Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo /ISPA, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Clin Nutr. 2020 Dec;39(12):3663-3670. doi: 10.1016/j.clnu.2020.03.018. Epub 2020 Mar 27.
BACKGROUND & AIMS: Fatty acid supplementation increases muscle mass and function in older adults, but the effect of habitual dietary intake is uncertain. Therefore, the objective of this study was to examine the association between habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment (LEFI) in older adults.
Prospective study with 1873 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-10 and 2012, a validated face-to-face diet history was used to record the one-year consumption of up to 880 foods. Then, fatty acids, other nutrients and energy intake were estimated using standard food composition tables. Means of intake between these years were calculated to represent cumulative consumption over the follow-up. Study participants were followed up through 2015 to assess incident muscle weakness (lowest quintile of grip strength) and incident LEFI (Short Physical Performance Battery score ≤6). Analyses were performed with Cox regression and adjusted for the main confounders, including other types of fatty acids.
Over a median follow-up of 5.2 years, 331 participants developed muscle weakness and 397 LEFI. Intake of saturated fatty acids (SFA) did not show an association with muscle weakness but was associated with higher risk of LEFI (multivariable hazard ratio (HR) for tertile 3 vs. tertile 1: 1.15; 95% confidence interval: 1.05-2.01; p-trend = 0.02). This association was mostly due to consumption of Spanish cold cuts and pastry and, to a lesser extent, dairy. Monounsaturated fatty acids (MUFA) intake was associated with lower risk of muscle weakness (HR t3 vs. t1: 0.73; 0.54-0.99; p trend = 0.04), and intake of n-3 polyunsaturated fatty acids (PUFA) was associated with reduced risk of both muscle weakness (0.70; 0.52-0.95; p-trend = 0.02) and LEFI (0.49; 0.35-0.68; p-trend <0.001). Olive oil and blue fish, the main sources of MUFA and PUFA, were also associated with lower risk of muscle weakness and LEFI.
Habitual intake of SFA was associated with increased risk of LEFI. By contrast, habitual intake of MUFA and PUFA were associated with lower risk of physical performance impairment.
脂肪酸补充剂可增加老年人的肌肉量和功能,但习惯性饮食摄入的效果尚不确定。因此,本研究旨在探讨老年人习惯性饮食脂肪摄入与肌肉无力和下肢功能障碍(LEFI)风险之间的关系。
前瞻性研究,纳入来自 Seniors-ENRICA 队列的 1873 名年龄≥60 岁的个体。2008-10 年和 2012 年,使用经过验证的面对面饮食史记录了一年中多达 880 种食物的消费情况。然后,使用标准食物成分表估算脂肪酸、其他营养素和能量摄入。通过计算这两年的摄入量平均值来代表随访期间的累积摄入量。通过 2015 年评估肌肉无力(握力最低五分位数)和下肢功能障碍(短体物理性能电池评分≤6)的发生率来对研究参与者进行随访。使用 Cox 回归分析,并调整了主要混杂因素,包括其他类型的脂肪酸。
在中位随访 5.2 年期间,331 名参与者出现肌肉无力,397 名参与者出现下肢功能障碍。摄入饱和脂肪酸(SFA)与肌肉无力无关,但与更高的下肢功能障碍风险相关(三分位 3 与三分位 1 相比:1.15;95%置信区间:1.05-2.01;p 趋势=0.02)。这种关联主要归因于西班牙冷切和糕点的消费,以及奶制品的消费。单不饱和脂肪酸(MUFA)摄入与肌肉无力风险降低相关(三分位 3 与三分位 1 相比:0.73;0.54-0.99;p 趋势=0.04),摄入 n-3 多不饱和脂肪酸(PUFA)与肌肉无力(0.70;0.52-0.95;p 趋势=0.02)和下肢功能障碍(0.49;0.35-0.68;p 趋势<0.001)的风险降低相关。MUFA 和 PUFA 的主要来源,橄榄油和蓝鱼,也与肌肉无力和下肢功能障碍风险降低相关。
习惯性 SFA 摄入与 LEFI 风险增加相关。相比之下,习惯性 MUFA 和 PUFA 摄入与较低的身体机能障碍风险相关。