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Abstract
PURPOSE OF REVIEW Frailty is a multidimensional condition common in older adults, where reduced resiliency leads to adverse outcomes. It has strong links with malnutrition and sarcopenia, mostly through muscle health. This review explores the links between nutrition and frailty from different perspectives. RECENT FINDINGS Studies linking malnutrition and frailty show that most malnourished persons are frail, and malnutrition risk is increased in frail people. Energy and protein intake and some micronutrients are linked to frailty. Research on the role of microbiota and specific amino acids is increasing. Recent literature on the prevention of frailty with nutrition confirms that an appropriate intake of proteins, vitamin D and other nutrients is needed, but this information is still not in the public domain. Interventions to reverse frailty and sarcopenia should include exercise and nutrition interventions, usually with a multidomain approach including other elements. SUMMARY Public health recommendations to eat an optimal diet with the right amount of energy and proteins should be moved to the public domain. Whenever frailty is present, nutrition has a role in reverting it and avoiding adverse outcomes, but high-quality research is still needed in this area.
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Affiliation(s)
| | - Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hongkong, Hong Kong, China
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Bolzetta F, Veronese N, Stubbs B, Noale M, Vaona A, Demurtas J, Celotto S, Cacco C, Cester A, Caruso MG, Reddavide R, Notarnicola M, Maggi S, Koyanagi A, Fornaro M, Firth J, Smith L, Solmi M. The Relationship between Dietary Vitamin K and Depressive Symptoms in Late Adulthood: A Cross-Sectional Analysis from a Large Cohort Study. Nutrients 2019; 11:nu11040787. [PMID: 30959758 PMCID: PMC6520944 DOI: 10.3390/nu11040787] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/26/2019] [Accepted: 03/29/2019] [Indexed: 12/11/2022] Open
Abstract
Few studies assessed the associations between dietary vitamin K and depressive symptoms. We aimed to investigate the association between dietary vitamin K and depressive symptoms in a large cohort of North American People. In this cross-sectional analysis, 4,375 participants that were aged 45⁻79 years from the Osteoarthritis Initiative were included. Dietary vitamin K intake was collected through a semi-quantitative food frequency questionnaire and categorized in quartiles. Depressive symptoms were diagnosed using the 20-item Center for Epidemiologic Studies-Depression (CES-D) ≥ 16. To investigate the associations between vitamin K intake and depressive symptoms, logistic regression analysis were run, which adjusted for potential confounders. Overall, 437 (=10%) subjects had depressive symptoms. After adjusting for 11 confounders, people with the highest dietary vitamin K intake had lower odds of having depressive symptoms (OR = 0.58; 95%CI: 0.43⁻0.80). This effect was only present in people not taking vitamin D supplementation. In conclusion, higher dietary vitamin K intake was significantly associated with a lower presence of depressive symptoms, also after accounting for potential confounders. Future longitudinal research is required to explore the directionality of the association.
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Affiliation(s)
- Francesco Bolzetta
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", 30031 Dolo-Mirano District, Italy.
| | - Nicola Veronese
- Aging Branch, Neuroscience Institute, National Research Council, 35128 Padua, Italy.
- National Institute of Gastroenterlogy, Research Hospital, IRCCS De Bellis, Castellana Grotte, 70013 Bari, Italy.
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK.
- Faculty of Health, Social care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK.
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) King's College London, De Crespigny Park, London SE5 8AF, UK.
| | - Marianna Noale
- Aging Branch, Neuroscience Institute, National Research Council, 35128 Padua, Italy.
| | - Alberto Vaona
- Primary Care Department, Azienda ULSS20 Verona, 37122 Verona, Italy.
| | - Jacopo Demurtas
- Primary Care Department, Azienda USL Toscana Sud Est, 58100 Grosseto, Italy.
| | - Stefano Celotto
- Primary Care Department, Aziendale AAS3 Alto Friuli ⁻ Collinare ⁻ Medio Friuli, 33013 Udine, Italy.
| | | | - Alberto Cester
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", 30031 Dolo-Mirano District, Italy.
| | - Maria Gabriella Caruso
- National Institute of Gastroenterlogy, Research Hospital, IRCCS De Bellis, Castellana Grotte, 70013 Bari, Italy.
| | - Rosa Reddavide
- National Institute of Gastroenterlogy, Research Hospital, IRCCS De Bellis, Castellana Grotte, 70013 Bari, Italy.
| | - Maria Notarnicola
- National Institute of Gastroenterlogy, Research Hospital, IRCCS De Bellis, Castellana Grotte, 70013 Bari, Italy.
