Verspoor Eline, Voortman Trudy, van Rooij Frank J A, Rivadeneira Fernando, Franco Oscar H, Kiefte-de Jong Jessica C, Schoufour Josje D
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur J Nutr. 2020 Oct;59(7):2919-2928. doi: 10.1007/s00394-019-02131-0. Epub 2019 Nov 14.
To investigate the longitudinal association between the macronutrient composition of the diet and frailty.
Data were obtained from 5205 Dutch middle-aged and older adults participating in the Rotterdam Study. Frailty was measured using a frailty index based on the accumulation of 38 health-related deficits, score between 0 and 100, and a higher score indicating more frailty. Frailty was assessed at baseline and 11 years later (range of 23 years). Macronutrient intake was assessed using food-frequency questionnaires. The association between macronutrients and frailty over time was evaluated using multivariable linear regression, adjusted for the frailty index at baseline, energy intake, and other relevant confounders. All analyses were performed in strata of BMI.
Median frailty index score was 13.8 points (IQR 9.6; 19.1) at baseline and increased by a median of 2.3 points (IQR - 2.0; 7.6) after 11 years. Overall, we found no significant associations between intake of carbohydrates or fat and frailty over time. We did observe a significant positive association between an iso-energetic intake of 10 g protein and frailty over time (β 0.31 (95% CI 0.06; 0.55)) which was mainly driven by animal protein (β 0.31 (95% CI 0.07; 0.56)). It did not depend on whether it was substituted fat or carbohydrates.
Our findings suggest that a reduction in the intake of animal protein may improve the overall health status over time in a relatively healthy population. More research is needed on the optimal macronutrient composition of the diet and frailty in more vulnerable populations.
研究饮食中宏量营养素组成与衰弱之间的纵向关联。
数据来自参与鹿特丹研究的5205名荷兰中老年人。使用基于38种与健康相关缺陷累积情况的衰弱指数来测量衰弱程度，得分范围为0至100分，分数越高表明衰弱程度越高。在基线时和11年后（时间跨度为23年）评估衰弱情况。使用食物频率问卷评估宏量营养素摄入量。采用多变量线性回归评估宏量营养素与随时间变化的衰弱之间的关联，并对基线时的衰弱指数、能量摄入和其他相关混杂因素进行了调整。所有分析均在体重指数分层中进行。
基线时衰弱指数得分中位数为13.8分（四分位间距9.6；19.1），11年后中位数增加了2.3分（四分位间距-2.0；7.6）。总体而言，我们发现碳水化合物或脂肪摄入量与随时间变化的衰弱之间没有显著关联。我们确实观察到，等量摄入10克蛋白质与随时间变化的衰弱之间存在显著正相关（β0.31（95%置信区间0.06；0.55）），这主要由动物蛋白驱动（β0.31（95%置信区间0.07；0.56））。它不取决于替代的是脂肪还是碳水化合物。
我们的研究结果表明，减少动物蛋白的摄入量可能会随着时间推移改善相对健康人群的整体健康状况。对于更脆弱人群饮食中最佳宏量营养素组成与衰弱的关系，还需要更多研究。
