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Clin Nutr. 2018 Oct;37(5):1492-1497. doi: 10.1016/j.clnu.2017.08.028. Epub 2017 Sep 4.

Adherence to a Mediterranean diet is associated with lower incidence of frailty: A longitudinal cohort study.

Author information

1
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; Laboratory of Nutritional Biochemistry, Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy. Electronic address: ilmannato@gmail.com.
2
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, De Crespigny Park, London SE5 8AF, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, United Kingdom.
3
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.
4
Laboratory of Nutritional Biochemistry, Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, Bari, Italy; Department of Neurosciences, University of Padova, Padova, Italy; National Health Care System, Padova Local Unit ULSS 17, Italy.
5
Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
6
Primary Care Department, Azienda ULSS20 Verona, Verona, Italy.
7
Primary Care Department, Azienda USL Toscana Sud Est, Grosseto, Italy.

Abstract

BACKGROUND & AIMS:

There is a paucity of data investigating the relationship between the Mediterranean diet and frailty, with no data among North American people. We aimed to investigate if adherence to a Mediterranean diet is associated with a lower incidence of frailty in a large cohort of North American people.

METHODS:

This study included subjects at higher risk or having knee osteoarthritis. Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED) as proposed by Panagiotakos and classified into five categories. Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of ≥2 out of: (i) weight loss ≥5% between baseline and the subsequent follow-up visit; (ii) inability to do five chair stands; (iii) low energy level.

RESULTS:

During the 8 years follow-up, of the 4421 participants initially included (mean age: 61.2 years, % of females = 58.0), the incidence of frailty was approximately half in those with a higher adherence to the Mediterranean diet (8 for 1000 person years) vs. those with a lower adherence (15 for 1000 persons-years). After adjusting for 10 potential confounders (age, sex, race, body mass index, education, smoking habits, yearly income, physical activity level, Charlson co-morbidity index and daily energy intake), participants with the highest aMED scores were found to have a significant reduction in incident frailty (hazard ratio = 0.71; 95% CIs: 0.50-0.99, p = 0.047) with respect to those in a lower category. Regarding individual components of the Mediterranean diet, low consumption of poultry was found to be associated with higher risk of frailty.

CONCLUSIONS:

A higher adherence to a Mediterranean diet was associated with a lower incidence of frailty over an 8-year follow-up period, even after adjusting for potential confounders.

KEYWORDS:

Frailty; Mediterranean diet; Older people; Osteoarthritis initiative

PMID:
28918168
PMCID:
PMC5835189
[Available on 2019-10-01]
DOI:
10.1016/j.clnu.2017.08.028

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