Effects of Dietary Diversity on Frailty in Chinese Older Adults: a 3-year Cohort Study

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Mar 15

PMID 36918767

Authors

Ying Duan

Qi Qi

Yan Cui

Ling Yang

Min Zhang

Huaqing Liu

Affiliations

Soon will be listed here.

Abstract

Background: Frailty has emerged as a global health burden with increased population aging. A diverse diet is essential for an adequate and balanced supply of nutrients. However, limited evidence supports the relationship between dietary diversity and frailty. We therefore assessed the associations of dietary diversity with the risk of frailty.

Methods: We used the Chinese Longitudinal Healthy Longevity Survey to analyze a prospective cohort of Chinese older adults. A total of 1948 non-frail older adults were included in the final sample. Participants were categorized into groups with high or low dietary diversity scores (DDSs) using a food frequency questionnaire. A Generalized Estimating Equation were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for determining frailty incidence.

Results: Among 1,948 participants, 381 had frailty with the prevalence of 19.56% during the 3-year follow-up period. Compared with the low DDS group, the high DDS group exhibited a lower risk of frailty (RR, 0.72; 95% CI: 0.57-0.91). Compared with those with a consistently low DDS, the RR of participants with a consistently high DDS for frailty was 0.56 (95% CI: 0.42-0.74). Moreover, meat, beans, fish, nuts, fresh fruits, and fresh vegetables were inversely associated with frailty. In stratified analysis, a consistently high DDS, compared with a consistently low DDS, reduced the risk of frailty for people aged 65-79 years and those living in town and rural areas.

Conclusion: This study found a prospective association between dietary diversity and frailty among Chinese older adults. These findings stressed that it is important to improve dietary diversity for older adults to promote healthy ageing, particularly for young older adults and in town and rural areas.

Citing Articles

Relationship between leisure activity and depression in Chinese older adults: chain mediating effect of diet and cognition.

Cui Y, Duan Y, Du J, Yang L, Tian X, Liu H BMC Geriatr. 2025; 25(1):14.

PMID: 39773373 PMC: 11706181. DOI: 10.1186/s12877-024-05671-1.

Developmental trajectories and heterogeneity of social engagement among Chinese older adults: a growth mixture model.

Zhou H, Zhang C, Wang S, Yu C, Wu L BMC Geriatr. 2024; 24(1):846.

PMID: 39425024 PMC: 11488232. DOI: 10.1186/s12877-024-05448-6.

The Association of Dietary Diversity with Hyperuricemia among Community Inhabitants in Shanghai, China: A Prospective Research.

Xu X, He M, Zhao G, Liu X, Liu X, Xu H Nutrients. 2024; 16(17).

PMID: 39275283 PMC: 11397405. DOI: 10.3390/nu16172968.

Association between dietary diversity changes and frailty among Chinese older adults: findings from a nationwide cohort study.

Wang X, Zhong W, Zhang Y, Xiang J, Chen H, Li Z Nutr J. 2024; 23(1):91.

PMID: 39138490 PMC: 11320915. DOI: 10.1186/s12937-024-00997-3.

A Mendelian randomization study to examine the causal associations of circulating micronutrient levels with frailty risk.

Kuribanjiang K, Min Y, Yan S, Chen S, Aiheti N, Wupuer A Front Nutr. 2024; 11:1386646.

PMID: 38746935 PMC: 11091248. DOI: 10.3389/fnut.2024.1386646.

References

Cano-Ibanez N, Gea A, Martinez-Gonzalez M, Salas-Salvado J, Corella D, Zomeno M . Dietary Diversity and Nutritional Adequacy among an Older Spanish Population with Metabolic Syndrome in the PREDIMED-Plus Study: A Cross-Sectional Analysis. Nutrients. 2019; 11(5). PMC: 6567048. DOI: 10.3390/nu11050958. View

Meng L, Wang Y, Li T, van Loo-Bouwman C, Zhang Y, Szeto I . Dietary Diversity and Food Variety in Chinese Children Aged 3⁻17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?. Nutrients. 2018; 10(11). PMC: 6267553. DOI: 10.3390/nu10111674. View

Walters K, Frost R, Kharicha K, Avgerinou C, Gardner B, Ricciardi F . Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT. Health Technol Assess. 2017; 21(73):1-128. PMC: 5742456. DOI: 10.3310/hta21730. View

