Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study.

Misato Hayakawa,Hunkyung Kim,Kaori Yamamoto,Shoji Shinkai,Maki Shirobe,Hiroki Inagaki,Yutaka Watanabe,Motonaga Kojima,Ayako Edahiro,Shuichi Awata,Masanori Iwasaki,Hisashi Kawai,Hirohiko Hirano,Yuki Ohara,Atsushi Araki,Shuichi Obuchi,Kazushige Ihara,Yoshinori Fujiwara,Köiti Motokawa ,Yoshiki Mikami

doi:10.3390/nu13020641

Abstract

The association between dietary diversity and frailty remains unknown in older people. We evaluated whether a limited dietary variety is associated with frailty in older adults with diabetes mellitus (DM). This cross-sectional investigation included 1357 adults (median age: 77 years, women: 61.3%). DM was determined by self-reporting, the Dietary Variety Score (DVS) was used to evaluate dietary variety, and the revised Japanese version of the Cardiovascular Health Study criteria evaluated frailty. Participants were divided into 4 groups: no DM/high DVS (non-DMHV), no DM/low DVS (non-DMLV), DM/high DVS (DMHV), and DM/low DVS (DMLV). The prevalence of frailty in each group was 3.6%, 6.7%, 6.7%, and 12.2%. After adjusting for covariates, logistic regression analysis revealed the highest odds ratio (OR) of frailty in the DMLV (non-DMLV, OR = 2.18 (95% confidence interval (CI): 1.25–3.83); DMHV, OR = 1.87 (95% CI: 0.63–5.52); DML, OR = 5.03 (95% CI: 2.05–12.35)). Another logistic regression analysis revealed that a low DVS and DM were independently associated with frailty. Both a low dietary variety and DM were independently related to frailty in older people and the combination increased the prevalence of frailty. These findings suggest that high dietary variety could be important for the prevention of frailty in people with DM.

Highlights

As the population aging rate continues to increase, it is of the utmost importance to prevent disability and extend healthy life expectancy
Hyperglycemia [10,11], hypoglycemia [12], low hemoglobin A1c (HbA1c) [13], hyperlipidemia [11], abdominal obesity [11], macrovascular complications [14], and low levels of physical activity [11] are associated with frailty, few studies have been conducted on the role of nutrition in the increased risk of frailty in older individuals with diabetes mellitus (DM)
The median body mass index (BMI), Dietary Variety Score (DVS), serum creatinine, and HbA1c, and the prevalence of sex, alcohol consumption, a past history of hypertension, heart disease, hyperlipidemia, and osteoporosis were significantly different among the 4 groups

Summary

Introduction

As the population aging rate continues to increase, it is of the utmost importance to prevent disability and extend healthy life expectancy. Frailty is defined as being vulnerable to falls, disability, hospitalization, and mortality after a stressor event due to the age-related loss of functional reserve. Appropriate interventions, such as diet and exercise, can improve the condition of people with frailty, as it is reversible [1]. National prevalence of frailty in the older Japanese population is reported to be 8.7% [2]. Hyperglycemia [10,11], hypoglycemia [12], low hemoglobin A1c (HbA1c) [13], hyperlipidemia [11], abdominal obesity [11], macrovascular complications [14], and low levels of physical activity [11] are associated with frailty, few studies have been conducted on the role of nutrition in the increased risk of frailty in older individuals with DM. Malnutrition associated with comorbidities in old age and the overly strict dietary management of DM may lead to frailty

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