In the JournalsPerspective

Poor diet increases frailty risk in older age

Poorer overall diet quality and lower vegetable protein intake increased the risk for frailty in old age, according to findings published in the Journal of the American Geriatrics Society.

Only a few previous studies have looked at indicators of diet quality — such healthy eating and protein and energy intake — and their impact on frailty, according to Linda M. Hengeveld, MSc, of the department of health sciences at the Vrije Universiteit Amsterdam in the Netherlands, and colleagues.

In their analysis, researchers examined associations between the diet quality of 2,154 community dwelling men and women aged 70 to 81 years and their frailty over 4-year period.

Adjusting for energy intake and other confounders, the researchers found that older adults with poor- and medium-quality diets (HR = 1.92; 95% CI, 1.17-3.17) had a higher frailty incidence than their counterparts who had good-quality diets (HR = 1.4; 95% CI, 0.99-1.98). The incidence of what the researchers called “pre-frailty” and frailty increased with each 10 fewer grams of vegetable protein a person ate (HR = 1.2; 95% CI, 1.04-1.39).

“Although some prospective studies showed that higher protein intake may lower frailty risk, our study indicates that the quality of the overall diet may be more important than protein intake for reducing the development of frailty in old age,” Hengeveld and colleagues concluded. by Janel Miller

Disclosures : The authors report no relevant financial disclosures.

Poorer overall diet quality and lower vegetable protein intake increased the risk for frailty in old age, according to findings published in the Journal of the American Geriatrics Society.

Only a few previous studies have looked at indicators of diet quality — such healthy eating and protein and energy intake — and their impact on frailty, according to Linda M. Hengeveld, MSc, of the department of health sciences at the Vrije Universiteit Amsterdam in the Netherlands, and colleagues.

In their analysis, researchers examined associations between the diet quality of 2,154 community dwelling men and women aged 70 to 81 years and their frailty over 4-year period.

Adjusting for energy intake and other confounders, the researchers found that older adults with poor- and medium-quality diets (HR = 1.92; 95% CI, 1.17-3.17) had a higher frailty incidence than their counterparts who had good-quality diets (HR = 1.4; 95% CI, 0.99-1.98). The incidence of what the researchers called “pre-frailty” and frailty increased with each 10 fewer grams of vegetable protein a person ate (HR = 1.2; 95% CI, 1.04-1.39).

“Although some prospective studies showed that higher protein intake may lower frailty risk, our study indicates that the quality of the overall diet may be more important than protein intake for reducing the development of frailty in old age,” Hengeveld and colleagues concluded. by Janel Miller

Disclosures : The authors report no relevant financial disclosures.

    Perspective
    Barbara Resnick

    Barbara Resnick

    Hengeveld and colleagues’ findings are very much a reality among our older population. Protein is a critical part of maintaining muscle and muscle strength throughout the lifespan; however, protein is one of the most common nutrients that older individuals often lack in their daily meals.

    Health care providers should use these findings to start a discussion with older patients that tells them protein intake needs to be spread throughout the day. An older person with a normal BMI should eat about 30 g of protein with every meal. Consuming more than that amount in one setting, such as having a carbohydrate-based meal for breakfast, largely repeating this pattern at lunch and then having a big steak at dinner time rarely does a patient any good. Consuming less than 30 g of protein in each meal can contribute to frailty as described in the study.

    Health care providers also need to remember that those messages outlined above need to be repeated multiple times over the latter part of patients’ lifespan. You can’t tell a patient this information once and assume they will remember for the rest of the lives. Health care providers should also provide their patients with examples of foods high in protein such as eggs, peanut butter and milk products, meat, chicken and fish.

    • Barbara Resnick, PhD, RN, CRNP
    • Co-Director, Center of Excellence in Biology and Behavior Across the Life Span Past president, American Geriatrics Society

    Disclosures: Resnick reports no relevant financial disclosures.

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