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, 35128 Padua, Italy.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, 28029 Barcelona, Spain.
| | - Michele Fornaro
- New York State Psychiatric Institute, Columbia University, New York, NY 10027, USA.
| | - Joseph Firth
- NICM Health Research Institute, University of Western Sydney, Penrith, NSW 2751, Australia.
- Division of Psychology and Mental Health, University of Manchester, Manchester M13 9PL, UK.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK.
| | - Marco Solmi
- Department of Neuroscience, University of Padova, 35122 Padova, Italy.
- Padova Neuroscience Center, University of Padova, 35122 Padova, Italy.
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53
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Network analysis of the relationship between depressive symptoms, demographics, nutrition, quality of life and medical condition factors in the Osteoarthritis Initiative database cohort of elderly North-American adults with or at risk for osteoarthritis. Epidemiol Psychiatr Sci 2019; 29:e14. [PMID: 30698512 PMCID: PMC8061212 DOI: 10.1017/s204579601800077x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIMS A complex interaction exists between age, body mass index, medical conditions, polypharmacotherapy, smoking, alcohol use, education, nutrition, depressive symptoms, functioning and quality of life (QoL). We aimed to examine the inter-relationships among these variables, test whether depressive symptomology plays a central role in a large sample of adults, and determine the degree of association with life-style and health variables. METHODS Regularised network analysis was applied to 3532 North-American adults aged ⩾45 years drawn from the Osteoarthritis Initiative. Network stability (autocorrelation after case-dropping), centrality of nodes (strength, M, the sum of weight of the connections for each node), and edges/regularised partial correlations connecting the nodes were assessed. RESULTS Physical and mental health-related QoL (M = 1.681; M = 1.342), income (M = 1.891), age (M = 1.416), depressive symptoms (M = 1.214) and education (M = 1.173) were central nodes. Depressive symptoms' stronger negative connections were found with mental health-related QoL (-0.702), income (-0.090), education (-0.068) and physical health-related QoL (-0.354). This latter was a 'bridge node' that connected depressive symptoms with Charlson comorbidity index, and number of medications. Physical activity and Mediterranean diet adherence were associated with income and physical health-related QoL. This latter was a 'bridge node' between the former two and depressive symptoms. The network was stable (stability coefficient = 0.75, i.e. highest possible value) for all centrality measures. CONCLUSIONS A stable network exists between life-style behaviors and social, environmental, medical and psychiatric variables. QoL, income, age and depressive symptoms were central in the multidimensional network. Physical health-related QoL seems to be a 'bridge node' connecting depressive symptoms with several life-style and health variables. Further studies should assess such interactions in the general population.
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Abstract
PURPOSE OF REVIEW To examine eating patterns, and with a particular focus on the different healthy diets followed by older persons across the world and the factors that can limit accessibility to healthy foods. RECENT FINDINGS Recent evidence has demonstrated that older people are, generally speaking, following less healthy diets with respect to the past. The only exception seems to be China, but the quality of the food there appears to be less than optimal. Socioeconomic status and, in particular, the price of food seems to be the most important factors linked to diet quality. SUMMARY Although healthy diets are associated with lower risk of several chronic disabling diseases, elderly people tend to follow less healthy diets with respect to the past. Public health strategies can and should promote healthy eating patterns in this population.
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Affiliation(s)
- Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
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55
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Veronese N, Koyanagi A, Stubbs B, Cooper C, Guglielmi G, Rizzoli R, Punzi L, Rogoli D, Caruso MG, Rotolo O, Notarnicola M, Al-Daghri N, Smith L, Reginster JY, Maggi S. Mediterranean diet and knee osteoarthritis outcomes: A longitudinal cohort study. Clin Nutr 2018; 38:2735-2739. [PMID: 30553579 DOI: 10.1016/j.clnu.2018.11.032] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. METHODS Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of ≥14%. RESULTS 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR = 0.96; 95% CI: 0.91-0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR = 0.91; 95% CI: 0.82-0.998). No significant associations emerged between aMED and incident ROA. CONCLUSION Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA.
