title: Major dietary patterns and risk of frailty in older adults: a prospective cohort study.
abstract: BACKGROUND
  There is emerging evidence of the role of certain nutrients as risk factors for frailty. However, people eat food, rather than nutrients, and no previous study has examined the association between dietary patterns empirically derived from food consumption and the risk of frailty in older adults.
  
  
  METHODS
  This is a prospective cohort study of 1,872 non-institutionalized individuals aged ≥60 years recruited between 2008 and 2010. At baseline, food consumption was obtained with a validated diet history and, by using factor analysis, two dietary patterns were identified: a 'prudent' pattern, characterized by high intake of olive oil and vegetables, and a 'Westernized' pattern, with a high intake of refined bread, whole dairy products, and red and processed meat, as well as low consumption of fruit and vegetables. Participants were followed-up until 2012 to assess incident frailty, defined as at least three of the five Fried criteria (exhaustion, weakness, low physical activity, slow walking speed, and unintentional weight loss).
  
  
  RESULTS
  Over a 3.5-year follow-up, 96 cases of incident frailty were ascertained. The multivariate odds ratios (95% confidence interval) of frailty among those in the first (lowest), second, and third tertile of adherence to the prudent dietary pattern were 1, 0.64 (0.37-1.12), and 0.40 (0.2-0.81), respectively; P-trend = 0.009. The corresponding values for the Westernized pattern were 1, 1.53 (0.85-2.75), and 1.61 (0.85-3.03); P-trend = 0.14. Moreover, a greater adherence to the Westernized pattern was associated with an increasing risk of slow walking speed and weight loss.
  
  
  CONCLUSIONS
  In older adults, a prudent dietary pattern showed an inverse dose-response relationship with the risk of frailty while a Westernized pattern had a direct relationship with some of their components. Clinical trials should test whether a prudent pattern is effective in preventing or delaying frailty.
authors.affiliation: CIBER of Epidemiology and Public Health (CIBERESP), Arzobispo Morcillo, s/n 28029, Madrid, Spain. luz.leon@uam.es.
authors.forename: Luz M
authors.initials: LM
authors.lastname: León-Muñoz
authors.forename: Esther
authors.initials: E
authors.lastname: García-Esquinas
authors.forename: Esther
authors.initials: E
authors.lastname: López-García
authors.forename: José R
authors.initials: JR
authors.lastname: Banegas
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D015992:Body Mass Index; D004032:Diet; D066273:Diet, Western / Q000009:adverse effects; D005163:Factor Analysis, Statistical; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors