Myths and truths on dietary supplements and nutraceuticals for musculoskeletal health: a scoping review

Background: An inadequate intake of nutrients, low levels of physical activity, and chronic diseases contribute to reduce muscle mass and physical performance in elderly. WHO reported that number of individuals aged ≥60 years will triple in 2050, with the sub-population aged >85 years that will grow faster than the others. Market of nutraceuticals and dietary supplements is growing in Italy, in particular aimed to improve health in elderly. Objective of this scoping review was to analyse the state of the art on micronutrients, available in nutraceuticals or in dietary supplements, commercialized in Italy, in order to identify, according to an evidence-based approach, which of them improve the areas typically involved in functional deterioration of the elderly: bone, skeletal muscle and nervous tissues. Material and methods: The Italian Group for the Study of Healthy Ageing by Nutraceuticals and Dietary Supplements (HANDS) performed a scoping review through different steps: list of micronutrients available in dietary supplements and nutraceuticals, used in elderly to improve their physical functioning in three systems (bone, muscle and central nervous system); identification of relevant studies on PubMed, using as MeSH terms the selected micronutrients, adding through PubMed Search Builder the terms: ‘bone’, ‘skeletal muscle’ and ‘central nervous system’; selection of effective micronutrients; identification of effective and safe dosage regimen. Results: We evaluated 12 relevant studies (one international society guideline recommendations, one systematic review, seven randomized controlled trials, and three prospective cohort studies). Of the 39 micronutrients available in the market, only 16 resulted to have appropriate scientific evidence of their effectiveness in terms of improving musculoskeletal health in elderly: beta-alanine, calcium, creatine, fluorides, leucine, magnesium, omega-3 fatty acids, potassium, vitamin B6, vitamin B9, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K2, and zinc. Conclusions: This scoping review shows that selected micronutrients in specific doses might effectively improve the musculoskeletal health and cognitive function in elderly. A precise analysis carried out according to the EBM principles might deliver significant benefits in the field of dietary supplements and nutraceuticals