Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study

H. Sandoval-Insausti, R.F. Pérez-Tasigchana, E. López-García , E. García-Esquinas, F. Rodríguez-Artalejo, P. Guallar-Castillón

J Gerontol A Biol Sci Med Sci.2016;71(10):1329-34

Only a few studies have assessed the association between protein intake and frailty incidence and have obtained inconsistent results.

This study examined the association of protein and other macronutrient intake with the risk of frailty in older adults.

Data were taken from the Seniors-ENRICA (Study on Nutrition and Cardiovascular risk factors in Spain) cohort, which was established in 2008–2010 with 2,614 community-dwelling individuals aged 60 years and older in Spain. Participants were followed-up through 2012.

At baseline, food consumption was assessed with a validated, computerized face-to-face diet history. In 2012, individuals were contacted again to ascertain incident frailty, defined as the presence of at least three of the five Fried criteria: low physical activity, slowness, unintentional weight loss, muscle weakness, and exhaustion.

During a mean follow-up of 3.5 years, 132 persons with incident frailty were identified. The odds ratios (95% confidence interval) of frailty across increasing quartiles of total protein were 1.00, 0.55 (0.32–0.93), 0.45 (0.26–0.78), and 0.41 (0.23–0.72); p trend: .001. The corresponding figures for animal protein intake were 1.00, 0.68 (0.40–1.17), 0.56 (0.32–0.97), and 0.48 (0.26–0.87), p trend: .011. For intake of monounsaturated fatty acids (MUFAs), the results were 1.00, 0.66 (0.37–1.20), 0.54 (0.28–1.02), and 0.50 (0.26–0.96); p trend: .038. No association was found between intake of vegetable protein, saturated fats, long-chain ω-3 fatty acids, α-linolenic acid, linoleic acid, simple sugars, or polysaccharides and the risk of frailty.

Comment: Total protein, animal protein, and MUFA intakes were inversely associated with incident frailty in community-dwelling older adults. Moreover, higher animal protein intake was associated with lower risk of slow walking speed, and higher MUFA intake was associated with reduced risk of unintentional weight loss. The main sources of MUFAs in Spain and other Mediterranean countries differ from those in northern Europe, America, or Asia. The main source of MUFAs in Spain is olive oil while the main contributors to total MUFA intake in non-Mediterranean countries are meat and meat products, added fats, and dairy products.

Promoting the intake of these nutrients might reduce frailty.