Total Carotenoid Intake Reduces the Odds of Frailty over 9 Years in Older Adults: Results from the Framingham Offspring Study

Abstract

Abstract Objectives Frailty occurs in 10–15% of community-living older adults. The benefit of a Mediterranean style diet in reducing frailty is not well established in older Americans. The aim was to determine the association of Mediterranean-Style Dietary Pattern and related antioxidants (vitamin C, E and total carotenoids from diet and supplements) with the odds of frailty over 9y in older adults from the Framingham Offspring study. Methods The Mediterranean-style dietary pattern score (MSDPS) was used to characterize a Mediterranean-style diet in 2541 men and women with completed food frequency questionnaires at baseline (1998–2001). Average intake of each antioxidant (vitamin C, E and total carotenoids, mg/d) at baseline and one prior exam (1995–98) was calculated. Total carotenoids were calculated as the sum of intake of α-carotene, β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin. Frailty was assessed using Fried's frailty criteria at baseline and follow-up exam (2005–08). Participants categorized as frail at baseline were excluded (n = 27). Logistic regression was used to calculate odds ratios and 95% confidence intervals (95% CI) adjusting for age, sex, follow-up time, BMI, energy intake, current smoking and multivitamin use. Antioxidants were adjusted for each other in the same model. Results Mean age (±SD) was 60 ± 9y (range 33–86), 55% were female and mean follow-up time was 6.6y (range 3.7–9.1). Mean (±SD) was 45 ± 13 (range: 10.8–84.1) for the MSDPS, 36.5 (±32.3) mg/d for vitamin C, 16.4 (±199) mg/d for vitamin E and 1.8 (±0.8) mg/d for carotenoids. Prevalent frailty at follow-up exam was 5%. Although not significant, a 10 unit increase in MSDPS reduced the odds of frailty by 8.7% (95% CI: 0.78–1.08, P = 0.28) in the combined sample of men and women. Each 10 mg increase in total carotenoid intake reduced the odds of frailty by 29% (95% CI: 0.53–1.01, P = 0.02). Neither Vitamin C (P = 0.79) or E (P = 0.25) were individually associated with frailty. Conclusions A Mediterranean style diet was not significantly associated with frailty in this sample of largely older adults. However, total carotenoids intake reduced the odds of frailty. Future work should consider if a Mediterranean style diet and related antioxidants delay the progression of frailty. Funding Sources Boston Claude D. Pepper Center OAIC and Peter and Barbara Sidel Fund.