Dietary factors and nutritional guidelines for sarcopenia in older adults: a narrative review

Objectives: Sarcopenia is a condition characterized by the loss of muscle mass and function and is often accompanied by aging and chronic diseases such as diabetes and obesity. It increases the risk of falls, frailty, disability, hospitalization, and mortality in older adults. Its global prevalence is estimated as approximately 10%–27% in adults aged > 60 years. This review analyzes evidence from research findings and recommendations to provide a comprehensive overview of dietary factors and nutritional strategies for preventing and managing sarcopenia in older adults. Methods: Literatures were searched to integrate findings from observational studies, clinical trials, systematic reviews, and meta-analysis on dietary factors and nutritional guidelines for the prevention and management of sarcopenia. Particularly, points were emphasized on protein intake, micronutrient adequacy, dietary patterns, and combined lifestyle interventions relevant to older populations.Results: Sarcopenia develops through multifactorial mechanisms such as dysfunction in muscle protein synthesis, chronic inflammation, mitochondrial dysfunction, and aging-related hormonal decline. Nutritional factors, particularly protein intake, play a central role in its development and management. Adequate protein intake is typically 1.0–1.2 g/kg/day for healthy older adults and more than 1.2 g/kg/day for individuals with sarcopenia or frailty. High-quality protein intake, sufficient leucine intake, and amino acids or β-hydroxy-β-methylbutyrate supplementation may help to counteract dysfunction in muscle protein synthesis. The adequacy of vitamin D supports musculoskeletal health. Dietary patterns, such as the Mediterranean and Dietary Approaches to Stop Hypertension diets have been consistently associated with better muscle mass, strength, and function. Strong evidence has demonstrated synergistic benefits when optimized nutrition is combined with resistance exercise. Conclusion: The comprehensive management of sarcopenia in older adults requires an integrated strategy that prioritizes adequate protein and energy intake, vitamin D adequacy, healthy dietary patterns, and regular resistance exercise.