Article Dietary Patterns and Risk of Frailty in Chinese Community-Dwelling Older People in Hong Kong: A Prospective Cohort Study (original) (raw)
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Nutrients, 2015
Dietary pattern analysis is an emerging approach to investigate the association between diet and frailty. This study examined the association of dietary patterns with frailty in 2724 Chinese community-dwelling men and women aged ě 65 years. Baseline dietary data were collected using a food frequency questionnaire between 2001 and 2003. Adherence to a priori dietary patterns, including the Diet Quality Index-International (DQI-I) and the Mediterranean Diet Score (MDS) was assessed. Factor analysis identified three a posteriori dietary patterns, namely "vegetables-fruits", "snacks-drinks-milk products", and "meat-fish". Incident frailty was defined using the FRAIL scale. Binary logistic regression was applied to examine the associations between dietary patterns and four-year incident frailty. There were 31 (1.1%) incident frailty cases at four years. Every 10-unit increase in DQI-I was associated with 41% reduced risk of frailty in the sex-and age-adjusted model (odds ratio (OR) (95% confidence interval (CI)): 0.59 (0.42-0.85), p = 0.004). The association attenuated in the multivariate adjusted model (0.69 (0.47-1.02), p = 0.056). No association between other dietary patterns and incident frailty was observed. Our study showed that a better diet quality as characterized by higher DQI-I was associated with lower odds of developing frailty. The contribution of MDS or a posteriori dietary patterns to the development of frailty in Chinese older people remains to be explored.
Major dietary patterns and risk of frailty in older adults: a prospective cohort study
BMC Medicine, 2015
Background: There 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. Methods: This 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). Results: Over 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. Conclusions: In 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.
Nutrition, sarcopenia and frailty: An Asian perspective
Translational Medicine of Aging, 2019
Despite a growing body of evidence that nutrition plays a key role in the pathophysiology, prevention and intervention programs of frailty and sarcopenia, as well as in promoting brain health, the awareness and the need to study the relationship between nutrition and functional goals of healthy ageing have not received as much attention or support from research or policy makers. This review reports on the state of knowledge relating to availability of nutrition survey data for older people relating to prevalence of frailty and sarcopenia in Asia, using data from Netherlands for comparison. Data were obtained from a meeting of a group of nutrition experts from Asia supplemented by literature search using key terms of nutrition, frailty, and sarcopenia. Although nutrition surveys may be carried out regularly in several countries, surveys are mainly carried out for the general adult population rather than specifically among the elderly population, and little data is available relating to the impact of nutrition on sarcopenia and frailty. There is an urgent need for more nutritional data relating to maintaining function with age as opposed to disease prevention, to guide health promotion policies and clinical management of increasingly older population and patients. A shift in the gathering of national nutrition data may need to include such functional measurements in relation to older people, as the latter forms the rapidly growing sector of ageing populations worldwide .
Nutrients
There are few studies on dietary patterns and frailty in Asians, and the results are controversial. Therefore, this study examined the association between dietary patterns and frailty in older Korean adults using the Korean Frailty and Aging Cohort Study (KFACS). The sample consisted of 511 subjects, aged 70–84 years, community-dwelling older people from the KFACS. Dietary data were obtained from the baseline study (2016–2017) using two nonconsecutive 24-h dietary recalls, and dietary patterns were extracted using reduced rank regression. Frailty was measured by a modified version of the Fried Frailty Phenotype (FFP) in both the baseline (2016) and the first follow-up study (2018). A logistic regression analysis was used to examine the association between dietary patterns and frailty status in 2018. The “meat, fish, and vegetables” pattern was inversely associated with pre-frailty (OR = 0.41, 95% CI = 0.21–0.81, p for trend = 0.009) and exhaustion (OR = 0.41, 95% CI = 0.20–0.85, p f...
Dietary Patterns and Their Relationship with Frailty in Functionally Independent Older Adults
Nutrients, 2018
The impact of dietary patterns rather than single foods or nutrients on health outcomes is increasingly recognized. This cross-sectional study examines the dietary patterns of 527 non-institutionalized functionally independent older people aged ≥70 years from Gipuzkoa (Spain). Sociodemographic characteristics, health status, anthropometric measures and dietary data are collected. Multiple correspondence analysis (MCA) and cluster analysis are performed to identify dietary patterns and groups of individuals. Frequency of selected food items and compliance with food recommendations are included in the MCA. A high proportion of the sample population are overweight or obese, whereas only 3.3% are at risk of malnutrition (determined with the Mini Nutritional Assessment). Frail individuals (n = 130), measured with the Timed-Up and Go test are older, have a lower educational level, are more obese, present a poorer health status (more depressive symptoms, polypharmacy and falls, among others) and worse compliance with food recommendations than robust individuals (n = 392). Three groups of individuals are identified: cluster one (n = 285), cluster two (n = 194) and cluster three (n = 48). A gradient of increasing frailty and poorer health status is observed from cluster one to cluster three. The latter also shows the poorest dietary pattern, regarding dietary recommendations. The use of an easy-to-use tool to assess diet allows detection of differences among the three clusters. There is a need to increase awareness on the implementation of nutritional screening and a subsequent dietary assessment in primary care settings to provide nutritional care to elder, and moreover, frail individuals.
