Lo Yen-Li, Hsieh Yao-Te, Hsu Li-Lin, Chuang Shao-Yuan, Chang Hsing-Yi, Hsu Chih-Cheng, Chen Ching-Yu, Pan Wen-Harn
Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.
J Am Geriatr Soc. 2017 Sep;65(9):2009-2015. doi: 10.1111/jgs.14972. Epub 2017 Jun 12.
To investigate whether dietary patterns are associated with frailty phenotypes in an elderly Taiwanese population.
Cross-sectional.
Nutrition and Health Survey in Taiwan (NAHSIT), 2014-2016.
Noninstitutionalized Taiwanese nationals aged 65 years and older enrolled in the NAHSIT (N = 923).
Dietary intake was assessed using a 79-item food-frequency questionnaire (FFQ). Presence of 5 frailty phenotypes was determined using modified Fried criteria and are summed into a frailty score. Using data from the NAHSIT (2014-15), reduced rank regression was used to find a dietary pattern that explained maximal degree of variation of the frailty scores. Logistic regression models were used to estimate the association between frailty and dietary pattern. The findings were validated with data from 2016.
The derived dietary pattern was characterized with a high consumption of fruit, nuts and seeds, tea, vegetables, whole grains, shellfish, milk, and fish. The prevalence of frailty was 7.8% and of prefrailty was 50.8%, defined using the modified Fried criteria. Using data from the NAHSIT (2014-15), the dietary pattern score showed an inverse dose-response relationship with prevalence of frailty and pre-frailty. Individuals in the second dietary pattern tertile were one-third as likely to be frail as those in the first tertile (adjusted odds ratio (aOR) = 0.32, 95% confidence interval (CI) = 0.12-0.85), and those in the third tertile were 4% as likely to be frail as those in the first tertile (aOR = 0.04, 95% CI = 0.01-0.18). The dietary pattern score estimated using FFQ data from the NAHSIT 2016 was also significantly and inversely associated with frailty.
Individuals with a dietary pattern with more phytonutrient-rich plant foods, tea, omega-3-rich deep-sea fish, and other protein-rich foods such as shellfish and milk had a reduced prevalence of frailty. Further research is necessary to confirm these findings and investigate whether related dietary interventions can reduce frailty in older adults.
探讨饮食模式是否与台湾老年人群的衰弱表型相关。
横断面研究。
2014 - 2016年台湾营养与健康调查（NAHSIT）。
纳入NAHSIT的65岁及以上非机构化台湾居民（N = 923）。
使用79项食物频率问卷（FFQ）评估饮食摄入量。采用改良的弗里德标准确定5种衰弱表型的存在情况，并将其汇总为衰弱评分。利用NAHSIT（2014 - 15年）的数据，采用降秩回归来找出能解释衰弱评分最大程度变异的饮食模式。使用逻辑回归模型估计衰弱与饮食模式之间的关联。研究结果用2016年的数据进行验证。
得出的饮食模式特点是大量摄入水果、坚果和种子、茶、蔬菜、全谷物、贝类、牛奶和鱼类。按照改良的弗里德标准定义，衰弱患病率为7.8%，衰弱前期患病率为50.8%。利用NAHSIT（2014 - 15年）的数据，饮食模式评分与衰弱和衰弱前期患病率呈负剂量反应关系。处于第二饮食模式三分位数的个体衰弱的可能性仅为处于第一三分位数个体的三分之一（调整优势比（aOR）= 0.32，95%置信区间（CI）= 0.12 - 0.85），处于第三三分位数的个体衰弱的可能性仅为处于第一三分位数个体的4%（aOR = 0.04，95% CI = 0.01 - 0.18）。利用NAHSIT 2016年FFQ数据估计的饮食模式评分也与衰弱显著负相关。
饮食模式中富含植物营养素的植物性食物、茶、富含ω-3的深海鱼类以及其他富含蛋白质的食物（如贝类和牛奶）的个体，衰弱患病率较低。有必要进一步研究以证实这些发现，并调查相关饮食干预措施是否能降低老年人的衰弱程度。