Gu D, Dupre M, Sautter J, Zhu H, Liu Y, Yi Z . Frailty and mortality among Chinese at advanced ages. J Gerontol B Psychol Sci Soc Sci. 2009; 64(2):279-89. PMC: 2655172. DOI: 10.1093/geronb/gbn009. View

Ni Lochlainn M, Bowyer R, Steves C . Dietary Protein and Muscle in Aging People: The Potential Role of the Gut Microbiome. Nutrients. 2018; 10(7). PMC: 6073774. DOI: 10.3390/nu10070929. View

Pickard S, Cluley V, Danely J, Laceulle H, Leon-Salas J, Vanhoutte B . New horizons in frailty: the contingent, the existential and the clinical. Age Ageing. 2019; 48(4):466-471. DOI: 10.1093/ageing/afz032. View

Clegg A, Young J, Iliffe S, Rikkert M, Rockwood K . Frailty in elderly people. Lancet. 2013; 381(9868):752-62. PMC: 4098658. DOI: 10.1016/S0140-6736(12)62167-9. View

Kojima G, Taniguchi Y, Iliffe S, Jivraj S, Walters K . Transitions between frailty states among community-dwelling older people: A systematic review and meta-analysis. Ageing Res Rev. 2019; 50:81-88. DOI: 10.1016/j.arr.2019.01.010. View

Heiman M, Greenway F . A healthy gastrointestinal microbiome is dependent on dietary diversity. Mol Metab. 2016; 5(5):317-320. PMC: 4837298. DOI: 10.1016/j.molmet.2016.02.005. View

10.

Wang H, Liu C, Fan H, Tian X . Rising food accessibility contributed to the increasing dietary diversity in rural and urban China. Asia Pac J Clin Nutr. 2017; 26(4):738-747. DOI: 10.6133/apjcn.052016.03. View

11.

Ni Lochlainn M, Cox N, Wilson T, Hayhoe R, Ramsay S, Granic A . Nutrition and Frailty: Opportunities for Prevention and Treatment. Nutrients. 2021; 13(7). PMC: 8308545. DOI: 10.3390/nu13072349. View

12.

Blodgett J, Theou O, Howlett S, Rockwood K . A frailty index from common clinical and laboratory tests predicts increased risk of death across the life course. Geroscience. 2017; 39(4):447-455. PMC: 5636769. DOI: 10.1007/s11357-017-9993-7. View

13.

Aihemaitijiang S, Zhang L, Ye C, Halimulati M, Huang X, Wang R . Long-Term High Dietary Diversity Maintains Good Physical Function in Chinese Elderly: A Cohort Study Based on CLHLS from 2011 to 2018. Nutrients. 2022; 14(9). PMC: 9105097. DOI: 10.3390/nu14091730. View

14.

Hayakawa M, Motokawa K, Mikami Y, Yamamoto K, Shirobe M, Edahiro A . Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study. Nutrients. 2021; 13(2). PMC: 7920314. DOI: 10.3390/nu13020641. View

15.

Otsuka R, Kato Y, Nishita Y, Tange C, Nakamoto M, Tomida M . Dietary diversity and 14-year decline in higher-level functional capacity among middle-aged and elderly Japanese. Nutrition. 2016; 32(7-8):784-9. DOI: 10.1016/j.nut.2016.01.022. View

16.

Liu Z, Wei Y, Wei L, Jiang X, Wang X, Shi Y . Frailty transitions and types of death in Chinese older adults: a population-based cohort study. Clin Interv Aging. 2018; 13:947-956. PMC: 5960243. DOI: 10.2147/CIA.S157089. View

17.

Hoover M, Rotermann M, Sanmartin C, Bernier J . Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep. 2013; 24(9):10-7. View

18.

OCaoimh R, Sezgin D, ODonovan M, Molloy D, Clegg A, Rockwood K . Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies. Age Ageing. 2020; 50(1):96-104. DOI: 10.1093/ageing/afaa219. View

19.

Kojima G, Iliffe S, Jivraj S, Walters K . Fruit and Vegetable Consumption and Incident Prefrailty and Frailty in Community-Dwelling Older People: The English Longitudinal Study of Ageing. Nutrients. 2020; 12(12). PMC: 7766547. DOI: 10.3390/nu12123882. View

20.

Ferrucci L, Bandinelli S, Benvenuti E, Di Iorio A, Macchi C, Harris T . Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc. 2000; 48(12):1618-25. DOI: 10.1111/j.1532-5415.2000.tb03873.x. View