Abstract
Overweight and obesity in older adults is associated with disability and is exacerbated by the presence of type 2 diabetes (T2DM). There is emerging evidence that adherence to a Mediterranean diet (MedDiet) reduces adiposity and attenuates physical disability. These cross-sectional studies explored the associations of adherence to a MedDiet with body mass index (BMI), adiposity, muscle strength, and physical performance in older adults without diabetes and in middle-aged or older adults with T2DM. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener. Fat mass and percent body fat were assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength, while physical performance was assessed using the Short Physical Performance Battery and gait speed. A total of n = 87 participants with T2DM (T2DM sample: 71.2 ± 8.2 years, BMI: 29.5 ± 5.9) and n = 65 participants without diabetes (non-T2DM sample: 68.7 ± 5.6 years, BMI: 33.7 ± 4.9) were included in these analyses. In the T2DM sample, when controlled for age, gender, and appendicular lean mass index, adherence to a MedDiet was inversely associated with BMI, fat mass, and percent body fat. However, this was no longer maintained in the fully adjusted models. Although, adherence to a MedDiet was positively associated with gait speed (β = 0.155; p = 0.050) independent of all covariates used. Adherence to a MedDiet may be a suitable dietary strategy for preserving lower body physical function in middle-aged and older adults with T2DM. However, these findings should be further investigated using well-designed randomised controlled trials and prospective cohort studies with a wider range of adherence scores to investigate temporal associations.
Highlights
With improved life expectancy in an ageing population, the preservation of musculoskeletal health in later life has become increasingly important [1]
Age-related changes in body composition are unfavourable from a metabolic perspective, with evidence suggesting that additional body fat and reduced muscle mass may contribute to the development of cardiometabolic diseases, including type 2 diabetes mellitus (T2DM) [6,7,8,9]
We showed that adherence to a Mediterranean diet (MedDiet) was not associated with body mass index (BMI) and measures of adiposity in the fully adjusted models used in the present study
Summary
With improved life expectancy in an ageing population, the preservation of musculoskeletal health in later life has become increasingly important [1]. Age-related changes in body composition are unfavourable from a metabolic perspective, with evidence suggesting that additional body fat and reduced muscle mass may contribute to the development of cardiometabolic diseases, including type 2 diabetes mellitus (T2DM) [6,7,8,9]. This is potentially a bidirectional relationship, as the loss of lean body mass, strength, and function is proposed to be accelerated in T2DM [10,11,12] due to underlying pathological mechanisms of insulin resistance, hyperglycaemia, inflammation, and oxidative stress [13]. Given that secular trends in diabetes incidence are forecasted to increase in the coming decades [16], strategies to attenuate adiposity and musculoskeletal decline in middle-aged and older adults with T2DM is warranted
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
