The Impact of Dietary Factors on Indices of Chronic Disease in Older People: A Systematic Review

Understanding exogenous factors and biological mechanisms for cognitive frailty: A multidisciplinary scoping review

Cognitive frailty (CF) is the conjunction of cognitive impairment without dementia and physical frailty. While predictors of each element are well-researched, mechanisms of their co-occurrence have not been integrated, particularly in terms of relationships between social, psychological, and biological factors. This interdisciplinary scoping review set out to categorise a heterogenous multidisciplinary literature to identify potential pathways and mechanisms of CF, and research gaps. Studies were included if they used the definition of CF OR focused on conjunction of cognitive impairment and frailty (by any measure), AND excluded studies on specific disease populations, interventions, epidemiology or prediction of mortality. Searches used Web of Science, PubMed and Science Direct. Search terms included "cognitive frailty" OR (("cognitive decline" OR "cognitive impairment") AND (frail*)), with terms to elicit mechanisms, predictors, causes, pathways and risk factors. To ensure inclusion of animal and cell models, keywords such as "behavioural" or "cognitive decline" or "senescence", were added. 206 papers were included. Descriptive analysis provided high-level categorisation of determinants from social and environmental through psychological to biological. Patterns distinguishing CF from Alzheimer's disease were identified and social and psychological moderators and mediators of underlying biological and physiological changes and of trajectories of CF development were suggested as foci for further research.

The role of nutrition in the prevention of sarcopenia

Sarcopenia is a common skeletal muscle disorder characterized by a loss of muscle mass and impaired muscle function that is associated with poor health outcomes. Although nutrition is considered an important factor in the etiology of sarcopenia, the preventive potential of diet, specifically the extent to which differences in habitual patterns of diet and/or nutrient intakes impact risk of its development, is poorly understood. This narrative review considered research evidence on dietary patterns and nutrient intakes in mid- (<60 y) and young-older (60-70 y) adulthood to evaluate how they relate to age-related changes in muscle mass and function. A key finding was that current evidence on adult diet and sarcopenia risk in older age is limited and fragmented, with different outcomes reported across studies (for example, lean mass, strength) and few reporting links to incident diagnosed sarcopenia. As these outcomes are not interchangeable, it challenges collation of the evidence, leaving many gaps in understanding. There is also limited information about adult (<70 y) diet and few longitudinal studies with repeated dietary assessments to enable definition of cumulative exposures across adulthood. However, despite these limitations, findings from studies of dietary patterns already provide reasonably consistent messages about the benefits of diets of higher quality in earlier adulthood for later physical performance, although whole-diet intervention trials are urgently needed to understand their potential. In comparison, there is little evidence of benefits of higher intakes of individual nutrients in earlier adulthood for later muscle mass and function. Although these gaps need to be addressed in future research, there may already be sufficient data to promote messages about diet quality more widely - that healthier diets of higher quality across adulthood, with known benefits for a range of health outcomes, are also linked to the effective preservation of muscle mass and function.

Demographic and Socioeconomic Factors Associated to Fruits and Vegetables Consumption in Elderly Europeans: A Systematic Review

Several epidemiological studies stress the association between a diet based on high fruits and vegetables intake and a better health condition. However, elderly Europeans cannot manage the recommended fruits and vegetables consumption. This systematic review aims to explore the main factors related to fruits and vegetables consumption in elderly Europeans. We conducted literature searches on Medline, Scopus, and Web of Science from inception to May 2022. Published articles including data related to certain fruits and vegetables consumption among elderly Europeans were selected. The New Castle-Ottawa Scale and National Heart, Lung, and Blood Institute tools were used for methodological quality assessment by two authors independently. A total of 60 articles were retrieved, and data from twenty-one high-quality cross-sectional studies and five moderate-to-high-quality cohort studies, including a total of 109,516 participants, were synthesized. Associated factors mostly analyzed were those relating to demographic and socioeconomic status, such as sex, age, marital status, educational level, and income. However, the findings show a high discrepancy. Some evidence suggests a possible positive association, while other evidence shows an inverse or no association at all. The relationship between demographic and socioeconomic factors with fruits and vegetables consumption is not at all clear. More epidemiological studies with an appropriate design and corresponding statistical methods are required.