Nutrition and Frailty: Opportunities for Prevention and Treatment
Nutrients
Frailty is a syndrome of growing importance given the global ageing population. While frailty is a multifactorial process, poor nutritional status is considered a key contributor to its pathophysiology. As nutrition is a modifiable risk factor for frailty, strategies to prevent and treat frailty should consider dietary change. Observational evidence linking nutrition with frailty appears most robust for dietary quality: for example, dietary patterns such as the Mediterranean diet appear to be protective. In addition, research on specific foods, such as a higher consumption of fruit and vegetables and lower consumption of ultra-processed foods are consistent, with healthier profiles linked to lower frailty risk. Few dietary intervention studies have been conducted to date, although a growing number of trials that combine supplementation with exercise training suggest a multi-domain approach may be more effective. This review is based on an interdisciplinary workshop, held in November...
Journal of Nutritional Science
Disease-related malnutrition is prevalent among older adults; therefore, identifying the modifiable risk factors in the diet is essential for the prevention and management of disease-related malnutrition. The present study examined the cross-sectional association between dietary patterns and malnutrition in Chinese community-dwelling older adults aged ≥65 years in Hong Kong. Dietary patterns, including Diet Quality Index International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score, ‘vegetable–fruit’ pattern, ‘snack–drink–milk product’ pattern and ‘meat–fish’ pattern, were estimated and generated from a validated food frequency questionnaire. Malnutrition was classified according to the modified Global Leadership Initiative on Malnutrition (GLIM) criteria based on two phenotypic components (low body mass index and reduced muscle mass) and one aetiologic component (inflammation/disease burden). The association between the tertile or level of adhe...
Nutrients
This study aims to investigate whether frailty severity in conjunction with cognitive function, termed as” cognitive frailty”, is associated with dietary diversity in older adults. This cross-sectional study used the data from the 2014–2016 Nutrition and Health Survey in Taiwan (N = 1115; age ≥ 65 years). Dietary intake was assessed using a 24 h dietary recall and food-frequency questionnaire, and dietary diversity score (DDS; range, 0–6) and food intake frequency were calculated. The presence of frailty phenotypes was determined using the FRAIL scale, which was proposed by the International Association of Nutrition and Aging, and cognitive function was assessed using the Mini–Mental State Examination (MMSE) score. The prevalence of cognitive frailty (FRAIL scale score ≥ 3 and MMSE score ≤ 26) was 4.2%. A higher consumption frequency of dairy products, whole grains, vegetables, fruit, fish and seafood, nuts, tea, and coffee, as well as lower pickled vegetable, was inversely associat...
Novel Healthy Eating Index to Examine Daily Food Guides Adherence and Frailty in Older Taiwanese
Nutrients, 2021
This study was conducted to investigate the adherence of Daily Food Guides (DFGs) among older Taiwanese, and the relationship of dietary quality and frailty. 154 functional independent older adults who were retirement home residents or community dwellers involved in congregate meal services were recruited. DFGs adherence was measured using a novel Taiwanese Healthy Index (T-HEI). Dietary quality was further assessed using Dietary Approach to Stop Hypertension (DASH) and Mediterranean Diet Score (MDS). Frailty was defined using modified Fried’s criteria. Of the total participants, 12.3% were considered non-frail individuals, while 77.3% were prefrail, and 10.4% were frail. Compared to non-frail participants, prefrail and frail individuals indicated significantly lower adherence to DFGs (ptrend = 0.025). Intake of dark or orange vegetables (ptrend = 0.010), whole grains (ptrend = 0.007), as well as nuts and seeds (ptrend = 0.029) by non-frail individuals were significantly higher than...
A Prospective Investigation of Dietary Intake and Functional Impairments among the Elderly
American journal of epidemiology, 2018
Limited information is available in Asian populations regarding the association of dietary intake and patterns with age-related functional impairments. Using data from two population-based cohort studies, the Shanghai Women's Health Study (1996-2015) and Shanghai Men's Health Study (2002-2015), we prospectively examined adherence to dietary guidelines, including the Chinese Food Pagoda, the Dietary Approaches to Stop Hypertension and the Alternative Healthy Eating Index, as well as specific food consumption, for their associations with impairment in function, both physical (walking, hearing/vision) and mental (memory, decision-making). Included in the analyses were 30,484 participants who had been followed up for an average of 14.4 years and were between the ages of 70 and 86 at the functional status assessment. Higher dietary recommendation adherence scores were associated with a lower likelihood of developing functional impairments. The odds ratios ranged from 0.61 (95% co...