Supervisors info:
Ανδρέας Κυρώζης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βασιλική Μπενέτου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ανδρονίκη Νάσκα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Background: The prevalence of Frailty syndrome is increasing globally in the elderly population, drawing the attention of the scientific community, given its public health consequences. Several factors have been reported to affect the presence and severity of the syndrome, among which nutrition plays a significant role. Thus, higher adherence to the Mediterranean Diet (MD) may prevent the onset of frailty. Recently, scientific interest has focused on specific dietary factors such as macronutrients. However, findings have been inconclusive. The aim of the current study was to investigate associations between daily protein intake and the risk of frailty syndrome. Methods: Study sample derived from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD), which contains a mixture of urban and rural settings considered representative of the Greek population. In the current study, 1984 participants were included (50,3% women) with a mean (±SD) age of 73.9 (±5.32) years. Frailty syndrome was defined using two definitions: (a) the Fried Phenotype (FP) proposed by Fried et al., and (b) the Frailty Index (FI). Dietary intakes were assessed using validated Food Frequency Questionnaires (FFQ). Daily protein intake was expressed as nutrient density based on daily energy intake . Food groups high in proteins (>8g/30g) were also assessed for potential associations with frailty syndrome. Adherence to the MD was measured with Mediterranean Diet score (MD score). For the purposes of the study, linear and logistic regression analysis was utilized including potential confounding factors.
Results: In total, 2.3 % and 18.4% of participants were frail using the FP and FI definition, respectively. The prognostic factors of frailty, using both definitions were: advanced age, low educational level, manual labour and low adherence to the MD diet (p<0.001). Regarding daily protein intake which was measured with g/Kg Body weight (BW), the risk of frailty (based on the FP definition) was lower among participants with a protein intake between 0.8-0.9 g/Kg BW (p<0.05). In the case of higher protein intakes (>1 g/Kg/BW), the risk of frailty was found lower, albeit not significantly, using both definitions. Further analysis between each of the five criteria of FP definition and quartiles of daily protein intakes revealed that participants with protein intake between 0.8-0.9 g/Kg/BW had 56% 95%CI:( 0.21 – 0.94) less odds of having a low grip strength, defined as weakness, in comparison to those with an intake <0.7 g/Kg/BW. With respect to food groups high in proteins , persons consuming fish and seafood were found to have 41% 95%CI:( 0.40 – 0.87)less odds of being frail using the FI definition. Adherence to the MD was not found to reduce significantly the risk of frailty based on both definitions.
Conclusions: Findings from the current study suggest that a higher daily protein intake in a large sample of the Greek elderly residents of rural and urban settings showed a possible inverse association with the risk of frailty. Concerning food groups, the consumption of fish and seafood products were found to reduce the risk of frailty.
However, findings using the two definitions of frailty were found to differ depending on the definition used, resulting in inconsistent findings in some cases. That is possible due to the different criteria to define frailty, used in the two definitions.
However, more prospective studies are needed to better understand the role of nutrition and specific food groups in the prevention of frailty syndrome. Results of the present study might contribute to future investigations aiming at clarifying the importance of specific protein intake-related factors in the prevention and treatment of frailty syndrome and lead to more specific public health policy recommendations.
Keywords:
Frailty, Nutrition, Food groups, Macronutrients, Protein