Exercise Capacity, Iron Status, Body Composition, and Mediterranean Diet in Patients with Chronic Heart Failure

In addition to drug therapy, lifestyle modification, including physical activity, and nutrition management are an integral part of current guidelines for patients with chronic heart failure (CHF). However, evidence on which clinical parameters are most influenced by nutritional behaviour, exercise capacity, or iron status is scarce. For a multicenter intervention study, we included participants with diagnosed CHF (n = 165) as well as participants with elevated NT-proBNP values and risk factors for CHF (n = 74). Cardiorespiratory fitness was tested with a bicycle test, and adherence to the Mediterranean diet (MedDiet) was assessed with the MDS questionnaire. Our data strengthened previous results confirming that the higher a person's adherence to MedDiet, the higher the cardiorespiratory fitness and the lower the body fat. Furthermore, our results showed that anemia in patients with CHF has an impact in terms of cardiorespiratory fitness, and functional outcomes by questionnaire. Since our data revealed gaps in iron supply (37.9% with iron deficiency), malnutrition (only 7.8% with high adherence to MedDiet), and both symptomatic and non-symptomatic study participants failed to meet reference values for physical performance, we encourage the enforcement of the guidelines in the treatment of CHF more strongly.

Adherence to a Mediterranean Diet Pattern, Physical Activity, and Physical Self-Concept in Spanish Older Adults

Background: The aging world population is accelerating rapidly. Physical self-concept (PSC) is one of the psychosocial factors with the greatest influence on an individual’s well-being and health. The traditional Mediterranean dietary pattern (MDP) is considered one of the healthiest dietary models, as it is nutritionally complete and easy to follow. Objective: To assess the adherence to MDP and its association with the practice of physical activity (PA) and PSC levels in the older adult Spanish population. Methods: A cross-sectional study was conducted on a representative sample of Spanish older adults (n = 342; older than 55 years old). Their PSC was assessed using a previously validated PSC questionnaire. Adherence to an MDP was assessed using a validated Mediterranean Diet Adherence Screener questionnaire. Their PA was measured using the Spanish version of the Rapid Assessment of Physical Activity Questionnaire. Data on age, sex, hypertension, cholesterol or diabetes suffered in the last 12 months, as well as weight, height, and BMI, were collected. Results: At the lowest levels of PSC, the percentage of individuals who were non-active and non-adhering to the MDP was lower compared to the highest levels (75.0% vs. 19.6; p = 0.001; Cramer’s V = 0.414, and 83.3% vs. 57.9%; p = 0.001; Cramer’s V = 0.221, respectively). This sample showed an abandonment of the most classic habits of the MDP, such as the consumption of olive oil, vegetables, fruits, nuts and fish. Conclusions: Non-adherence to the MDP and low levels of PA are associated with low levels of PSC in older adults.

Development of a nutrition management software based on selected Middle Eastern and Mediterranean dishes to support personalized diet and weight management

The nutrient composition of 50 commonly consumed Jordanian food dishes was determined to support the development of a novel nutrition management system designed to assist with dietary intake assessment and diet management. Composite dishes were selected by interviewing households located in the northern region of Jordan. For each dish, five different recipes were collected from experienced chefs and the typical recipe was formulated based on the average weights of ingredients and net weight of the dish. Proximate composition as well as vitamin and mineral contents were determined and related to ingredient composition and cooking conditions. The newly created food composition database was used to develop a user-centric nutrition management software tailored to reflect the characteristics of the Jordanian diet with representative items from this diet. This novel nutrition management system is customizable, enabling users to build daily meal plans in accordance with personalized dietary needs and goals.

Trends in Diet Quality Among Older US Adults From 2001 to 2018

IMPORTANCE

Poor diet is a major risk factor for chronic diseases, disability, and death in the US. As older adults comprise the fastest-growing population segment in the US, it is crucial to describe dietary trends among older adults to identify opportunities and challenges for improving health in old age.

OBJECTIVE

To characterize trends in overall dietary quality and key food components and nutrients among older US adults by age, sex, race and ethnicity, marital status, educational level, and income.

DESIGN, SETTING, AND PARTICIPANTS

This serial cross-sectional study used 24-hour dietary recall data from 10 837 adults aged 65 years or older in 9 National Health and Nutrition Examination Survey cycles (2001-2002 to 2017-2018). Statistical analysis was conducted from June 1 to October 1, 2021.

EXPOSURES

Calendar year and sociodemographic subgroups.

