Consumption of Coffee, Tea, and Caffeine at Midlife, and the Risk of Physical Frailty in Late Life

The impact of lifestyle factors across the life course on sarcopenia and physical frailty

PURPOSE OF REVIEW

Muscle health helps maintain locomotor capacity, a key component of intrinsic capacity, which is required for healthy ageing. Sarcopenia is characterized by the age-related decline in muscle mass and strength leading to impaired physical performance, and has been described as a biological substrate of physical frailty. Both sarcopenia and physical frailty share phenotypic features of weakness and slowness, lead to common adverse outcomes, and have potential for reversal through early identification and intervention. The purpose of this review is to present recent evidence for the impact of lifestyle interventions across the life course on sarcopenia and physical frailty.

RECENT FINDINGS

Resistance exercise alone or combined with balance and aerobic training as part of a multicomponent exercise program and high-quality diets incorporating adequate protein remain the mainstay of treatment for sarcopenia and physical frailty. Reducing sedentary time and increasing physical activity, adherence to Mediterranean diet, increasing vegetable and caffeinated beverage intake, cardiovascular risk factor modification, improving sleep hygiene and depressive symptoms may also contribute to slowing down age-related decline in muscle health.

SUMMARY

Lifestyle interventions such as physical activity, diet, sleep and mental health are effective against sarcopenia and physical frailty. Targeting lifestyle modifications in early to midlife may retard further decline in locomotor capacity and optimize intrinsic capacity of older persons, reducing the risk of sarcopenia, physical frailty and their attendant negative health outcomes.

Habitual coffee consumption and risk of frailty in later life: the Longitudinal Aging Study Amsterdam (LASA)

This study examined associations of current habitual and midlife coffee consumption with risk of (pre-)frailty in 1161 community-dwelling older adults (≥ 55 years) participating in the Longitudinal Aging Study Amsterdam.Habitual and retrospectively assessed midlife (ages 40-65) coffee consumption was measured using questionnaires and divided into five categories (no coffee, > 0-2, > 2-4, > 4-6, > 6 cups/day). Frailty status was assessed using Fried's five-component frailty phenotype. Generalized estimating equations, Cox proportional hazards models, and logistic regression analyses were performed to assess the associations of coffee consumption with frailty and pre-frailty prevalence, and the 3- and 7-year incidence of (pre)frailty.Habitual coffee consumption of > 4-6 and > 6 cups/day was associated with lower odds of frailty compared with consumption of > 0-2 cups/day (ORs (95%CI) of 0.36 (0.16-0.82) and 0.37 (0.16-0.84), respectively). Similar but statistically non-significant associations were found for coffee consumption during midlife and between habitual coffee consumption and the 3- and 7-year incidence of frailty, except for a statistically significant lower hazard (HR: 0.41 [95%CI 0.23-0.71]) of frailty after 7 years for the consumption of > 2-4 cups/day compared to > 0-2 cups/day. No associations were found between coffee consumption and pre-frailty, with the exception of lower odds for those who consumed > 2-4 cups/day compared to > 0-2 cups/day (OR 0.73 [95%CI 0.54-0.99])The results of this study indicate that higher habitual coffee consumption is associated with lower odds of frailty. Further research is needed to confirm our findings and investigate possible underlying mechanisms by which coffee might influence frailty development.

The causal association between plasma caffeine and frailty: A two-sample mendelian randomization study

BACKGROUND

Frailty is one of the most common and challenging consequences of aging, which negatively affects older adults, their families, and society. Caffeine has been shown to be associated with a reduced risk of frailty by observational studies, yet its causal relationship with frailty remains to be tested using more robust methods.

AIMS

This study aimed to explore the causal association between plasma caffeine and frailty using a two-sample Mendelian Randomization (MR) analysis.