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Affiliation(s)
- Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, De Crespigny Park, London SE5 8AF, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK
| | - Cyrus Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK; National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Renè Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Leonardo Punzi
- Rheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Domenico Rogoli
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Maria Gabriella Caruso
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Ornella Rotolo
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Maria Notarnicola
- National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - Nasser Al-Daghri
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jean-Yves Reginster
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia; Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
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56
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Jeruszka-Bielak M, Kollajtis-Dolowy A, Santoro A, Ostan R, Berendsen AAM, Jennings A, Meunier N, Marseglia A, Caumon E, Gillings R, de Groot LCPGM, Franceschi C, Hieke S, Pietruszka B. Are Nutrition-Related Knowledge and Attitudes Reflected in Lifestyle and Health Among Elderly People? A Study Across Five European Countries. Front Physiol 2018; 9:994. [PMID: 30108512 PMCID: PMC6079245 DOI: 10.3389/fphys.2018.00994] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/06/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Nutrition-related knowledge (NRK) and nutrition-related attitudes (NRAs) are necessary for dietary changes toward healthier dietary patterns. In turn, healthier dietary patterns can be beneficial in maintaining health of older adults. Therefore, the aim of this cross-sectional study was to investigate whether NRK and NRAs were associated with lifestyle and health features among older adults (65+ years) from five European countries (France, Italy, Poland, the Netherlands and United Kingdom). Methods: Within the European project NU-AGE, 1,144 healthy elderly volunteers (65–79 years) were randomly assigned to two groups: intervention (NU-AGE diet) or control. After 1-year of follow-up, both NRK and NRAs were assessed during exit interviews, in combination with a number of lifestyle and health variables (e.g., physical activity, smoking, alcohol use, BMI, self-assessed health status). Multivariable linear regression models were used in data analysis. Results: In the NU-AGE study sample, good NRK was associated with lower BMI and higher physical activity. More positive NRAs were related to lower BMI and self-reported very good or good appetite. Moreover, both NRK and NRAs were associated with some socio-economic determinants, like financial situation, age, education, living area (for NRK), and country (for NRAs). Participants in the intervention group showed a better NRK (β = 0.367 [95% CI: 0.117; 0.617], p = 0.004) and more positive NRAs (β = 0.838 [95% CI: 0.318; 1.358], p = 0.002) than those in the control group. Higher self-evaluated knowledge was also significantly related to more positive NRAs (p < 0.001). The most popular sources of nutrition information were food labels, books and magazines on health, the dietitian and the doctor's office, although their importance varied significantly among countries, and, to a lesser extent, between women and men and between intervention and control group. Conclusion: Higher NRK and NRA scores were associated with lower BMI and higher physical activity level. Therefore, a good nutrition-related knowledge and positive nutrition-related attitudes can strongly and positively influence the health status and quality of life among the older population. These results offer a great opportunity for policy makers to implement educational programs in order to counteract the epidemic of obesity and to improve the health span of European population.
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Affiliation(s)
- Marta Jeruszka-Bielak
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Anna Kollajtis-Dolowy
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", University of Bologna, Bologna, Italy
| | - Rita Ostan
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,C.I.G. Interdepartmental Centre "L. Galvani", University of Bologna, Bologna, Italy
| | - Agnes A M Berendsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Amy Jennings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Nathalie Meunier
- Centre Hospitalier Universitaire de Clermont Ferrand, Clermont-Ferrand, France
| | - Anna Marseglia
- Care Sciences and Society, Department of Neurobiology, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Elodie Caumon
- Centre Hospitalier Universitaire de Clermont Ferrand, Clermont-Ferrand, France
| | - Rachel Gillings
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Lisette C P G M de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.,Institute of Neurological Sciences (IRCCS), Bologna, Italy
| | - Sophie Hieke
- European Food Information Council, Brussels, Belgium
| | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
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57
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Affiliation(s)
- B Vellas
- John E. Morley, MB,BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
