The effectiveness of a protein-enriched Mediterranean diet and exercise intervention on nutritional status and cognitive performance in older adults at risk of undernutrition: the PROMED-EX Trial

At the outset, many participants had low intakes of key nutrients, including energy, protein, fibre, vitamin D and selenium. Furthermore, 63% reported poor appetite. Both interventions significantly improved MNA scores after 6 months (+4.5; +4.5; +0.9 in the PROMED-EX, PROMED and Control; P<0.001).

There were significant improvements in the intake of several nutrients and micronutrients; however, exercise compliance was poor, with no significant changes in PAEE score in the PROMED-EX group.<br><br>Discussion:<br>The PROMED-EX RCT demonstrated that a personalised, nutrient-dense diet improved nutritional status and diet quality among older adults at increased risk of undernutrition and cognitive decline, and that older adults can improve diet behaviour with the right level of support.

This food-based approach had beneficial effects on important health outcomes, including cognitive function, even though the ability to detect this was underpowered. These results support the value of early dietary intervention and justify a larger, longer-term study.<br><br><i>Thesis is embargoed until 31 July 2027</i>.<br>