METHODS

Single nucleotide polymorphisms related to plasma caffeine concentrations were selected as instrumental variables. Data on the Frailty Index (FI) were sourced from the UK Biobank and TwinGen meta-analysis (n = 175,226), while data on the Fried Frailty Score (FFS) were obtained from the UK Biobank (n = 386,565). The causal association between plasma caffeine levels and frailty was tested using five MR methods, with the inverse-variance weighted method as the primary approach.

RESULTS

Our results consistently showed significantly negative associations between genetically predicted plasma caffeine with FI (β = -0.050, 95 % CI:0.077 to -0.023, P < 0.001) and FFS (β = -0.049, 95 % CI:0.064 to -0.034, P < 0.001). These results remained robust in further sensitivity analyses using a leave-one-out approach.

CONCLUSION

Our findings confirm a causal relationship between plasma caffeine and frailty and suggest that increasing plasma caffeine levels may help prevent and reduce the risk of frailty.

Common Questions and Misconceptions About Energy Drinks: What Does the Scientific Evidence Really Show?

Energy drinks are a commonly consumed beverage, and studies suggest a possible performance-enhancing effect. A Google Scholar search using the keywords "energy drinks" and "exercise" yields numerous results, underscoring the voluminous research on this topic. However, there are questions regarding the effectiveness and safety of energy drinks. These questions include, but are not limited to: (1) What are the main active ingredients in energy drinks? (2) Do energy drinks assist in weight management? (3) Do energy drinks enhance aerobic performance? (4) Do energy drinks enhance athletic speed? (5) Do energy drinks improve reaction time? (6) Do energy drinks enhance lean tissue mass? (7) Can energy drinks improve cognitive performance? (8) Does the acute consumption of energy drinks elevate resting energy expenditure? (9) Is there any evidence to suggest that energy drinks are more effective than an identical serving of caffeine alone? (10) Are there sex differences in the response to energy drink consumption? (11) Do energy drinks affect sleep or sleepiness? (12) Should pregnant women avoid energy drinks? (13) Do energy drinks adversely affect cardiovascular function? (14) Does consuming energy drinks cause brain damage? (15) What are other safety considerations regarding energy drinks? (16) Is there any evidence to suggest that energy drinks are more effective than an identical serving of caffeine alone? (17) If caffeine is the main active ingredient in energy drinks and coffee, why is there a discrepancy in the adverse events reported for each? To address these questions, we performed an evidence-based scientific evaluation of the literature on energy drink supplementation.

Association of serum metabolites with frailty phenotype and its components: a cross-sectional case-control study

New insights into the metabolic mechanisms of frailty are needed. This study aimed to identify serum metabolites linked to frailty phenotype and its component through gas chromatography-mass spectrometry metabolomic analysis among community-dwelling older individuals. An exploratory, cross-sectional case-control study. Setting and participants: The participants were recruited from the ''Otassha Study,'' a cohort study conducted in Itabashi Ward, Tokyo, targeting women aged 65 years and older. The study population included 39 frail and 76 robust individuals. Metabolomic analysis was performed using the GCMS-TQTM8040 NX system and the Smart Metabolites Database Ver.2 to explore the primary metabolite characteristic of a frailty state. Conditional logistic regression analysis was conducted with frailty as the outcome and with metabolites as exposures. Concentrations of seven metabolites, including caffeine, catechol, paraxanthine, niacinamide, 5-hydroxymethyl-2-furoic acid, daidzein, and cytosine were lower in the frail than in the robust individuals. Odds ratios [95% confidence intervals] for frailty by halving the value were significant for catechol (1.26 [1.00, 1.59]), 5-hydroxymethyl-2-furoic acid (1.28 [1.04, 1.58]), caffeine (1.37 [1.07, 1.75]), paraxanthine (1.18 [1.00, 1.39]), and daidzein (1.29 [1.02, 1.62]). Furthermore, distinct patterns of metabolites associated with specific frailty symptoms, such as muscle weakness, fatigue, and reduced physical activity, were identified, especially with 5-hydroxymethyl-2-furoic acid and caffeine commonly associated with these components. Metabolomic analysis identified metabolites associated with frailty. In particular, low levels of caffeine, catechol, paraxanthine, niacinamide, 5-hydroxymethyl-2-furoate, daidzein, and cytosine contributed to frailty. These results provide new insights into the pathophysiology of frailty through metabolomic analysis.

Threshold effects between caffeine intake and urine flow rate: a population-based cross-sectional study

PURPOSE

The potential benefits of caffeine intake are currently receiving much attention and exploration. Urine flow rate (UFR) is an objective index to comprehensively reflect bladder function. The aim of this study was to investigate the association between caffeine intake and UFR using the National Health and Nutrition Examination Survey (NHANES) database.

METHODS

14,142 participants were enrolled in this study. Weighted multivariate adjusted regression models were used to explore the relationship between caffeine intake and UFR. The dose-response relationships were explored using a restricted cubic spline (RCS) and a threshold effect analysis was conducted based on the inflection points identified by the two-segment linear regression model. In addition, subgroup analysis and sensitivity analysis were applied.

RESULTS

The findings suggested that the intake of caffeine was correlated with improved UFR [Model 3: 0.091 (0.057, 0.126), P value < 0.001]. In addition, the RCS supported a nonlinear relationship between them. The analysis of threshold effect further revealed a specific level of caffeine intake (34.51 mg/day) that exhibited a significant enhancement in UFR. Finally, through re-analyzing the data set obtained after multiple imputation (MI), we obtained similar results.

CONCLUSION

This study found a nonlinear beneficial relationship between caffeine intake and UFR, and revealed the recommended intake of caffeine. The values varied by gender, race, education, and smoking status.

Impact of coffee intake on human aging: Epidemiology and cellular mechanisms

The conception of coffee consumption has undergone a profound modification, evolving from a noxious habit into a safe lifestyle actually preserving human health. The last 20 years also provided strikingly consistent epidemiological evidence showing that the regular consumption of moderate doses of coffee attenuates all-cause mortality, an effect observed in over 50 studies in different geographic regions and different ethnicities. Coffee intake attenuates the major causes of mortality, dampening cardiovascular-, cerebrovascular-, cancer- and respiratory diseases-associated mortality, as well as some of the major causes of functional deterioration in the elderly such as loss of memory, depression and frailty. The amplitude of the benefit seems discrete (17 % reduction) but nonetheless corresponds to an average increase in healthspan of 1.8 years of lifetime. This review explores evidence from studies in humans and human tissues supporting an ability of coffee and of its main components (caffeine and chlorogenic acids) to preserve the main biological mechanisms responsible for the aging process, namely genomic instability, macromolecular damage, metabolic and proteostatic impairments with particularly robust effects on the control of stress adaptation and inflammation and unclear effects on stem cells and regeneration. Further studies are required to detail these mechanistic benefits in aged individuals, which may offer new insights into understanding of the biology of aging and the development of new senostatic strategies. Additionally, the safety of this lifestyle factor in the elderly prompts a renewed attention to recommending the maintenance of coffee consumption throughout life as a healthy lifestyle and to further exploring who gets the greater benefit with what schedules of which particular types and doses of coffee.

Intake of vegetables and fruits at midlife and the risk of physical frailty in later life

OBJECTIVES

Our study evaluated the independent and overall associations of vegetable and fruit consumption at midlife with the likelihood of physical frailty in later life. We also investigated whether specific nutrients in these foods could have accounted for these associations, if present.

DESIGN

Prospective cohort study.

SETTING

A population-based cohort of Chinese adults followed over a period of 20 years in Singapore.

PARTICIPANTS

We used data from 11,959 subjects who participated in the baseline (1993-1998) and follow-up 3 (2014-2017) interviews of the Singapore Chinese Health Study.

MEASUREMENTS

At baseline, dietary intake was evaluated using a validated food frequency questionnaire. During the follow-up 3 visits, physical frailty was assessed using a modified Cardiovascular Health Study phenotype that included weakness, slowness, exhaustion and weight loss. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations with physical frailty.

