title: Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults.
abstract: Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation.
  
  
  
  We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults.
  
  
  
  Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model.
  
  
  
  During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend < 0.01. When FVs were analyzed together, the pooled ORs (95% CIs) of incident frailty were 0.41 (0.21, 0.60), 0.47 (0.25, 0.68), 0.36 (0.18, 0.53), and 0.31 (0.13, 0.48), with a P-trend < 0.01 for participants who consumed 2, 3, 4, or ≥5 portions/d, respectively, compared with those who consumed ≤1 portion/d. An inverse dose-response relation was also found between the baseline consumption of fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss.
  
  
  
  Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d.
authors.affiliation: Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain; Institute for Health Research, La Paz University Hospital, Madrid, Spain; Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain; esthergge@gmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Esquinas
authors.affiliation: French Institute of Health and Medical Research, Bordeaux, France; University of Bordeaux, Bordeaux, France;
authors.forename: Berna
authors.initials: B
authors.lastname: Rahi
authors.affiliation: French Institute of Health and Medical Research, Bordeaux, France; University of Bordeaux, Bordeaux, France;
authors.forename: Karine
authors.initials: K
authors.lastname: Peres
authors.affiliation: Department of Statistics, University of Florence, Florence, Italy; and.
authors.forename: Marco
authors.initials: M
authors.lastname: Colpo
authors.affiliation: French Institute of Health and Medical Research, Bordeaux, France; University of Bordeaux, Bordeaux, France;
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: Geriatric Unit, Florence Health Agency, Florence, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Bandinelli
authors.affiliation: French Institute of Health and Medical Research, Bordeaux, France; University of Bordeaux, Bordeaux, France;
authors.forename: Catherine
authors.initials: C
authors.lastname: Feart
authors.affiliation: Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid, Spain; Institute for Health Research, La Paz University Hospital, Madrid, Spain; Biomedical Research Center Network for Epidemiology and Public Health (CIBERESP), Madrid, Spain;
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000368:Aged; D004032:Diet; D004034:Diet Surveys; D015444:Exercise; D005221:Fatigue / Q000517:prevention & control; D005247:Feeding Behavior; D005260:Female; D016330:Frail Elderly; D005638:Fruit; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D014675:Vegetables; D015431:Weight Loss
keywords: elderly; exhaustion; frailty; fruits; slow walking speed; vegetables