Abstract
BackgroundThere is emerging evidence of the role of certain nutrients as risk factors for frailty. However, people eat food, rather than nutrients, and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults.MethodsThis is a prospective cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010. At baseline, food consumption was obtained with a validated diet history and, by using factor analysis, two dietary patterns were identified: a ‘prudent’ pattern, characterized by high intake of olive oil and vegetables, and a ‘Westernized’ pattern, with a high intake of refined bread, whole dairy products, and red and processed meat, as well as low consumption of fruit and vegetables. Participants were followed-up until 2012 to assess incident frailty, defined as at least three of the five Fried criteria (exhaustion, weakness, low physical activity, slow walking speed, and unintentional weight loss).ResultsOver a 3.5-year follow-up, 96 cases of incident frailty were ascertained. The multivariate odds ratios (95% confidence interval) of frailty among those in the first (lowest), second, and third tertile of adherence to the prudent dietary pattern were 1, 0.64 (0.37–1.12), and 0.40 (0.2–0.81), respectively; P-trend = 0.009. The corresponding values for the Westernized pattern were 1, 1.53 (0.85–2.75), and 1.61 (0.85–3.03); P-trend = 0.14. Moreover, a greater adherence to the Westernized pattern was associated with an increasing risk of slow walking speed and weight loss.ConclusionsIn older adults, a prudent dietary pattern showed an inverse dose-response relationship with the risk of frailty while a Westernized pattern had a direct relationship with some of their components. Clinical trials should test whether a prudent pattern is effective in preventing or delaying frailty.
Highlights
There is emerging evidence of the role of certain nutrients as risk factors for frailty
Compared to individuals in the first tertile of the prudent’ pattern (PP), those in the third tertile were younger, had a higher energy intake, and there was a lower percentage of smokers, persons diagnosed with diabetes or depression, and with limitations in instrumental activities of daily living (IADL); there was a higher percentage of individuals with Body mass index (BMI) ≥30 kg/m2 and reporting osteomuscular disease
Our results show that adherence to a PP, characterized by high intake of olive oil and vegetables, had an inverse dose-response relationship with frailty; in contrast, an increasing adherence to the Westernized’ pattern (WP), characterized by high intake of refined cereals, whole dairy, and red and processed meat, was associated with increased the risk of slow walking speed and weight loss
Summary
There is emerging evidence of the role of certain nutrients as risk factors for frailty. People eat food, rather than nutrients, and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults. Frailty is a medical syndrome resulting from age-associated impairments in several physiological systems. This syndrome is characterized by a high vulnerability to even minor environmental stressors (e.g., a minor infection), which leads to increased risk of disability, dependency, need for long-term care, and mortality [1]. Given the elevated prevalence of this syndrome [2,3] and its serious consequences, there is substantial interest in the identification of Emerging evidence suggests that low intake of certain micronutrients and protein could be a risk factor for frailty [6,7]. The investigation of dietary patterns can complement the study of individual nutrients and overcome its potential limitations [8]
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