Frailty and Diet

Eat Better to avoid frailty

More protein, less added sugar

Frailty reflects health deficits, including cardiovascular disease, some cancers, and dementia, that accumulate over time. Might people who Eat Better reduce their risk of frailty? Researchers at University College London conducted a systematic review and meta-analysis of four relevant studies. They included longitudinal studies with 5,789 older people living in France, Spain, Italy, and China. The Mediterranean Diet Score (on a scale from 0-9) measured adherence to the Mediterranean diet. Greater consumption of fruits, vegetables, legumes, nuts, cereals, fish, and olive oil lead to high (healthier) scores. Compared to persons with scores of 0-3 (low adherence), persons with scores of 4-5 (medium adherence) and 6-9 (high adherence) had significant 18 and 35 percent lower risks of developing frailty over an average follow-up of 3.9 years. Eating a Mediterranean diet predicts better health, including lower risk of frailty.

Frailty leads to diminished ability to function effectively in the world. Characteristics include low grip strength, low energy, slowed waking speed, low physical activity, and unintentional weight loss. Frailty arises from several causes, possibly including inadequate dietary protein. A recent systematic review and meta-analysis evaluated whether the level of dietary protein intake predicted lower risk of frailty. Seven cross-sectional and three longitudinal studies passed the criteria for inclusion. Pooled data from four of the cross-sectional studies showed that high protein intake predicted a 33 percent lower risk of frailty.

Health authorities encourage us to eat less added sugar. Alas, 65 percent of older adults consume more than 10 percent of their daily calories as sugar-sweetened beverages. Researchers at Harvard and in Spain wondered if increased consumption of sugar-sweetened beverages predicted increased risk of frailty. The study used data from 71,935 older female nurses enrolled in the Nurses’ Health Study with an average age of 63 years at baseline. Participants were classified as frail if they had at least 3 of the 5 conditions from the FRAIL scale. A healthy diet reflected higher scores (ranging from 0-10) in a modified version of the Alternate Healthy Eating Index. Compared to women in the lowest category of sugar-sweetened beverage intake (never or almost never), the risk of frailty of women in the highest category (two or more standard-sized beverages per day) increased by 12 percent for each daily serving. This result reflected adjustment for potentially confounding factors such as diet quality, body-mass index, and smoking. Each additional daily serving of artificially sweetened beverages increased frailty risk by 9 percent. Interestingly, each serving of orange juice consumption predicted a significant 11 percent decline in risk of frailty.

The researchers at Harvard and in Spain also evaluated three other widely recommended diets. They included the alternate Mediterranean diet (AMED), the Dietary Approaches to Stop Hypertension (DASH) diet, and the alternate Healthy Eating Index-2010 (AHEI-2010). Would higher scores for these diets predict reduced risk of frailty among older women? Participants again included 71,941 women 60 or more years old in the Nurses’ Health Study. Frailty was scored using the FRAIL scale. During follow-up, 11,564 participants became frail. The relative risk of becoming fail declined by 13, 7, and 10 percent for each one standard deviation increase in AMED, DASH, and AHEI-2010 scores respectively. All four diet quality scores predicted lower risk of the following individual frailty criteria: fatigue, reduced resistance, reduced aerobic capacity, and weight loss. Lower intakes of red and processed meat and sodium, increased intake of vegetables and moderate alcohol, and a higher ratio of monounsaturated to saturated fat independently predicted lower risk of frailty.

Eat Better and reduce your risk of frailty.

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