Association between nut consumption and frailty in the elderly: a large sample cross-sectional study

Impact of energy intake on the association between protein intake and the prevalence of frailty in older Korean adults: The Korea National Health and Nutrition Examination Survey, 2014-2018

OBJECTIVES

Findings regarding dietary protein and frailty are inconsistent. This inconsistency may be attributed to variations in energy intake adequacy. We hypothesized that the prevalence of frailty in older adults with sufficient energy intake is inversely associated with the intake of total, animal, and plant proteins; however, in those with deficient energy intake, this association may not be observed.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS

This cross-sectional study included data of 5,768 adults aged ≥65 years from the Korea National Health and Nutrition Examination Survey 2014-2018. Frailty was assessed using a modified Cardiovascular Health Study frailty index. Protein intake was measured via a 24-h recall and analyzed using multivariable logistic regression.

RESULTS

In older adults with sufficient energy intake, frailty was inversely associated with the intake of total (odds ratio [OR], 0.67; 95% confidence interval [CI], 0.46-0.97; p = 0.032), animal (OR, 0.59; 95% CI, 0.43-0.82; p = 0.001), and plant proteins (OR, 0.68; 95% CI, 0.50-0.92; p = 0.043). In those with deficient energy intake, total and animal protein intake showed no significant associations with frailty, whereas plant protein intake was inversely associated with frailty.

CONCLUSION

Adequate energy intake appears essential for the protective effects of total and animal protein against frailty. Higher plant protein intake appears to confer benefits regardless of energy intake, highlighting its potential role in frailty prevention.

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.

Daily consumption of specific categories of fruit and vegetables negatively correlated with frailty: findings from the US National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES

The specific impact of different fruit and vegetable consumption categories on frailty is not completely understood. This study examined the relationships between the daily consumption of fruit and vegetables and frailty in a large general population.

SUBJECTS/METHODS

This study used the data from the US National Health and Nutrition Examination Survey (2005-2020). Two intermittent 24-h dietary recalls were used to evaluate fruit and vegetable consumption. Frailty was assessed using the frailty index. Logistic regression, stratified analyses, and restricted cubic spline models were used to examine these associations.

RESULTS

A higher daily intake of citrus, melons, and berries (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.65-0.92), other fruit (OR, 0.74; 95% CI, 0.62-0.88), intact fruit (OR, 0.71; 95% CI, 0.60-0.84), dark-green vegetables (OR, 0.71; 95% CI, 0.60-0.83), and total vegetables (OR, 0.80; 95% CI, 0.66-0.96), along with a lower fruit juice intake (OR, 0.81; 95% CI, 0.69-0.96), were associated with a reduced risk of frailty in adults aged 18 yrs and older. Further analysis showed that the daily consumption of citrus melons and berries, other fruit, intact fruit, fruit juice, and tomatoes and tomato products were inversely associated with frailty in adults under 60 yrs and females. Dark green vegetables were inversely correlated with frailty in individuals aged 40-60 yrs and over 60 yrs, regardless of sex.

CONCLUSION

The daily consumption of most types of fruit, dark green vegetables, and tomatoes and tomato products may reduce the risk of frailty in American adults, particularly for individuals under 60 yrs of age and females.

Meat-Egg-Dairy Consumption and Frailty among Chinese Older Adults: Exploring Rural/Urban and Gender Differences

The dietary patterns of older adults, particularly in relation to meat, egg, and dairy (MED) consumption, significantly impact frailty, a state of heightened vulnerability to adverse health outcomes. This paper investigates the association between MED consumption and frailty among older Chinese adults, considering rural/urban disparities and gender differences. Analyzing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning from 2008 to 2018, this study explores how MED consumption influences frailty levels over time. The results show that moderate MED consumption is associated with slower frailty progression, suggesting a protective effect against frailty among older adults. However, excessive MED consumption, particularly among rural residents and females, is linked to accelerated frailty progression. Urban residents and males report higher MED consumption levels, possibly due to their greater access to diverse food options and traditional dietary preferences. The findings underscore the complex interplay between dietary habits, demographic factors, and frailty outcomes. Understanding these dynamics is crucial for developing targeted interventions to mitigate frailty risk factors and promote healthy aging among Chinese older adults.

The Association between Dietary Protein Diversity and Protein Patterns with Frailty in Older Chinese Adults: A Population-Based Cohort Study

OBJECTIVES

Frailty is a pervasive condition among older people worldwide. Despite the association between higher protein intake and lower frailty risk has been well documented, older individuals encounter barriers to enhancing their protein consumption due to reduced appetite and impaired digestive capacity. This study aims to delve into the potential correlation between dietary protein diversity, protein patterns, and the risk of frailty among older Chinese individuals.

DESIGN

Prospective cohort study.

SETTING

Community-based.

PARTICIPANTS

2,216 participants aged 65 and above and not frail at the baseline were recruited from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset spanning from 2014 to 2018.

MEASUREMENTS

Dietary protein diversity was evaluated utilizing a protein diversity score (PDS), calculated based on the results of a food frequency questionnaire. Dietary protein patterns were identified by employing principal component analysis (PCA). Frailty was ascertained using a 40-item frailty index (FI) where FI > 0.21 indicated frailty. Logistic analysis was employed to investigate the association between dietary variables and frailty.

RESULTS

541 participants were identified as frail after a 4-year follow-up. After adjusting for confounders, each 1-unit increase in PDS was linked to a 10% decrease in frailty risk. Compared to individuals with PDS ≤ 1, those with PDS scores of 2-3, 4-5, and 6 had lower risks of frailty, with OR (95% CI) of 0.78 (0.58-1.06), 0.58 (0.38-0.87), 0.42 (0.20-0.81), respectively (P trend = 0.038). Individuals who consistently maintained high PDS demonstrated a lower frailty risk in contrast to those who maintained low PDS (OR = 0.60, 95% CI, 0.41-0.87). Additionally, the "meat-fish" pattern exhibited a protective association with frailty, with OR Q4 versus Q1 (95% CI) of 0.54 (0.40-0.74), P trend < 0.001.

CONCLUSION

Maintaining a variety of dietary protein sources and following a "meat-fish" protein pattern might decrease the likelihood of frailty among the older Chinese population.