Entry #: 51
Date: 31 May 2018
Section: Mediterranean Diet
Topic: Mediterranean Diet and frailty
Type: Human Trial

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D. Elizabeth McCord, Nancy B. Ray and Tom C. Karagiannis

Title

Mediterranean diet and risk of frailty syndrome among women with type 2 diabetes

Author(s)

Lopez-Garcia et al

Citation / Year

(1) / 2018

Keywords

Mediterranean diet, type 2 diabetes, Nurses’ health study, fatigue, low resistance, low aerobic capacity

Summary

Frailty, which is essentially associated with an increased risk of falls, disability, and hospitalization occurs predominantly in those older people with incidences of approximately, 10% and 25% in those aged >60 years and >80 years, respectively (2-4). It is skewed positively females and those are relatively well educated (4). Typically, it is precipitated by stressors including disease and drug treatments for those diseases. Diabetes and diabetic complications, which are rapidly increasing, represent an important risk factor for frailty, and antidiabetic therapy attenuates frailty presumably by diminishing muscle tone (5, 6). Apart from numerous other health benefits, the Mediterranean diet has been shown to reduce the risk of frailty in susceptible individuals (7-9). This study represents a large, long-term prospective study examining adherence to the Mediterranean diet and risk of frailty.

Key points and implications

This study is a subset of the large Nurses’ Health Study established in 1976, in which 121,700 female nurses were enrolled (aged 30-55 years); medical history, health-related behaviours, and dietary intake were part of baseline and follow-up questionnaires completed by the participants (10). For this study, women (>60 years), with type 2 diabetes (reported between 1992 and 2010), were analysed. In summary, in this study type 2 diabetes was confirmed, dietary intake was assessed with a reliable questionnaires (11), (with a focus on calculating a Mediterranean diet adherence score), and self-reported frailty was evaluated with the use of appropriate FRAIL and Fried scales (12, 13); analysis was completed for 8790 women. Although, there are obvious limitations associated with self-reporting, this is a relatively very large study, with meticulous analyses. The findings clearly highlight a reduction in frailty with increasing adherence to the Mediterranean diet. Indeed, a two-point increase in Mediterranean diet score was associated with a 28% decrease risk in frailty. Overall, these findings extend the previous findings and more generally, add to the growing list of potential health benefits associated with the Mediterranean diet.

Related publications

  1. E. Lopez-Garcia, K. A. Hagan, T. T. Fung, F. B. Hu, F. Rodriguez-Artalejo, Mediterranean diet and risk of frailty syndrome among women with type 2 diabetes. The American journal of clinical nutrition 107, 763-771 (2018).
  2. L. P. Fried et al., Frailty in older adults: evidence for a phenotype. The journals of gerontology. Series A, Biological sciences and medical sciences 56, M146-156 (2001).
  3. R. M. Collard, H. Boter, R. A. Schoevers, R. C. Oude Voshaar, Prevalence of frailty in community-dwelling older persons: a systematic review. Journal of the American Geriatrics Society 60, 1487-1492 (2012).
  4. K. Harttgen, P. Kowal, H. Strulik, S. Chatterji, S. Vollmer, Patterns of frailty in older adults: comparing results from higher and lower income countries using the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Study on Global AGEing and Adult Health (SAGE). PloS one 8, e75847 (2013).
  5. J. S. Lee et al., Physical frailty in older adults is associated with metabolic and atherosclerotic risk factors and cognitive impairment independent of muscle mass. The journal of nutrition, health & aging 15, 857-862 (2011).
  6. M. S. Kirkman et al., Diabetes in older adults. Diabetes care 35, 2650-2664 (2012).
  7. J. Bollwein et al., Dietary quality is related to frailty in community-dwelling older adults. The journals of gerontology. Series A, Biological sciences and medical sciences 68, 483-489 (2013).
  8. J. M. Shikany et al., Macronutrients, diet quality, and frailty in older men. The journals of gerontology. Series A, Biological sciences and medical sciences 69, 695-701 (2014).
  9. L. M. Leon-Munoz, P. Guallar-Castillon, E. Lopez-Garcia, F. Rodriguez-Artalejo, Mediterranean diet and risk of frailty in community-dwelling older adults. Journal of the American Medical Directors Association 15, 899-903 (2014).
  10. Y. Bao et al., Origin, Methods, and Evolution of the Three Nurses’ Health Studies. American journal of public health 106, 1573-1581 (2016).
  11. C. Yuan et al., Validity of a Dietary Questionnaire Assessed by Comparison With Multiple Weighed Dietary Records or 24-Hour Recalls. American journal of epidemiology 185, 570-584 (2017).
  12. J. E. Morley, T. K. Malmstrom, D. K. Miller, A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. The journal of nutrition, health & aging 16, 601-608 (2012).
  13. D. M. Mijnarends et al., Instruments to assess sarcopenia and physical frailty in older people living in a community (care) setting: similarities and discrepancies. Journal of the American Medical Directors Association 16, 301-308 (2015).