Department of Clinical and Experimental Medicine, University Magna Grecia, 88100, Catanzaro, Italy.
Department of Medical and Surgical Science, University Magna Grecia, 88100, Catanzaro, Italy.
Eur J Nutr. 2024 Aug;63(5):1651-1662. doi: 10.1007/s00394-024-03370-6. Epub 2024 Apr 3.
Although numerous studies have investigated the impact of dietary factors on the prevention of decreased muscle mass and function, limited research has examined the relationship between dietary patterns and sarcopenia. This study aimed to assess the associations between dietary patterns, and sarcopenia, muscle strength, and mass in adults following a Mediterranean diet residing in southern Italian cities.
This cross-sectional study utilized data from an existing database, comprising 528 individuals aged 50 years or older who underwent health-screening tests at the Clinical Nutrition Unit of the "R.Dulbecco" University Hospital. Strength was assessed through handgrip strength, and appendicular skeletal muscle mass was estimated using bioelectrical impedance analysis. Dietary intake information was collected through a food frequency questionnaire linked to the MetaDieta 3.0.1 nutrient composition database. Principal Component Analysis, a statistical technique identifying underlying relationships among different nutrients, was employed to determine dietary patterns. Multinomial logistic regression analysis was conducted to estimate the odds ratio for sarcopenia or low handgrip strength in relation to the lowest tertile of dietary pattern adherence compared to the highest adherence.
The participants had a mean age of 61 ± 8 years. Four dietary patterns were identified, with only the Western and Mediterranean patterns showing correlations with handgrip strength and appendicular skeletal muscle mass. However, only the Mediterranean pattern exhibited a correlation with sarcopenia (r = - 0.17, p = 0.02). The highest tertile of adherence to the Mediterranean dietary pattern demonstrated significantly higher handgrip strength compared to the lowest tertile (III Tertile: 28.3 ± 0.5 kg vs I Tertile: 26.3 ± 0.5 kg; p = 0.01). Furthermore, even after adjustment, the highest tertile of adherence to the Mediterranean pattern showed a significantly lower prevalence of sarcopenia than the lowest adherence tertile (4% vs 16%, p = 0.04). The lowest adherence to the Mediterranean dietary pattern was associated with increased odds of having low muscle strength (OR = 2.38; p = 0.03; 95%CI = 1.05-5.37) and sarcopenia (OR = 9.69; p = 0.0295; %CI = 1.41-66.29).
A high adherence to the Mediterranean dietary pattern, characterized by increased consumption of legumes, cereals, fruits, vegetables, and limited amounts of meat, fish, and eggs, is positively associated with handgrip strength and appendicular skeletal muscle mass. The highest adherence to this dietary model is associated with the lowest odds of low muscle strength and sarcopenia. Despite the changes brought about by urbanization in southern Italy compared to the past, our findings continue to affirm the superior benefits of the Mediterranean diet in postponing the onset of frailty among older adults when compared to other dietary patterns that are rich in animal foods.
尽管许多研究已经调查了饮食因素对预防肌肉质量和功能下降的影响，但有限的研究调查了饮食模式与肌肉减少症之间的关系。本研究旨在评估地中海饮食模式下的饮食模式与成年人肌肉减少症、肌肉力量和质量之间的关系，这些成年人居住在意大利南部城市。
这是一项横断面研究，利用了现有数据库中的数据，该数据库包含了在“R.Dulbecco”大学医院临床营养科接受健康筛查测试的 528 名年龄在 50 岁或以上的个体。通过握力测试评估力量，通过生物电阻抗分析估计四肢骨骼肌质量。通过与 MetaDieta 3.0.1 营养成分数据库相关联的食物频率问卷收集饮食摄入信息。主成分分析是一种确定不同营养素之间潜在关系的统计技术，用于确定饮食模式。使用多变量逻辑回归分析来估计与最低三分位的饮食模式依从性相比，肌肉减少症或低握力与最高依从性的比值比。
参与者的平均年龄为 61±8 岁。确定了四种饮食模式，只有西方和地中海模式与握力和四肢骨骼肌质量相关。然而，只有地中海模式与肌肉减少症呈相关性（r=-0.17，p=0.02）。与最低三分位相比，地中海饮食模式最高三分位的依从性显著更高（III 三分位：28.3±0.5 公斤 vs I 三分位：26.3±0.5 公斤；p=0.01）。此外，即使经过调整，地中海模式最高依从性 tertile 也显示出比最低依从性 tertile 显著更低的肌肉减少症患病率（4%比 16%，p=0.04）。地中海饮食模式依从性最低与肌肉力量较弱的几率增加有关（OR=2.38；p=0.03；95%CI=1.05-5.37）和肌肉减少症（OR=9.69；p=0.0295；%CI=1.41-66.29）。
地中海饮食模式的高依从性，其特点是增加豆类、谷物、水果、蔬菜的摄入量，限制肉类、鱼类和蛋类的摄入量，与握力和四肢骨骼肌质量呈正相关。这种饮食模式的最高依从性与低肌肉力量和肌肉减少症的几率最低相关。尽管与过去相比，意大利南部的城市化带来了变化，但我们的发现继续证实了地中海饮食在延缓老年人虚弱方面的优越益处，而与富含动物食品的其他饮食模式相比。
