Abstract
Background:
The benefit of a Mediterranean-style diet in reducing frailty is not well established in older Americans.
Objective:
To determine associations of a Mediterranean-style dietary pattern and related antioxidants with frailty onset and worsening of the Fried Phenotype in adults.
Design and methods:
This prospective study included 2,384 non-frail adults from the Framingham Offspring Study with Mediterranean-style dietary pattern score (MSDPS) and antioxidant intakes [vitamin C, E, and total carotenoids] estimated from a food frequency questionnaire (FFQ) at the index examination (1998-2001) and one prior examination (if available), and frailty assessment at the index examination and at least 1 follow-up. Frailty onset was defined as ≥3 of 5 Fried Phenotype criteria at follow-up and the worsening of the Fried Frailty Phenotype as an increased number of frailty criteria over follow-up (yes/no). Logistic regression with generalized estimating equations (GEE) estimated odds ratios (OR) and 95% confidence intervals (95%CI) adjusting for confounders. Analyses were stratified (age <60 and ≥60y) for significant interactions.
Results:
Mean±SD age was 60±9y (range 33-86); 55% were female. In adjusted models, a 1-unit higher MSDPS reduced the odds of frailty by 3% [OR (95%CI): 0.97 (0.96, 0.99)]. Each 10-mg higher total carotenoid and vitamin E intake reduced the odds of frailty by 16% [OR (95%CI): 0.84 (0.73, 0.98)] and 1% [OR (95%CI): 0.99 (0.98, 1.00)], respectively. No association with vitamin C (P=0.36) was observed. The associations among participants aged <60y of age were stronger for each 1-unit higher MSDPS [OR (95%CI): 0.93 (0.89, 0.96)] and total carotenoids [OR (95%CI): 0.59 (0.41, 0.82)] than those observed in older individuals [OR (95%CI): 0.98 (0.97, 1.00) and 0.92 (0.79, 1.08)] MSDP and total carotenoids, respectively.
Conclusions:
Our findings suggest that adherence to a Mediterranean-style diet and higher total carotenoid intake is associated with frailty prevention over time, particularly in adults <60y.
Full text