MAIN OUTCOMES AND MEASURES

Survey-weighted, energy-adjusted mean diet scores and proportions of older US adults with poor, intermediate, or ideal diet scores based on the American Heart Association (AHA) 2020 Strategic Impact Goals for diet. Additional outcomes included the AHA secondary score and the Healthy Eating Index (HEI)-2015 score.

RESULTS

A total of 10 837 individuals (5423 women [50.0%]; 6339 White participants [58.5%]; mean [SD] age, 73.9 [0.1] years) were analyzed. Overall dietary quality deteriorated from 2001 to 2018 among older adults. The mean primary AHA score (total = 50 points) decreased from 19.84 (95% CI, 19.40-20.29) to 18.28 (95% CI, 17.84-18.73; a decrease of 7.9%; P < .001 for trend). The mean secondary AHA score (total = 80 points) decreased from 34.75 (95% CI, 34.11-35.39) to 31.83 (95% CI, 31.17-32.48; a decrease of 8.4%; P < .001 for trend). The mean HEI-2015 score (total = 100 points) decreased from 47.82 (95% CI, 47.11-48.52) to 45.25 (95% CI, 44.53-45.98; a decrease of 5.4%; P < .001 for trend). Based on the primary AHA score, the proportion of US older adults with a poor diet quality significantly increased from 50.9% to 60.9%, the proportion with an intermediate diet quality significantly decreased from 48.6% to 38.7%, and the proportion with ideal diet quality remained consistently low (0.4% in both 2001-2002 and 2017-2018). Dietary variations were identified by sociodemographic subgroups. We found a significant decreasing trend in diet scores among both sexes and all age groups except for those aged 75 to 79 years.

CONCLUSIONS AND RELEVANCE

The findings of this cross-sectional study suggest that dietary quality worsened for most dietary components among older US adults between 2001 and 2018. Despite improvement in some dietary components, more than half of older US adults still have poor dietary quality.

Dietary quality, food security and glycemic control among adults with diabetes

BACKGROUND AND AIMS

Nutritionally adequate diets can slow the progression of diabetes, but adherence to recommended dietary choices can be hindered by food insecurity. We examined the relationship between dietary quality, food insecurity, and glycemic control among adults with Type 2 Diabetes.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey (2011-2016) for 1682 adults =>20 years old with Type 2 diabetes. Glycemic control was measured by HbA1c. Dietary quality was computed using the Healthy Eating Index 2015 score. Food security was assessed by a questionnaire. We analyzed the data using multinomial regression models.

RESULTS

About 16% of the population had an HbA1c ≥ 9; 31.8% had food insecurity; 68.3% consumed a poor quality diet. About 24% consumed a poor quality diet and had food insecurity. In the multinomial model, an HbA1c of 8-<9% was associated with poor diet quality (adjusted odds ratio (AOR) = 5.2, 95% confidence interval (CI) = 1.4-19.2, p = 0.01) and food insecurity (AOR = 8.5, 95% CI = 1.4-52.0, p = 0.02). Those with both factors had higher odds of both an HbA1c 8-<9% (AOR = 6.1, 95% CI = 1.5-24.8, p = 0.01) and HbA1c ≥ 9% (AOR = 6.7, 95% CI = 2.0-22.2, p < 0.01). Other risk factors for poor glycemic control were being Black or Hispanic, having no regular source of care, and ever having visited a diabetes specialist (p < 0.05).

CONCLUSIONS

Poor glycemic control among adults with diabetes was associated with poor quality of diet and/or food insecurity, being Black, Hispanic, and lacking a regular source of care. There is a need for policies that improve access to healthy food in patients with type 2 diabetes, particularly among minority populations.

Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands

Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or "some concerns" (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.

Greater adherence to the dietary approaches to stop hypertension dietary pattern is associated with preserved muscle strength in patients with autosomal dominant polycystic kidney disease: a single-center cross-sectional study

