Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy.
IRCCS SDN, Napoli Via Gianturco 113, 80143, Naples, Italy.
Clin Nutr. 2019 Apr;38(2):721-729. doi: 10.1016/j.clnu.2018.03.012. Epub 2018 Apr 3.
BACKGROUND & AIMS: Mediterranean Diet (MD) is an eating pattern associated with multiple healthy benefits, including the conservation of skeletal muscle. Frailty is a major geriatric syndrome characterized by low muscle strength. The Hand Grip Strength (HGS) is the most frequently used indicator of muscle functional capacity for clinical purposes. The association between the adherence to the MD and HGS in elderly has not yet fully investigated. The goal of this study was to examine the association between the adherence to the MD and HGS in a not hospitalized elderly who participated in the project PERsonalised ict Supported Services for Independent Living and Active Ageing (PERSSILAA).
Eighty-four elderly women were consecutively enrolled (aged 60-85 years) in this cross-sectional observational study. Anthropometric measures were evaluated. A validated 14-item questionnaire PREDIMED (PREvención con DIeta MEDiterránea) was used for the assessment of adherence to the MD. Dietary data were collected by a 7-day food records. Muscle strength was measured by HGS using a grip strength dynamometer (KERN & SOHN GmbH).
The majority of participants were overweight (46.4%). An average adherence to the MD was found in 52.4% of participants, while the minority of them showed a low adherence (21.4%). HGS > cut-point of 20 kg were found in 43 subjects (51.2%). According to the adherence to MD, 39% participants with HGS values higher than cut-point presented a high adherence score compared with 14% of those with lower values of HGS (p = 0.018). The participants with HGS > cut-point presented significantly higher PREDIMED score than those with HGS < cut-point (p < 0.001). Based on ROC curves, the most sensitive and specific cut-point for the PREDIMED score to predict HGS categories was ≥8. No evident correlations were observed between HGS and age, while HGS was negatively correlated with hip circumference (r = -0.233, p = 0.033) and BMI (r = -0.219, p = 0.045), and positively correlated with PREDIMED score (r = 0.598, p < 0.001). At binomial logistic regression analysis almost all 14-items of PREDIMED questionnaire were significantly associated with HGS adjusted for BMI. At multinomial logistic regression analysis to assess the association of the three classes of adherence to the MD with the HGS, after adjusting for BMI the lowest adherence to MD was associated with the lowest Odds Ratio of HGS (p < 0.001).
This study evidenced a positive association between the adherence to the MD and muscle strength in a sample of active elderly women, stratified according to the HGS > cut-point of 20 kg. Our study highlights the usefulness of the developing health services to detect and prevent age-associated decline in physical performance in elderly subjects by addressing nutritional and physical intervention.
地中海饮食(Mediterranean Diet,MD)是一种与多种健康益处相关的饮食模式,包括维持骨骼肌健康。衰弱是一种主要的老年综合征,其特征是肌肉力量低。握力(Hand Grip Strength,HGS)是临床最常用的肌肉功能容量指标。MD 依从性与老年人 HGS 之间的关联尚未得到充分研究。本研究的目的是在参加 PERsonalised ict Supported Services for Independent Living and Active Ageing(PERSSILAA)项目的非住院老年人中,研究 MD 依从性与 HGS 之间的关系。
本横断面观察性研究连续纳入 84 名老年女性(年龄 60-85 岁)。评估了人体测量学指标。采用经过验证的包含 14 个项目的 PREvención con DIeta MEDiterránea(PREDIMED)问卷评估 MD 依从性。通过 7 天的食物记录收集饮食数据。使用握力测力计(KERN & SOHN GmbH)测量肌肉力量。
大多数参与者超重(46.4%)。发现 52.4%的参与者平均 MD 依从性较高,而少数参与者 MD 依从性较低(21.4%)。发现 43 名参与者(51.2%)的 HGS>20kg 截定点。根据 MD 依从性,HGS 值高于截定点的参与者中,39%具有较高的 MD 依从性评分,而 HGS 值较低的参与者中,只有 14%具有较高的 MD 依从性评分(p=0.018)。HGS>截定点的参与者的 PREDIMED 评分明显高于 HGS<截定点的参与者(p<0.001)。基于 ROC 曲线,PREDIMED 评分预测 HGS 类别的最敏感和最特异的截定点为≥8。HGS 与年龄之间未观察到明显相关性,而 HGS 与臀围(r=-0.233,p=0.033)和 BMI(r=-0.219,p=0.045)呈负相关,与 PREDIMED 评分呈正相关(r=0.598,p<0.001)。在二项逻辑回归分析中,PREDIMED 问卷的 14 项几乎全部与 BMI 调整后的 HGS 显著相关。在多分类逻辑回归分析中,为了评估 MD 依从性的三个等级与 HGS 的关系,在调整 BMI 后,MD 最低依从性与 HGS 的最低比值比相关(p<0.001)。
本研究在一组活跃的老年女性中发现,根据 HGS>20kg 的截定点,MD 依从性与肌肉力量之间存在正相关。我们的研究强调了开发健康服务的重要性,以通过针对营养和身体干预来检测和预防老年人与年龄相关的身体机能下降。