Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, Madrid, Spain.
CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
Am J Clin Nutr. 2018 May 1;107(5):763-771. doi: 10.1093/ajcn/nqy026.
Previous research indicates that patients with type 2 diabetes are at higher risk of becoming frail. Emerging evidence also indicates that the Mediterranean diet may prevent frailty in the older population.
The aim of this study was to assess whether a Mediterranean-style diet pattern was associated with lower risk of frailty among older women with diabetes.
This was a prospective cohort study in 8970 women aged ≥60 y with type 2 diabetes from the Nurses' Health Study. Adherence to the alternate Mediterranean diet (aMED) score was first measured in 1990 and repeated every 4 y until 2010. Frailty occurrence was ascertained up to 2012 and was defined as having ≥3 of the following 5 criteria from the fatigue, resistance, aerobic, illnesses, loss of weight (FRAIL) scale: Fatigue, low Resistance, low Aerobic capacity, having ≥5 Illnesses, and weight Loss of ≥5%. Those with frailty at baseline were excluded.
During follow-up, we identified 569 incident cases of frailty. After adjustment for lifestyle factors and medication use, the HR (95% CI) of frailty was 1 for the lowest quartile of the aMED score, 0.88 (0.71, 1.10) for the second quartile, 0.69 (0.53, 0.88) for the third quartile, and 0.54 (0.42, 0.71) for the highest quartile (P-trend < 0.001). A 2-point (∼1 SD) increase in the aMED score was associated with a 28% (95% CI: 19%, 36%) reduced risk of frailty. The largest reduction in the risk was observed for a higher consumption of vegetables and fruit, as well as for alcohol intake.
A Mediterranean-style diet pattern was associated with reduced risk of frailty syndrome in older women with type 2 diabetes.
既往研究表明，2 型糖尿病患者发生衰弱的风险更高。新出现的证据也表明，地中海饮食可能会预防老年人群的衰弱。
本研究旨在评估地中海饮食模式是否与患有 2 型糖尿病的老年女性衰弱风险降低相关。
这是一项对护士健康研究中 8970 名年龄≥60 岁的 2 型糖尿病女性的前瞻性队列研究。在 1990 年首次测量了交替地中海饮食（aMED）评分的依从性，并在 2010 年之前每 4 年重复一次。衰弱的发生情况在 2012 年之前进行了评估，并定义为以下 5 项 FRAIL 量表标准中有≥3 项：疲劳、抵抗力低、有氧运动能力低、患有≥5 种疾病和体重减轻≥5%。排除基线时患有衰弱的患者。
在随访期间，我们确定了 569 例衰弱新发病例。在调整生活方式因素和药物使用后，最低四分位数 aMED 评分的衰弱风险比（95%CI）为 1，第二四分位数为 0.88（0.71，1.10），第三四分位数为 0.69（0.53，0.88），最高四分位数为 0.54（0.42，0.71）（P 趋势<0.001）。aMED 评分增加 2 分（约 1 个标准差），衰弱风险降低 28%（95%CI：19%，36%）。蔬菜和水果摄入量以及酒精摄入量较高的情况下，风险降低幅度最大。
地中海饮食模式与 2 型糖尿病老年女性衰弱综合征风险降低相关。