The present study aimed to determine whether certain diets lower the risk of low muscle strength in patients with autosomal dominant polycystic kidney disease (ADPKD). In this cross-sectional study, outpatient ADPKD patients were enrolled from a tertiary care hospital. Muscle strength was assessed on the basis of handgrip strength (HGS), and dietary pattern indices were calculated using dietary intake data. Among the 68 participants included in this study, 19 (27.9%) had low HGS. Cystatin C concentrations were significantly higher in all participants, and in women in the low compared to the normal HGS group in the unadjusted analyses (P = 0.004). Among analyzed dietary pattern indices, the Dietary Approaches to Stop Hypertension (DASH) score was lower, for all participants and men, in the low compared to the normal HGS group (P < 0.05). Especially, the component score for whole grains of the DASH score was significantly lower in men in the low compared to the normal HGS group in unadjusted analyses. The DASH score was positively correlated with HGS in men (r = 0.387, P = 0.046). In addition, logistic regression analysis showed that the DASH score was negatively associated with low HGS, for all participants (odds ratio = 0.851, P = 0.049) and men (odds ratio = 0.716, P = 0.043), after adjusting for age, sex, and body weight. These findings suggest that the DASH dietary pattern may promote the preservation of muscle strength in ADPKD patients. The DASH diet can be considered as a nutritional strategy to maintain muscle strength and prevent sarcopenia in ADPKD patients.

Associations between Food Group Intake and Physical Frailty in Irish Community-Dwelling Older Adults

Background

Certain nutrients have shown protective effects against frailty, but less is known about the influence of individual food groups. Thus, this study aimed to investigate the relationship between the intake of different food groups and physical frailty in a cohort of community-dwelling older adults in Cork, Ireland.

Methods

One hundred and forty-two (n = 81 females, n = 61 males, age 74.1 ± 6.80 years) Irish community-dwelling volunteers aged ⩾65 years participated in this cross-sectional study. Dietary intake was assessed using a validated food frequency questionnaire (FFQ). Frailty was identified as having 3 or more of the following criteria: weight loss, exhaustion, weakness, slow walking speed and low physical activity. Relationships between intakes of food groups and frailty score were determined using Spearman's rank (and partial rank) correlations and ordinal logistic regression analysis.

Results

Negative Spearman's rank correlations were observed between frailty score and fish and fish products, fruit and vegetables and nuts and seeds, while positive correlations were found between frailty score and potatoes, fats and oils and sugars, preserves and snacks (P < .05). After adjustment for confounders, partial rank correlations remained statistically significant (P < .05) for all of the above dietary variables, with the exception of nuts and seeds (P > .05). Following ordinal logistic regression, the odds ratios (ORs) (95%CI) for frailty incidence for those in the lowest tertile of food group intake compared to the highest were; 3.04 (1.09-8.85) for fish and fish products, 4.34 (1.54-13.13) for fruit and vegetables, 1.52 (0.58-4.15) for nuts and seeds, 0.54 (0.19-1.51) for potatoes, 0.58 (0.17-1.95) for fats and oils and 0.49 (0.16-1.47) for sugars, preserves and snacks.

Conclusion

This study suggests that intakes of selected food groups are independently associated with frailty. These findings may hold significant relevance for the development of future frailty prevention strategies.

Higher Levels of Physical Activity Are Associated with Greater Fruit and Vegetable intake in Older Adults

OBJECTIVE

High levels of physical activity (PA) and optimal nutrition independently improve healthy aging, but few data are available about how PA may influence food preferences in older populations. Therefore, the aim of our study was to establish if there is an association between habitual PA and intake of nutrient-dense foods (i.e. fruits and vegetables).

DESIGN

A cross-sectional survey was conducted.

SETTING

The Netherlands.

PARTICIPANTS

2466 older adults (56% male, age 62±9 yr).

MEASUREMENTS

PA was assessed using the short questionnaire to assess health (SQUASH) and participants were classified into quintiles of weekly PA (MET-h/wk). Total fruit and vegetable intake was assessed using a validated food frequency questionnaire (FFQ) and were corrected for energy intake (g/kcal/d) in the analyses. Multiple regression analyses were performed to determine the association between PA and fruit and vegetable intake, including covariates.

RESULTS

Being in the higher quintiles of PA (Q3, Q4 and Q5) was positively associated with more daily fruit and vegetable consumption, even after correction for total energy intake (Q3; β=0.089, P<0.001, Q4; β=0.047, P=0.024, Q5; β=0.098, P<0.001).

CONCLUSIONS

Older adults who are moderately to highly physically active tend to consume more fruit and vegetable compared to less active peers, when corrected for total energy intake. Female gender, under- and overreporting dietary intake (Goldberg score), non-smoking, high level of education, less alcohol consumption and a lower body mass index positivity affected this relationship. Our data will help health-care professionals to accelerate their efforts to treat and prevent chronic diseases.

