title: Mediterranean diet and risk of frailty in community-dwelling older adults.
abstract: OBJECTIVE
  Low intake of certain micronutrients and protein has been associated with higher risk of frailty. However, very few studies have assessed the effect of global dietary patterns on frailty. This study examined the association between adherence to the Mediterranean diet (MD) and the risk of frailty in older adults.
  
  
  METHODS
  Prospective cohort study with 1815 community-dwelling individuals aged ≥60 years recruited in 2008-2010 in Spain.
  
  
  METHODS
  At baseline, the degree of MD adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, also known as the Trichopoulou index. In 2012, individuals were reassessed to detect incident frailty, defined as having at least 3 of the following criteria: exhaustion, muscle weakness, low physical activity, slow walking speed, and weight loss. The study associations were summarized with odds ratios (OR) and their 95% confidence interval (CI) obtained from logistic regression, with adjustment for the main confounders.
  
  
  RESULTS
  Over a mean follow-up of 3.5 years, 137 persons with incident frailty were identified. Compared with individuals in the lowest tertile of the MEDAS score (lowest MD adherence), the OR (95% CI) of frailty was 0.85 (0.54-1.36) in those in the second tertile, and 0.65 (0.40-1.04; P for trend = .07) in the third tertile. Corresponding figures for the Mediterranean Diet Score were 0.59 (0.37-0.95) and 0.48 (0.30-0.77; P for trend = .002). Being in the highest tertile of MEDAS was associated with reduced risk of slow walking (OR 0.53; 95% CI 0.35-0.79) and of weight loss (OR 0.53; 95% CI 0.36-0.80). Lastly, the risk of frailty was inversely associated with consumption of fish (OR 0.66; 95% CI 0.45-0.97) and fruit (OR 0.59; 95% CI 0.39-0.91).
  
  
  CONCLUSIONS
  Among community-dwelling older adults, an increasing adherence to the MD was associated with decreasing risk of frailty.
authors.affiliation: CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.
authors.forename: Luz M
authors.initials: LM
authors.lastname: León-Muñoz
authors.affiliation: CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Guallar-Castillón
authors.affiliation: CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.affiliation: CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, Madrid, Spain. Electronic address: fernando.artalejo@uam.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D038441:Diet, Mediterranean; D002149:Energy Intake; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain
keywords: Mediterranean diet; Spain; frailty; older adults