RESULTS

Participants had mean ages of 52 years at baseline, and 72 years at follow-up 3. Baseline intake of vegetables, but not of fruits, showed a dose-dependent inverse relationship with physical frailty at follow-up 3 (Ptrend = 0.001). Compared to participants in the lowest quintile of vegetable intake, those in the highest quintile had reduced odds of frailty [OR (95% CI): 0.73 (0.60-0.89)]. Among the components of physical frailty, vegetable intake had the strongest inverse association with weakness defined by handgrip strength [OR (95% CI) between extreme quintiles: 0.62 (0.52-0.73); Ptrend < 0.001]. In models that were individually adjusted for nutrients, the vegetable-frailty association was attenuated and no longer statistically significant after adjusting for the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates.

CONCLUSION

Increased midlife intake of vegetables was associated with reduced odds of physical frailty in later life, and the intake of β-carotene, lutein, folate, α-carotene, and isothiocyanates could have accounted for this association.

Quality of plant-based diets and frailty incidence: a prospective analysis of UK biobank participants

BACKGROUND

Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailty risk. However, the role of plant-based diets, particularly their quality, is poorly known.

OBJECTIVE

To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and older adults.

DESIGN

Prospective cohort.

SETTING

United Kingdom.

SUBJECTS

24,996 individuals aged 40-70 years, followed from 2009-12 to 2019-22.

METHODS

Based on at least two 24-h diet assessments, we built two diet indices: (i) the healthful Plant-based Diet Index (hPDI) and (ii) the unhealthful Plant-based Diet Index (uPDI). Incident frailty was defined as developing ≥3 out of 5 of the Fried criteria. We used Cox models to estimate relative risks (RR), and their 95% confidence interval (CI), of incident frailty adjusted for the main potential confounders.

RESULTS

After a median follow-up of 6.72 years, 428 cases of frailty were ascertained. The RR (95% CI) of frailty was 0.62 (0.48-0.80) for the highest versus lowest tertile of the hPDI and 1.61 (1.26-2.05) for the uPDI. The consumption of healthy plant foods was associated with lower frailty risk (RR per serving 0.93 (0.90-0.96)). The hPDI was directly, and the uPDI inversely, associated with higher risk of low physical activity, slow walking speed and weak hand grip, and the uPDI with higher risk of exhaustion.

CONCLUSIONS

In British middle-age and older adults, greater adherence to the hPDI was associated with lower risk of frailty, whereas greater adherence to the uPDI was associated with higher risk.

Metabolic clues to aging: exploring the role of circulating metabolites in frailty, sarcopenia and vascular aging related traits and diseases

Background: Physical weakness and cardiovascular risk increase significantly with age, but the underlying biological mechanisms remain largely unknown. This study aims to reveal the causal effect of circulating metabolites on frailty, sarcopenia and vascular aging related traits and diseases through a two-sample Mendelian Randomization (MR) analysis. Methods: Exposures were 486 metabolites analyzed in a genome-wide association study (GWAS), while outcomes included frailty, sarcopenia, arterial stiffness, atherosclerosis, peripheral vascular disease (PAD) and aortic aneurysm. Primary causal estimates were calculated using the inverse-variance weighted (IVW) method. Methods including MR Egger, weighted median, Q-test, and leave-one-out analysis were used for the sensitive analysis. Results: A total of 125 suggestive causative associations between metabolites and outcomes were identified. Seven strong causal links were ultimately identified between six metabolites (kynurenine, pentadecanoate (15:0), 1-arachidonoylglycerophosphocholine, androsterone sulfate, glycine and mannose) and three diseases (sarcopenia, PAD and atherosclerosis). Besides, metabolic pathway analysis identified 13 significant metabolic pathways in 6 age-related diseases. Furthermore, the metabolite-gene interaction networks were constructed. Conclusion: Our research suggested new evidence of the relationship between identified metabolites and 6 age-related diseases, which may hold promise as valuable biomarkers.