Does Diet Impact Frailty Risk?

A healthy diet may reduce the risk of frailty in older adults, a study has found.

“With the older population growing rapidly, an increase in the prevalence of frailty is to be expected. Given the components of frailty (ie, weight loss, weakness, exhaustion, slowness, and physical inactivity), diet is considered an important determinant of its development,” the researchers wrote, reporting in the Journal of the American Geriatrics Society. “Older adults especially may benefit from dietary strategies as their diet is commonly observed to be of insufficient overall quality or low in protein.”

The U.S.-based Health, Aging, and Body Composition (Health ABC) Study included 3,075 community-dwelling adults aged between 70 and 79 years at baseline (1997-98). All participants underwent a baseline home interview and clinical examination, and subsequent data were gathered annually. A 12-month follow-up examination was conducted between 1998 and 1999, which researchers used as the present study’s baseline. Diet quality was measured based on three parameters: overall diet quality, energy intake, and protein intake. Overall diet quality was measured using the 10-component 1994-1996 Healthy Eating Index (HEI). The HEI score ranges from 0 to 100 and a higher score indicates a better diet quality. Patients were classified as poor (< 51), needs improvement/medium (51-80), and good (> 80). “Energy intake was expressed in kcal/d, and total protein intake in g/d and g/kg adjusted [body weight] (aBW) per day. … Protein intake (g/kg aBW per day) was dichotomized according to the current Recommended Dietary Allowance into low (less than 0.8) and high (0.8 or greater),” the researchers added.

Overall Diet More Impactful than Protein Intake

The final analysis included 2,154 participants (mean age at baseline, 74.5 years; 51.5% were female), who were classified as robust (n = 1,020) or pre-frail (n = 1,134) at baseline. In the total cohort, most patients had a medium HEI score (72.9%), while 6.5% scored “poor” and 20.6% scored “good.”

All patients were followed for a mean 3.5 years, during which time 277 patients developed frailty. In adjusted analyses, poor-quality diets was associated with a 92% higher frailty incidence compared to good-quality diets; in medium-quality diets, the incidence was 40% greater.

When looking at the robust cohort, which had a mean 2.7 years of follow-up, 629 out of 1,020 patients developed frailty or pre-frailty. The study authors observed in this cohort, “The associations of overall diet quality with incident pre‐frailty or frailty were in the same direction as for frailty, but not statistically significant. A 10‐g lower vegetable protein intake was associated with a 20% higher incidence of pre‐frailty or frailty. No associations were observed with energy intake, total protein intake, or animal protein intake.”

The study authors reported no correlation between frailty and level of protein intake or energy: “Lower energy intake was associated only with a lower incidence of weight loss. Lower total protein intake (g/d) was associated only with a higher incidence of physical inactivity (P = .049 for trend).”