A 3-year prospective cohort study of dietary patterns and frailty risk among community-dwelling older adults

Chi Hsien Huang; Beatriz Arakawa Martins; Kiwako Okada; Eiji Matsushita; Chiharu Uno; Shosuke Satake; Masafumi Kuzuya

doi:10.1016/j.clnu.2020.05.013

A 3-year prospective cohort study of dietary patterns and frailty risk among community-dwelling older adults

Clin Nutr. 2021 Jan;40(1):229-236. doi: 10.1016/j.clnu.2020.05.013. Epub 2020 May 19.

Authors

Chi Hsien Huang¹, Beatriz Arakawa Martins², Kiwako Okada³, Eiji Matsushita³, Chiharu Uno⁴, Shosuke Satake⁵, Masafumi Kuzuya⁶

Affiliations

¹ Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi Prefecture, Japan; Department of Family Medicine, E-Da Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan, ROC; School of Medicine for International Students, College of Medicine, I-Shou University, No.8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City, 82445, Taiwan, ROC; Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya, Aichi Prefecture, Japan.
² Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi Prefecture, Japan; Adelaide Geriatrics Training and Research with Aged Care (G-TRAC Centre), Discipline of Medicine, Adelaide Medical School, University of Adelaide, 61 Silkes Rd, Paradise, SA, 5075 Australia; National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, The University of Adelaide, SA, 5005 Australia.
³ Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Takenoyama-57, Iwasakicho, Nisshin, Aichi Prefecture, Japan.
⁴ Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Takenoyama-57, Iwasakicho, Nisshin, Aichi Prefecture, Japan; Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya, Aichi Prefecture, Japan.
⁵ Section of Frailty Prevention, Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, Japan.
⁶ Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi Prefecture, Japan; Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya, Aichi Prefecture, Japan. Electronic address: kuzuya@med.nagoya-u.ac.jp.

PMID: 32507582
DOI: 10.1016/j.clnu.2020.05.013

Abstract

Background & aims: The association between dietary patterns and frailty is less investigated in Asia. We aimed to investigate the prospective associations between dietary patterns and frailty index (FI) in community-dwelling Japanese older adults aged 60 years or older.

Methods: A 3-year cohort collected the data on sociodemographic information, lifestyle behaviors, comorbidities, medication history, depression status, nutrition, and physical function from 2014 to 2017. Five dietary patterns including "Mediterranean-style," "sugar and fat," "salt and pickles," "noodle and alcohol," and "protein-rich" dietary patterns were identified using principal component analysis from 20 food groups obtained using a validated food frequency questionnaire. A 54-item FI was constructed on the basis of a deficit accumulation model. This project aimed to investigate the longitudinal association between dietary pattern and frailty trajectories with annual measurements over a 3-year period using a generalized estimating equation.

Result: After excluding 108 participants with incomplete data at baseline, 666 participants (56.5% female, 69.4 ± 4.4 years) were included for longitudinal analysis. Our results demonstrated that adherence score to "sugar and fat" dietary pattern" (Q4 vs. Q1: mean difference [0.017], 95% CI [0.006 to 0.029]) and "salt and pickles" dietary pattern (Q3 vs. Q1: mean difference [0.010], 95% CI [0.001 to 0.020]; Q4 vs. Q1: mean difference [0.014], 95% CI [0.003 to 0.025]) were positively associated with change in FI. Adherence score to a "protein-rich" dietary pattern was negatively associated with change in FI (Q4 vs. Q1: mean difference [-0.013], 95% CI [-0.025 to -0.002]).

Conclusions: "Salt and pickles" dietary pattern and "sugar and fat" dietary pattern were positively associated with frailty. In contrast, "protein-rich" dietary pattern was negatively associated with frailty.

Keywords: Dietary pattern; Frailty; Longitudinal study; Pickles; Salt.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Diet / adverse effects
Diet / statistics & numerical data*
Diet Surveys
Elder Nutritional Physiological Phenomena
Exercise
Feeding Behavior
Female
Frail Elderly / statistics & numerical data*
Frailty / etiology*
Geriatric Assessment*
Humans
Independent Living / statistics & numerical data*
Japan
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Risk Assessment
Surveys and Questionnaires