León-Muñoz Luz M, García-Esquinas Esther, López-García Esther, Banegas José R, Rodríguez-Artalejo Fernando
CIBER of Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo, s/n 28029, Madrid, Spain.
BMC Med. 2015 Jan 20;13:11. doi: 10.1186/s12916-014-0255-6.
There is emerging evidence of the role of certain nutrients as risk factors for frailty. However, people eat food, rather than nutrients, and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults.
This is a prospective cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010. At baseline, food consumption was obtained with a validated diet history and, by using factor analysis, two dietary patterns were identified: a 'prudent' pattern, characterized by high intake of olive oil and vegetables, and a 'Westernized' pattern, with a high intake of refined bread, whole dairy products, and red and processed meat, as well as low consumption of fruit and vegetables. Participants were followed-up until 2012 to assess incident frailty, defined as at least three of the five Fried criteria (exhaustion, weakness, low physical activity, slow walking speed, and unintentional weight loss).
Over a 3.5-year follow-up, 96 cases of incident frailty were ascertained. The multivariate odds ratios (95% confidence interval) of frailty among those in the first (lowest), second, and third tertile of adherence to the prudent dietary pattern were 1, 0.64 (0.37-1.12), and 0.40 (0.2-0.81), respectively; P-trend = 0.009. The corresponding values for the Westernized pattern were 1, 1.53 (0.85-2.75), and 1.61 (0.85-3.03); P-trend = 0.14. Moreover, a greater adherence to the Westernized pattern was associated with an increasing risk of slow walking speed and weight loss.
In older adults, a prudent dietary pattern showed an inverse dose-response relationship with the risk of frailty while a Westernized pattern had a direct relationship with some of their components. Clinical trials should test whether a prudent pattern is effective in preventing or delaying frailty.
越来越多的证据表明某些营养素作为衰弱的风险因素所起的作用。然而，人们摄入的是食物而非营养素，之前尚无研究实证检验从食物消费中得出的饮食模式与老年人衰弱风险之间的关联。
这是一项对2008年至2010年间招募的1872名年龄≥60岁的非机构化个体进行的前瞻性队列研究。在基线时，通过有效的饮食史获取食物消费情况，并采用因子分析确定了两种饮食模式：一种是“谨慎”模式，其特点是橄榄油和蔬菜摄入量高；另一种是“西化”模式，精制面包、全脂乳制品、红肉和加工肉类摄入量高，同时水果和蔬菜消费量低。对参与者进行随访至2012年，以评估新发衰弱情况，衰弱定义为符合五项弗里德标准（疲惫、虚弱、体力活动少、步行速度慢和非故意体重减轻）中的至少三项。
在3.5年的随访期间，确定了96例新发衰弱病例。遵循谨慎饮食模式处于第一（最低）、第二和第三三分位数的人群中，衰弱的多变量优势比（95%置信区间）分别为1、0.64（0.37 - 1.12）和0.40（0.2 - 0.81）；P趋势 = 0.009。西化模式的相应值分别为1、1.53（0.85 - 2.75）和1.61（0.85 - 3.03）；P趋势 = 0.14。此外，对西化模式的更高遵循程度与步行速度慢和体重减轻的风险增加相关。
在老年人中，谨慎的饮食模式与衰弱风险呈反向剂量反应关系，而西化模式与其某些组成部分呈直接关系。临床试验应检验谨慎模式在预防或延缓衰弱方面是否有效。
