Less favourable food consumption ratings in the Five-Color Nutri-Score are associated with incident frailty in older adults

Nutritional specificity of frailty: from epidemiological and clinical evidence to potential mechanisms

PURPOSE OF REVIEW

Considering the ageing of the population, age-related syndromes, such as frailty, are prominent. In this context, nutrition is a modifiable factor considered a key nonpharmacological approach to prevention and treatment. Yet, its contribution to the frailty pathophysiology is conflicting in the literature. This paper discusses the recent literature (January 2023-June 2024) on the implication of nutrition in frailty management.

RECENT FINDINGS

Malnutrition is one of the main frailty risk factors. Proteins are the targeted macronutrient for their effects on muscle anabolism, not only in terms of quantity consumed but also in terms of sources. The diversity in plant and animal sources demonstrates better results than relying on a single source. More globally, anti-inflammatory and antioxidant diets are associated with a lower risk of frailty, like the Mediterranean Diet and specific food groups, like seafood, nuts, and seeds. Nutrition is pivotal in frailty prevention and treatment, and multidomain interventions providing exercises seem to yield even better results.

SUMMARY

Diverse protein sources and anti-inflammatory and antioxidant diets associated with exercises are the primary recommendations for frailty prevention and treatment. However, there is a need to evaluate how to achieve and maintain this healthy behaviour in real life.

Less Favorable Nutri-Score Consumption Ratings Are Prospectively Associated with Abdominal Obesity in Older Adults

Nutri-Score is a front-of-package (FOP) labeling designed to assist consumers in selecting healthier options at the point of purchase and ultimately enhance their health. This study aims to evaluate the association between the Nutri-Score system and incident abdominal obesity (AO) in community-dwelling older adults. A prospective cohort of 628 individuals aged ≥ 60 were recruited in Spain between 2008-2010 and were reexamined between 2015-2017. Dietary intake was evaluated utilizing a validated computerized dietary history. Food was categorized based on the Nutri-Score system into five levels from A (green, representing the best quality) to E (red, representing the poorest quality). A five-color Nutri-Score dietary index (5-CNS DI) in g/day/kg was calculated for each participant. AO was determined by a waist circumference (WC) of ≥102 cm for men and ≥88 cm for women. Logistic regression models were adjusted for the main potential confounders. During a mean six-year follow-up, 184 incident cases of AO occurred. The odds ratio (OR) and 95% confidence interval (CI) for AO, when comparing the highest and lowest quartiles of the 5-CNS DI, were 2.45 (1.17-5.14), with a p-value for trend of 0.035. In sensitivity analyses, the OR was 2.59 (1.22-5.52, p-trend: 0.032) after adjustment for WC at baseline, and 1.75 (0.74-4.18, p-trend: 0.316) after adjustment for ultra-processed food consumption. In conclusion, less favorable food-consumption ratings in the Nutri-Score are associated with incident AO in the elderly. These findings support the use of this FOP system to potentially improve metabolic health.