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. 2020 Apr 1;111(4):877-883. doi: 10.1093/ajcn/nqaa028.
The frailty syndrome is associated with higher risk of disability and death after accounting for multimorbidity. Therefore, the determinants of frailty need to be identified to ensure older adults live not only longer but also healthier lives. However, the effect of diet quality on frailty is mostly unknown.
We aimed to evaluate the alternate Mediterranean diet (AMED), the Dietary Approaches to Stop Hypertension (DASH) diet, and the alternate Healthy Eating Index-2010 (AHEI-2010) in association with frailty risk among older women.
We analyzed data from 71,941 women aged ≥60 y participating in the Nurses' Health Study. The AMED, DASH, and AHEI-2010 were computed from validated FFQs in 1990 and repeated every 4 y until 2010. Frailty was defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, reduced resistance, reduced aerobic capacity, having ≥5 illnesses, and weight loss ≥5%. The occurrence of frailty was assessed every 4 y.
During follow-up we identified 11,564 incident cases of frailty. After adjusting for potential confounders, the RRs (95% CIs) of frailty per 1-SD increase in the AMED, DASH, and AHEI-2010 scores were 0.87 (0.85, 0.90), 0.93 (0.91, 0.95), and 0.90 (0.88, 0.92), respectively. All diet quality scores were associated with lower risk of the individual frailty criteria fatigue, reduced resistance, reduced aerobic capacity, and weight loss. Lower consumption of red and processed meat, a lower sodium intake, a higher ratio of monounsaturated to saturated fat, vegetables, and moderate alcohol intake were components of the diet quality scores independently associated with lower risk of frailty.
Adherence to a healthy diet, as defined by the AMED, DASH, and AHEI-2010 scores, was associated with reduced risk of frailty in older women.
虚弱综合征与多种疾病并存的情况下，残疾和死亡风险更高。因此，需要确定虚弱的决定因素，以确保老年人不仅活得更长，而且更健康。然而，饮食质量对虚弱的影响大多是未知的。
我们旨在评估替代地中海饮食（AMED）、停止高血压的饮食方法（DASH）和 2010 年替代健康饮食指数（AHEI-2010）与老年女性虚弱风险的关系。
我们分析了 71941 名年龄≥60 岁的参与护士健康研究的女性的数据。1990 年从经过验证的 FFQ 中计算出 AMED、DASH 和 AHEI-2010，并在 2010 年之前每 4 年重复一次。虚弱的定义是具有以下 FRAIL 量表的 5 个标准中的≥3 个：疲劳、抵抗力下降、有氧能力下降、患有≥5 种疾病和体重减轻≥5%。每 4 年评估一次虚弱的发生情况。
在随访期间，我们确定了 11564 例虚弱的新发病例。在调整潜在混杂因素后，AMED、DASH 和 AHEI-2010 评分每增加 1-SD，虚弱的 RR（95%CI）分别为 0.87（0.85，0.90）、0.93（0.91，0.95）和 0.90（0.88，0.92）。所有饮食质量评分均与疲劳、抵抗力下降、有氧能力下降和体重减轻等单个虚弱标准的风险降低相关。较低的红肉类和加工肉类消费、较低的钠摄入量、较高的单不饱和脂肪与饱和脂肪比例、蔬菜和适量饮酒是饮食质量评分与虚弱风险降低相关的独立成分。
根据 AMED、DASH 和 AHEI-2010 评分，健康饮食的依从性与老年女性虚弱风险的降低有关。
