Mediterranean diet may reduce frailty risk

Millar reports no relevant financial disclosures. Sahni reports receiving unrestricted institutional grants from Dairy Management Inc. and Solarea Bio Inc., has reviewed grants for the American Egg Board’s Egg Nutrition Center and serves on a scientific advisory board for the Protein Committee, Institute for the Advancement of Food and Nutrition Sciences.

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Several health benefits have been linked to the Mediterranean diet, and researchers just added “may prevent frailty” to the list.

Frailty, a state of increased vulnerability that is recognizable and results from multiple physiological systems’ functional decline, impacts between 10% and 15% of older adults, according to a press release. It is associated with a higher risk for falls, hospitalization, disability, fractures and mortality.

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Previous research has shown that lifestyle interventions like nutrition counseling and physical mobility have helped older adults with frailty, but little is known about how specific diets might affect them. The Mediterranean diet — which includes high intake of fruits, leafy green vegetables, nuts, cereal and extra virgin olive oil and moderate intake of dairy products, fish and other meat — has emerged as one of the most popular new diets, even being named best overall diet by U.S. News & World Report for 5 straight years. Recent research has shown that the Mediterranean diet has CVD benefits, cognitive benefits and may reduce preeclampsia risk by 22%.

Courtney Millar, PhD, a postdoctoral research fellow at Harvard Medical School, and colleagues found that following a Mediterranean diet might prevent frailty developing with age.

The study, published in The American Journal of Clinical Nutrition, included more than 2,300 adults who did not have frailty at baseline with Mediterranean-style diet pattern score and antioxidant intake, which includes vitamin C, E and total carotenoids. The participants were from the Framingham Offspring Study. These participants were enrolled in that prospective cohort study from 1971 to 1975, and for every 4 years that followed, “detailed, in-person examinations” were conducted.

For each person who scored one unit higher on the Mediterranean Style Dietary Pattern Score —meaning they more frequently adhere to the diet — the odds of frailty were reduced by 3% (OR, 0.97; 95% CI: 0.96-0.99). However, the associations of a Mediterranean-style diet with long-term frailty onset “appeared to be stronger” among participants who were less than 60 years old.

Those that were aged younger than 60 years had lower instances of comorbidities, but researchers noted they also “tended to have worse lifestyle habits, such as higher reports of current smoking, less physical activity, and lower intakes of vitamin C and E.” Therefore, researchers wrote, “it is possible that a Mediterranean diet was specifically beneficial in those with higher oxidative stress related to smoking and poor lifestyle choices.”

Researchers also sought to discover if specific antioxidants such as carotenoids, vitamin E and vitamin C might be related to frailty. Though vitamins E and C were “not meaningfully associated with frailty,” carotenoids, which are often found in “brightly colored fruits and vegetables,” had “the strongest association with reduced likelihood of frailty development in middle-aged and older men and women.”

For each 10 mg higher total carotenoid intake, the odds of frailty were reduced by 16% (OR, 0.84; 95% CI 0.73-0.98).

“Increasing the intake of brightly colored fruits and vegetables that are rich in carotenoids as well as other bioactive compounds may ultimately affect the health of older adults,” Shivani Sahni, PhD, an associate professor of medicine at Harvard Medical School, said in the release.

Since total carotenoids “had the strongest effect on frailty onset prevention,” researchers tested whether any proposed oxidative stress and inflammation markers were relevant to the findings, but adjustments for those markers did not “appreciably change the associations” and they concluded that the association of carotenoids intake with reduced odds of long-term frailty onset is independent of the markers for inflammation and oxidative stress.


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