Dairy Food Intake Is Not Associated With Frailty or Frailty Progression Over Time in Adults: Framingham Offspring Study

Abstract

Abstract Objectives High-fat dairy foods are calorically dense, which may prevent anorexia and malnutrition that are often seen in frail persons. We determined the association of dairy food intake [milk, yogurt, cheese, total dairy (milk + yogurt + cheese), low-fat, and high-fat dairy, serv/wk] with frailty and frailty progression in older adults from the Framingham Offspring study. Methods This prospective cohort study included non-frail participants at index exam (1998–01) with food frequency questionnaires (FFQ) and ≤2 follow-up frailty assessments (2005–08, 2011–14). Average dairy food intakes were calculated from index and prior FFQs (1998–01 and 1995–98). Fried's frailty phenotype was used: presence of ≥3 criteria of unintentional weight loss, exhaustion, slow gait speed, low physical activity, and low grip strength. Frailty progression was defined as an increased number of frailty criteria over follow-up. Repeated measures logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for frailty and frailty progression (separate models) adjusting for age, sex, energy intake (residual analysis), current smoking, multivitamin use, and self-reported health status. Results Mean baseline age was 60y ± 9 (range 33–86 y) and 45% were female. Mean dairy food intakes [serv/wk] were: 5.7 ± 5 (milk), 1.1 ± 1.9 (yogurt), 2.8 ± 3.0 (cheese), 9.6 ± 6.9 (total dairy), 6.2 ± 6.0 (low-fat dairy), and 4.5 ± 4.3 (high-fat dairy). Of the 2550 non-frail individuals at baseline, 8.8% (2005–08) and 13.5% (2011–14) became frail over time. Frailty progression was seen in 34% (2005–08) and 40% (2011–14) of the participants. In age and sex adjusted models, high-fat dairy foods were associated with 2% increased odds of frailty (95%CI: 1.00–1.04, P = 0.01). This association did not change after further adjustment (OR: 1.02, 95%CI: 0.99–1.05, P = 0.07). Other dairy foods were not associated with frailty (P range: 0.23–0.78) or with frailty progression (P range: 0.32–0.86). Conclusions In this study of healthy older adults, most dairy food intake was not associated with frailty or frailty progression after considering important covariables. The observed trend for slightly increased odds of frailty with high-fat dairy intake should be re-examined in other studies with frailty assessed over time. Funding Sources Boston Pepper Center OAIC, NHLBI & Dairy Management Inc.