Konieczynski Elsa M, Sahni Shivani, Jacques Paul F, Naumova Elena N
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
Marcus Institute, Hebrew SeniorLife and Harvard Medical School, Boston, MA 02131, USA.
Nutrients. 2025 Aug 14;17(16):2631. doi: 10.3390/nu17162631.
Ultra-Processed Foods (UPFs) make up a growing share of older adults' diets and may contribute to frailty through pro-inflammatory pathways. The objective of this study was to examine the association of UPF intake with frailty development and with annual changes in select frailty components. This prospective cohort study used data from 2547 participants in the Framingham Offspring Cohort. UPF intake was assessed using a food frequency questionnaire and classified according to the NOVA framework, and frailty was defined by the Fried frailty phenotype. We used cumulative and mixed logistic regression models to examine the association between daily servings of UPF and odds of developing frailty, adjusting for baseline age, education, energy intake, multivitamin use, smoking, self-rated health, history of diabetes, cancer, cardiovascular disease, and diet quality. For the frailty component analysis, we used cumulative linear regression models to assess the association between UPF intake and annual changes in grip strength, gait speed, and weight, further adjusting for BMI and physical activity. We also evaluated potential effect modification by sex and baseline age (<60 vs. ≥60 years). The study population was 55.1% female, with a mean age of 60.3 ± 8.9 years. Over an average follow-up of 10.8 years, 233 participants (9.2%) developed frailty. UPF intake was not associated with frailty development in either the cumulative or mixed regression models. UPF intake was not associated with annual weight change but was inversely associated with annual change in gait speed and with annual change in grip strength in men only. Our findings contribute preliminary evidence that, in middle-aged and older adults, increased UPF intake is not associated with frailty but may be related to worsening muscle strength and function. Further research with a more granular approach to UPF classification is required to translate these findings to practical recommendations and to clarify their clinical significance.
超加工食品（UPF）在老年人饮食中所占比例日益增加，可能通过促炎途径导致身体虚弱。本研究的目的是探讨UPF摄入量与身体虚弱发展以及特定虚弱成分的年度变化之间的关联。这项前瞻性队列研究使用了弗雷明汉后代队列中2547名参与者的数据。UPF摄入量通过食物频率问卷进行评估，并根据NOVA框架进行分类，身体虚弱则由弗里德虚弱表型定义。我们使用累积和混合逻辑回归模型来检验每日UPF份数与身体虚弱发生几率之间的关联，并对基线年龄、教育程度、能量摄入、复合维生素使用情况、吸烟状况、自我评估健康状况、糖尿病史、癌症史、心血管疾病史和饮食质量进行了调整。对于虚弱成分分析，我们使用累积线性回归模型来评估UPF摄入量与握力、步速和体重的年度变化之间的关联，并进一步对体重指数和身体活动进行了调整。我们还评估了性别和基线年龄（<60岁与≥60岁）的潜在效应修饰作用。研究人群中女性占55.1%，平均年龄为60.3±8.9岁。在平均10.8年的随访期内，233名参与者（9.2%）出现了身体虚弱。在累积或混合回归模型中，UPF摄入量与身体虚弱的发展均无关联。UPF摄入量与年度体重变化无关，但仅在男性中与步速的年度变化以及握力的年度变化呈负相关。我们的研究结果提供了初步证据，即在中老年人中，UPF摄入量增加与身体虚弱无关，但可能与肌肉力量和功能的恶化有关。需要采用更细致的UPF分类方法进行进一步研究，以便将这些发现转化为实际建议并阐明其临床意义。
