Department of Geriatric, The First Hospital of China Medical University, NO.155 Nanjing North Street, Heping Ward, Shenyang, 110001, China.
Department of Health Services and Policy Research, Queen's University, Kingston, ON, Canada.
BMC Geriatr. 2023 Oct 7;23(1):634. doi: 10.1186/s12877-023-04352-9.
Frailty has long been seen as an indicator of reduced physical functions in the elderly, which may be caused by a variety of chronic illnesses or cancerous tumors. Dietary fiber was connected with anemia and frailty, whereas it was uncertain if dietary fiber consumption modifies the impact of anemia on frailty in elderly adults.
We performed a secondary analysis using older adults aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Dietary fiber intake was estimated using two 24-h dietary recalls. Participants were dichotomized as frail or non-frail based on a modified Fried physical frailty phenotype from previous NHANES studies. The weighted logistic regression was used to estimate the odds ratio (OR) and confidence interval (CI) for the associations between hemoglobin levels and frailty at high- and low-dietary fiber intake levels.
A total of 9644 older adults were included in this study, and the weighted sample was 56,403,031, of whom 3,569,186 (6.3%) were deemed to be frail, and the remainder were deemed to be non-frail. Among the low dietary fiber intake group, higher hemoglobin was significantly associated with a lower risk of frailty (OR = 0.79, 95% CI: 0.71-0.87), and anemia was associated with an almost threefold elevated risk of frailty (OR = 3.24, 95% CI:1.98-5.29) in the fully adjusted model. However, this phenomenon was not observed in groups with high dietary fiber intake. In addition, L-shaped dose response relationship was found in the high dietary fiber intake group (P overall association < 0.001; P non-linear association = 0.076). Whereas the dose response relationship was not significant in the high dietary fiber intake group (P overall association 0.752; P non-linear association = 0.734).
Frailty was positively associated with the severity of anemia in older adults with low, but not high, dietary fiber intake. Adequate fiber intake may be an innovative dietary strategy to reduce frailty in older adults.
虚弱一直被视为老年人身体功能下降的指标，这可能是由各种慢性疾病或癌性肿瘤引起的。膳食纤维与贫血和虚弱有关，但尚不确定膳食纤维的摄入是否会改变贫血对老年人虚弱的影响。
我们使用 2007-2018 年国家健康和营养检查调查（NHANES）中年龄在 60 岁及以上的老年人进行了二次分析。膳食纤维的摄入量是通过两次 24 小时膳食回忆来估计的。根据之前 NHANES 研究中对改良的 Fried 身体虚弱表型的研究，参与者被分为虚弱或非虚弱。使用加权逻辑回归来估计血红蛋白水平与高、低膳食纤维摄入量水平下虚弱之间的关联的比值比（OR）和置信区间（CI）。
共有 9644 名老年人纳入本研究，加权样本为 56403031 人，其中 3569186 人（6.3%）被认为是虚弱的，其余的人被认为是非虚弱的。在低膳食纤维摄入组中，较高的血红蛋白与较低的虚弱风险显著相关（OR=0.79，95%CI：0.71-0.87），而贫血与虚弱的风险几乎增加了三倍（OR=3.24，95%CI：1.98-5.29）在完全调整的模型中。然而，在高膳食纤维摄入组中并未观察到这种现象。此外，在高膳食纤维摄入组中发现了 L 形剂量反应关系（总体关联 P<0.001；P 非线性关联=0.076）。然而，在高膳食纤维摄入组中，剂量反应关系不显著（总体关联 P=0.752；P 非线性关联=0.734）。
在膳食纤维摄入量低的老年人中，虚弱与贫血的严重程度呈正相关，但在膳食纤维摄入量高的老年人中则无此相关性。充足的纤维摄入可能是减少老年人虚弱的一种创新饮食策略。
