoids. You can get many of them from a diet high in fresh fruits and vegetables, and boost your levels with a good multivitamin.

While spinach and kale contain carotenoids, they’re present in high amounts in carrots (hence, their name), sweet potatoes, and tomatoes. These nutrients are found in red, yellow, and orange fruits and vegetables. If you’re not eating a lot of these foods regularly you may want to take a supplement made from spirulina, chlorella, or barley grass or a mixed greens powder.

This May Be the Hormone You Need

DHEA (Dehydroepiandrosterone) is a hormone that helps your body make estrogen and testosterone. Like all hormones, your body produces less as you age. DHEA is one of the safest hormones you can take. It could be all you need. DHEA has often been called the “mother” hormone for its critical role in creating androgens and estrogens. Among its many benefits, DHEA is associated with muscle strength and mass.

A simple blood test, DHEA-Sulfate, can tell your doctor whether or not you need DHEA, and how much. Normal levels for women vary by age and is dependent on the laboratory testing. Between 75-200  mg/dL are considered sufficient levels. If you’re fatigued and your doctor has not determined any cause, increasing your DHEA level to 125-150mg/dL often results in an increase in your daily energy.

One study found a significant correlation between women taking DHEA supplements and increased bone density. In addition, the Woman’s Health and Aging Study found that very high or very low levels of DHEA correspond with higher death rates. Women with the lowest levels died of heart disease. Those with the highest levels died of cancer. This is a case right out of the Three Little Bears. You want your DHEA level to be “just right.”

You can buy DHEA in health food stores, but don’t. I’ve found many of them contain much less hormone than they list on their labels. Take the smallest amount needed to normalize your levels. Many of my patients do well with 5-10 mg three to five days a week. This is considered almost a laughably small amount, but over time will alter your levels and is easily sustainable and affordable. Work with your doctor, nurse practitioner, or other skilled health care provider to evaluate your levels and get the best quality DHEA you can.

Get Enough “Muscle Food”

Amino acids and protein. Exercise won’t build strong muscles unless you’re eating enough protein. Protein is made from amino acids, and you need the full range of “essential” amino acids to build muscle. Animal products contain complete proteins, but most vegetable sources include a combination of beans and grains.

Few of us eat enough protein — especially if we grab a muffin for breakfast and a salad for lunch. Or if they are older women with small appetites. You can either take amino acid supplements, which are expensive, or increase your intake of protein. Aim for about 20 grams per meal. Obviously, if you have been diagnosed with kidney disease you will need to decrease this.

Getting enough protein and doing resistance exercises three to five times a week will protect you from becoming frail later on. If you’re already older, start today to increase both your exercising and protein.

Sandy did. She had a nutritional workup and found she needed DHEA. She also needed to eat much more protein. Sandy made these small changes. Then she got smart and found a friend to join her for weekly strength training sessions at her local gym. She and her friend began doing more exercises at home with light weights, as well. It took a little discipline, but Sandy is determined to be active as long as she can.

Let me know how your next steps to crushing frailty go.


Cherniack, E.P., et al. “Emerging therapies to treat frailty syndrome in the elderly,” Alt Med Rev, September 2007.

Michelon, E, et al. “Vitamin and carotenoid status in older women: associations with the frailty syndrome,” J Gerontol A Biol Sci Med Sci, June 2006.

New England Journal of Medicine, 2006.

Parise, G. and K.E. Yarasheski. “The utility of resistance exercise training and amino acid supplementation for reversing age-associated decrements in muscle protein mass and function,” Curr Opin Clin Nutr Metab Care, November 2000.

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