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Wang Y, Hao Q, Su L, Liu Y, Liu S, Dong B. Adherence to the Mediterranean Diet and the Risk of Frailty in Old People: A Systematic Review and Meta-Analysis. J Nutr Health Aging 2018; 22:613-618. [PMID: 29717762 DOI: 10.1007/s12603-018-1020-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/09/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Frailty is a common geriatric syndrome in old people. It remains controversial whether Mediterranean diet could prevent old people from developing into frailty. The aim of this study is to summarize the relevant studies and assess the effectiveness of adherence to Mediterranean diet on frailty in old people. METHOD A systematic search of MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials was conducted to identify all relevant studies up to Oct 2017. We included studies regarding the associations between adherence to Mediterranean diet and risk of frailty among elders. A meta-analysis was performed to explore the effects of Mediterranean diet on frailty. RESULTS Six studies matched the inclusion criteria, of which five were prospective and one was cross-sectional. A total of 10,210 participants from the five prospective cohort studies were included to perform the meta-analyses. In comparison with lowest adherence to Mediterranean diet, elders with highest adherence to Mediterranean diet were significantly associated with lower risk of frailty in the future (RR= 0.56, 95% CI=0.36-0.89, p=0.015). Furthermore, the pooled estimates from four studies performed among participants in western countries (European and North American) showed that higher adherence to Mediterranean diet was associated with a 52% reduced risk of frailty (RR= 0.48, 95% CI=0.32-0.72, p<0.001). However, one study showed no association between Mediterranean diet and frailty among Asian elders (RR=1.06, 95% CI=0.83-1.36, p=0.638). CONCLUSION A higher adherence to Mediterranean diet is associated with a lower risk of frailty in old people. Meanwhile, the benefits may be more obvious among elders from western countries.
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Affiliation(s)
- Y Wang
- Birong Dong, M.D. Professor of Medicine, Center of gerontology and geriatrics, West China Hospital, Sichuan University, No.37 guoxuexiang, Chengdu, China (610041), E-mail:
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59
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Veronese N, Stubbs B, Maggi S, Notarnicola M, Barbagallo M, Firth J, Dominguez LJ, Caruso MG. Dietary Magnesium and Incident Frailty in Older People at Risk for Knee Osteoarthritis: An Eight-Year Longitudinal Study. Nutrients 2017; 9:E1253. [PMID: 29144404 PMCID: PMC5707725 DOI: 10.3390/nu9111253] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 11/07/2017] [Accepted: 11/12/2017] [Indexed: 12/15/2022] Open
Abstract
Inadequate magnesium (Mg) intake is associated with lower physical performance, but the relationship with frailty in older people is unclear. Therefore, we aimed to investigate whether higher dietary Mg intake is associated with a lower risk of frailty in a large cohort of North American individuals. Details regarding Mg intake were recorded through a food-frequency questionnaire (FFQ) and categorized as greater than/equal to Recommended Dietary Allowance (RDA) vs. lower. Frailty was defined using the Study of Osteoporotic Fractures index. Multivariable Cox's regression analyses, calculating hazard ratios (HRs) with 95% confidence intervals (CIs), were undertaken by sex. In total, 4421 individuals with knee osteoarthritis or who were at high risk without frailty at baseline (mean age: 61.3, females = 58.0%) were followed for 8 years. After adjusting for 11 potential baseline confounders, reaching the RDA for Mg lowered risk of frailty among men (total n = 1857, HR = 0.51; 95% CI: 0.26-0.93), whilst no significant associations were found in women (total n = 2564). Each 100 mg of dietary Mg intake at baseline corresponded to a 22% reduction in men (HR = 0.78; 95% CI: 0.62-0.97; p = 0.03), but not in women (HR = 1.05; 95% CI: 0.89-1.23). In conclusion, higher dietary Mg intake appears to reduce the risk of frailty in men, but not in women.
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Affiliation(s)
- Nicola Veronese
- Ambulatory of Clinical Nutrition, Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128 Padua, Italy.
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK.
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK.
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN) King's College London, De Crespigny Park, London SE5 8AF, UK.
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128 Padua, Italy.
| | - Maria Notarnicola
- Ambulatory of Clinical Nutrition, Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90142 Palermo, Italy.
| | - Joseph Firth
- NICM Health Research Institute, University of Western Sydney, Sydney, NSW 2751, Australia.
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90142 Palermo, Italy.
| | - Maria Gabriella Caruso
- Ambulatory of Clinical Nutrition, Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
- Laboratory of Nutritional Biochemistry, National Institute of Gastroenterology-Research Hospital, IRCCS "S. de Bellis", Castellana Grotte, 70013 Bari, Italy.
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