The CHOKO-AGE project starts from the assumption that nutrition and physical exercise can support each other to prevent protein-energy malnutrition (PEM) and muscle wasting in the elderly at risk of frailty and disability. Age-dependent PEM is associated with specific alterations of endocrine factors, such as cortisol and insulin, and with a reduced competence of tissues, including the muscle, to utilize dietary nutrients to prevent and eventually repair the lesions deriving from the exposure to cellular stressors, such as reactive metabolites of molecular oxygen produced during metabolic processes, mechanical stresses, etc. The control of cortisol levels and the protection of mitochondrial function and membrane integrity in muscle cells, are key targets in PEM.
Our experimental hypothesis is that physical activity and chocolate polyphenols can combine their cortisol lowering effect with the antioxidant and cytoprotection function of vitamin E, to prevent the age-dependent decline of mitochondrial function and nutrient metabolism in skeletal muscle. Positive effects are also expected on immune cells and in the homeostatic control of inflammatory pathways and tissue repair mechanisms.
To test this hypothesis, a vitamin E-functionalized dark chocolate rich in polyphenols will be developed in collaboration with Perugina, Nestlè company, and its effects will be investigated combined with a high-intensity interval physical training in a 6-month randomized case-control trial in elderly dementia patients. This is a well-defined population of subjects at risk of PEM and frailty. Muscle mass will be the primary endpoint in this intervention study, whereas metabolomics and proteomics data on muscle metabolism, together with cortisol levels and clinical and laboratory indices of neurological and immuno-inflammatory functions, will represent secondary end-points. The latter will be important to interpret molecular and mechanistic aspects standing behind the response to nutrition and physical activity treatment.
To summarize, the fundamental aim of this project is to develop a nutritionally-enhanced and palatable food to support physical activity in preventing PEM in the elderly.
The CHOKO-AGE project involves a consortium of 5 university partners located in Italy, Norway, United Kingdom, and Spain, and of two external collaborators: “Perugina, NestlèItaliana, Spa” and “Molecular Horizon Srl”.