title: Low nutrient intake is an essential component of frailty in older persons.
abstract: BACKGROUND
  Poor nutrient intake is conceptualized to be a component of frailty, but this hypothesis has been little investigated. We examined the association between low energy and nutrient intake and frailty.
  
  
  METHODS
  We used data from 802 persons aged 65 years or older participating to the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) study. Frailty was defined by having at least two of the following criteria: low muscle strength, feeling of exhaustion, low walking speed, and reduced physical activity. The European Prospective Investigation into Cancer and nutrition (EPIC) questionnaire was used to estimate the daily intake of energy and nutrients. Low intake was defined using the value corresponding to the lowest sex-specific intake quintile of energy and specific nutrients. Adjusted logistic regression analyses were used to study the association of frailty and frailty criteria with low intakes of energy and nutrients.
  
  
  RESULTS
  Daily energy intake < or =21 kcal/kg was significantly associated with frailty (odds ratio [OR]: 1.24; 95% CI: 1.02-1.5). After adjusting for energy intake, a low intake of protein (OR: 1.98; 95% CI: 1.18-3.31); vitamins D (OR: 2.35; 95% CI: 1.48-3.73), E (OR: 2.06; 95% CI: 1.28-3.33), C (OR: 2.15; 95% CI: 1.34-3.45), and folate (OR: 1.84; 95% CI: 1.14-2.98); and having a low intake of more than three nutrients (OR: 2.12; 95% CI: 1.29-3.50) were significantly and independently related to frailty.
  
  
  CONCLUSIONS
  This study provides evidence that low intakes of energy and selected nutrients are independently associated with frailty.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853-6301, USA. bb232@cornell.edu
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bartali
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.forename: Fulvio
authors.initials: F
authors.lastname: Lauretani
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors