Nicola Veronese1, Brendon Stubbs2, Marianna Noale3, Marco Solmi4, Renè Rizzoli5, Alberto Vaona6, Jacopo Demurtas7, Gaetano Crepaldi3, Stefania Maggi3. 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.
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.
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