The Nordic diet and the risk of non-communicable chronic disease and mortality: a systematic review and dose-response meta-analysis of prospective cohort studies

We aimed to investigate the association between adherence to the Nordic diet (ND) and the risk of chronic disease. PubMed, Scopus, and ISI Web of Science were searched to February 2020 to find prospective cohort studies. The relative risks (RRs) were calculated using a fixed-effects/random-effects model. The certainty of evidence was rated using the GRADE approach. Thirteen prospective cohort studies with 930,153 participants were included. The RRs for the highest compared to the lowest category of adherence to the ND were 0.78 (95%CI: 0.69, 0.87; I² = 51%, n = 6) for all-cause mortality, 0.78 (95%CI: 0.74, 0.83; I² = 70%, n = 4) for cardiovascular mortality, 0.86 (95%CI: 0.80, 0.93; I² = 83%, n = 4) for cancer mortality, 0.88 (95%CI: 0.79, 0.98; I² = 3%, n = 3) for stroke, 0.80 (95%CI: 0.68, 0.95; I² = 47%, n = 3) for myocardial infarction, and 0.90 (95%CI: 0.82, 0.99; I² = 33%, n = 4) for type 2 diabetes. There was an inverse linear association between the ND score and the risk of mortality, and an inverse monotonic association for type 2 diabetes. The certainty in the estimates ranged from very low to low.

Changes in Dietary Intake of Animal and Vegetable Protein and Unhealthy Aging

BACKGROUND

Animal and vegetable-based proteins differ on their effect on many health outcomes, but their relationship with unhealthy aging is uncertain. Thus, we examined the association between changes in animal and vegetable protein intake and unhealthy aging in older adults.

METHODS

Data came from 1951 individuals aged ≥60 years recruited in the Seniors-ENRICA cohort in 2008-2010 (wave 0) and followed-up in 2012 (wave 1), 2015 (wave 2), and 2017 (wave 3). Dietary protein intake was measured with a validated diet history at waves 0 and 1, and unhealthy aging was measured with a 52-item health deficit accumulation index at each wave.

RESULTS

Compared with participants with a >2% decrease in energy intake from vegetable protein from wave 0 to wave 1, those with a >2% increase showed less deficit accumulation over 3.2 years (multivariable β [95% confidence interval (CI)]: -1.05 [-2.03, -0.06]), 6 years (-1.28 [-2.51, -0.03]), and 8.2 years of follow-up (-1.68 [-3.27, -0.09]). No associations were found for animal protein. Less deficit accumulation over 8.2 years was observed when substituting 1% of energy from vegetable protein for an equal amount of carbohydrate or fat (-0.50 [-0.93, -0.07]), animal protein (-0.44 [-0.81, -0.07]), dairy protein (-0.51 [-0.91, -0.12]), or meat protein (-0.44 [-0.84, -0.04]).

CONCLUSIONS

Increasing dietary intake of vegetable protein may delay unhealthy aging when replacing carbohydrates, fats, or animal protein, especially from meat and dairy.

Proportions of macronutrients, including specific dietary fats, in prospective anti-Alzheimer's diet

Here we present a novel life-long whole-population study, which enabled us to predict a diet that, in terms of macronutrient proportions, may be prophylactic against Alzheimer's Disease (AD). The method is based on the existence of oscillations in the correlation between historical per capita personal income (PCPI) and age-adjusted death rates (AADR) for AD for each state of the USA in 2005. These oscillations can be explained by changing proportions of macronutrients in the average American diet between 1929 and 2005. We assumed that reducing future correlation of PCPI with AADR will reduce the population's susceptibility to AD. Based on the results of fitting macronutrient availabilities to the variability of Roriginal, using Generalized Additive Models (GAM) analysis, we constructed four "Calculator" equations. The Calculator allowed for prediction of an optimal diet characterized by low correlation of PCPI with AADR (Rpredicted) and minimum energy difference from the historical average macronutrient consumption for each corresponding period of life. We predict that protein consumption should be reduced by half in early middle age and late middle age, whereas in late age it should increase. Our predictions are in line with results on humans and simpler organisms in the context of prolonging life.

Let food and physical activity be your medicine : Lessons from EuGMS Athens 2020 pre-congress seminar

Purpose In the context of the preparation of the 16th EuGMS Congress that will be held in Athens in 2020, EUGMS and the Hellenic Consortium for Geriatric Medicine organized a pre-congress seminar in November 2018.

METHODS

The seminar focused on the role of diet and physical activity in healthy aging.

