Greater adherence to a Mediterranean Diet is associated with better gait speed in older adults with type 2 diabetes mellitus

Abstract

Background & aims: Older adults with type 2 diabetes mellitus (T2DM) are vulnerable to the physical frailty phenotype. Adherence to a Mediterranean Diet (MedDiet) is emerging as a potential dietary strategy to attenuate physical disability with age. This cross-sectional analysis aimed to explore the association between adherence to a MedDiet and characteristics of the physical frailty phenotype in older adults with T2DM.

Methods: Adherence to a MedDiet was assessed using two dietary adherence tools: [1] alternate Mediterranean Food Score (MED); [2] Mediterranean Diet Adherence Screener (MEDAS). The short physical performance battery (SPPB) and gait speed was used to evaluate lower extremity physical function. Frailty was defined as having three of the following: exhaustion, low muscle strength, low physical activity, slow gait speed, and weight loss. Multiple regression analysis was used to summarise associations between dietary adherence, SPPB score, gait speed and muscle strength adjusted for age, physical activity and time since T2DM diagnosis.

Results: A total of n = 87 participants (71.2 ± 8.2 years) were included. A total of n = 6 (∼7%) and n = 32 (∼37%) participants were identified as frail and pre-frail respectively. After adjustment for age, physical activity and time since T2DM diagnosis, greater adherence to a MedDiet, using both adherence tools, was significantly associated with better gait speed (MED: β = 0.365; P = 0.002; MEDAS: β = 0.313; P = 0.007). When assessing the individual dietary elements included in the MED score, fish and seafood consumption was the single significant contributor to better gait speed (β = 0.229; P = 0.05). Nil associations were observed when assessing adherence against muscle strength.

Conclusions: Greater adherence to a MedDiet was associated with better lower extremity physical performance in older adults with T2DM. Future studies should investigate the efficacy of a MedDiet intervention for attenuation of physical frailty characteristics in older adults with T2DM.

Keywords: Mediterranean Diet; Physical frailty; Physical performance; Type 2 diabetes mellitus.