RESULTS

It seems that the Mediterranean Diet (MD) remains one of the most well-studied and scientifically appreciated diets and holds much promise also in older age. It is never too late to adhere to a healthier diet and MD seems to attenuate inflammaging and reduce the risk of various chronic diseases, impaired cognition, and frailty. Food preparation also emerges as a critical issue due to its relation to Advanced Glycation End-products that are tightly related to the aging process. Physical activity is the second pillar of health-promoting lifestyle changes. It can alleviate related to age structural and physiological decline. It does not only reduce total morbidity and mortality in older adults, but also improves functionality and decreases disability in aerobic capacity, body composition, muscle mass, bone density, articulation performance. A multi-component physical activity, combining endurance, strength, balance, and flexibility training which is preferable for older adults is advisable. However, adherence to an active lifestyle meets additional challenges for older people, which could be overcome by adjusting intensity and types of exercise in individual capacities and preferences and by campaigning against stereotypes.

CONCLUSIONS

Promoting healthy diet and physical activity as the new trend in healthy aging is a relevant, cost-effective, and challenging perspective, adjustable to individual needs and values. But most importantly, eating and moving are part of our living, our socializing, and our cultural routines, and by these means, could consist two particularly effective remedies.

Mediterranean diet and risk of falling in community-dwelling older adults

BACKGROUND

Although the association between nutrition and muscle and bone health has been widely studied, the role of adequate nutrition in the prevention of falls remains uncertain. Therefore, this study examined the association between a Mediterranean-style dietary pattern and the risk of falling in older adults.

METHODS

We performed a prospective cohort study with 2,071 participants aged ≥60 y from the Seniors-ENRICA study. In 2008-2010, adherence to the Mediterranean diet was assessed with the MEDAS score, and study participants were followed-up through 2012 to assess incident falls during the previous year.

RESULTS

Over a median follow-up of 3.5 years, 402 (19.4%) people reported at least one fall (69.2% of them fell once and 30.8% ≥ 2 times). After adjustment for potential confounders, participants in the highest tertile of the MEDAS score showed a lower frequency of falling compared with those in the lowest tertile (OR: 0.72; 95% confidence interval 0.53-0.98; P-trend: 0.04). Consuming ≥2 servings/day of vegetables was the individual target of the MEDAS score that showed a significant association with a lower risk of falling (OR: 0.63; 95% CI 0.44-0.89). Targets for consumption of fruit, red and process meat, butter and margarine, wine, fish and nuts also showed some tendency to a slightly lower risk of falls.

CONCLUSION

The Mediterranean diet was associated with lower risk of falling among older Spanish adults. These findings suggest that the total benefit from the Mediterranean diet is due to the accumulated or synergic impact of several foods rather than a single one.

The diversity of healthy diets for older persons across the world

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.

Nutrition, Daily Walking and Resilience Are Associated with Physical Function in the Oldest Old Men

BACKGROUND

Maintaining good physical functioning in old age is of utmost importance for healthy and active aging. We examined physical function and associated factors in the oldest-old men.

SUBJECTS AND METHODS

The participants of this cross sectional analysis of a longitudinal study were the oldest old men( n=394, mean age 88 years, range 82-97 years) from the Helsinki Business Men cohort who responded to a postal health and nutrition survey in 2016. Physical function was defined using the respective subscale (Physical Function, PF) in the RAND-36 health-related quality of life (HRQoL) instrument. Resilience was measured with validated Finnish version of Resilience scale. Diet quality was assessed using Mediterranean diet adherence score (MeDi) and Diet quality index (DQI) which is designed to show adherence to Finnish dietary recommendations. Food and dietary intakes were retrieved using 3-day food records (obtained from a sub-group of the respondents). The participants were divided into quartiles corresponding to their PF scores and health and nutrition indicators were calculated into these PF quartiles. Furthermore, a linear regression model was used to determine factors associated with PF.

RESULTS

PF quartiles were positively associated with lower age, daily walking habit, cognition, diet quality, resilience, alcohol use and negatively associated with blood glucose levels, weight loss, body weight (BW) and falls. Polyunsaturated to saturated fat ratio and berry intake were also associated with PF. In a linear regression model PF was positively associated (p < .001, adjusted R2 = .560) with MeDi, cognition, resilience, vitality (RAND-36), and negatively with age and BW.

CONCLUSION

MeDi, exercise, resilience, cognition, use of alcohol, fat quality and lower age were positively associated with PF in the oldest-old men. Weight loss, falls and interestingly BW were negatively associated with PF.