Discrepancies in the characteristics of the food components of a Mediterranean diet exist based on the country of origin. In Lebanon, a traditional Mediterranean diet emphasizes the high intakes of fruits (including dried), vegetables, burghol, and dairy products. Therefore, this cross-sectional study aimed to explore the association between adherence to the Lebanese Mediterranean diet (LMD) and frailty among older adults in Lebanon. A total of 112 community-dwelling older adults aged ≥65 years were recruited. Demographic and clinical characteristics were collected through face-to-face interviews. A 61-item food frequency questionnaire (FFQ) was used to collect dietary intake data, and adherence to LMD was calculated. Physical frailty was defined by the presence of three out of the five criterion: weight loss, weakness, exhaustion, slowness, and low activity. Binary logistic regression was used to examine the relationship between LMD adherence and frailty while adjusting for several confounders. The participants’ mean age was 73 ± 12.8 and 65% were females. Sixteen (14.3%) individuals were identified as frail. Frail individuals were significantly older (p = 0.001), depressed (p < 0.001), at risk of cognitive impairment (p = 0.006), and reported polypharmacy (p = 0.003). No significant association was found between LMD adherence and frailty in fully adjusted models (OR = 0.195; 95% CI: 0.033–1.154; p = 0.071 when categorical and OR = 0.856; 95% CI: 0.668–1.097; p = 0.218 when continuous). We also performed additional analyses with a modified frailty index where house chores were not considered as part of leisure activities of the physical activity criterion. The results showed that a higher LMD adherence was associated with a significantly decreased frailty prevalence (OR = 0.123, 95% CI: 0.022–0.676, p = 0.016 when categorical and OR = 0.773, 95% CI 0.608–0.983, p = 0.036). Larger, longitudinal studies are needed to clarify the relationship between the adherence to the Lebanese Mediterranean diet and frailty in Lebanese older adults.

Nutrition and in particular protein intake are shown to be key determinants of frailty. Nevertheless, the current daily protein recommendation of 0.8 g/kilogram (kg) BW has been proven to be inefficient in providing the required needs of the older population, and intake of 1 g/kg BW of protein was demonstrated to be more representative of the needs of older adults. Thus, this cross-sectional study aimed at examining the association between frailty and protein intake among Lebanese community-dwelling older adults. Dietary intake was assessed using an FFQ based on which protein intake was calculated using the USDA food database and frailty was determined via Fried’s Frailty Phenotype. A convenience sample of a total of 112 community-dwelling, older-adults were recruited through word-of-mouth, interviewed face to face, and screened in some areas of Greater Beirut and Byblos. SPSS software was used to conduct bivariate analyses and logistic regressions that either had frail or non-robust as outcomes, and protein intake was either entered as a cutoff (0.8 and 1 g/kg BW/d) or by protein source (animal protein corrected for plant protein intake, and plant protein corrected for animal protein intake). All the regressions were corrected for gender, age, educational level, BMI, number of chronic diseases, polypharmacy, dietary supplements, GDS score, RUDAS score, and MeDi score. Sixteen (14.41%) participants were identified as being frail, and the total participants, only 19.82% (n=22) reached a protein intake ≥0.8 g/kg BW and 11.7% (n=13) had an intake ≥1g/kg BW. Nevertheless, no association was found between total protein intake and the prevalence of frailty in this population. Only plant protein was positively associated with frailty with 6.2% (95% CI= 0.6% - 12.1%) higher frailty prevalence. In conclusion, it is important to further study the association between frailty and protein intake, within a larger sample size, considering protein distribution and timing as well as total energy intake, other macronutrients, physical activity, and diet quality.

Objectives Protein intake is shown to be key determinants of frailty. Nevertheless, the current daily protein recommendation of 0.8 g/kilogram (kg) BW has been proven to be inefficient in providing the required needs of the older population, and intake of 1 g/kg BW of protein was demonstrated to be more representative of the needs of older adults. Therefore, we aimed at examining the association between frailty and protein intake among Lebanese community-dwelling older adults. Methods A total of 111 community-dwelling older-adults were randomly recruited from the urban areas from Lebanon, and were interviewed face-to-face. Dietary intake was assessed using a validated FFQ and then analyzed using Nutripro. Energy and macronutrients were determined and protein intake was dichotomized at 0.8 and 1g/kg body weight. Frailty was evaluated via the Fried's Frailty Phenotype. Multivariate logistic regressions were performed to determine the association between frailty and protein intake and protein source (animal vs vegetable) while adjusting for several confounding variables. Results The participants’ mean age was 73±12.8 and 65% were females. Sixteen (14.3%) individuals were identified as frail. Frail individuals were significantly older (p = 0.001), depressed (p&lt; 0.001), at risk of cognitive impairment (p = 0.006) and reported polypharmacy (p = 0.003). Sixty-four % (n = 71) reached a protein intake ≥0.8 g/kg BW and 40.5% (n = 45) had an intake ≥1g/kg BW. No significant association was observed between protein intakes (OR = 1.2, 95%CI = 0.07-19.4), animal proteins (OR = 1.01, 95%CI = 0.99-1.04) or plant proteins (OR = 1.00, 95%CI = 0.996-1.004) and frailty prevalence in this population of community dwelling older adults. Conclusions It is important to further study the association between frailty and protein intake, within a larger sample size while taking into consideration protein distribution and timing. In the meantime, older people are recommended to have at least 1g/kg body weight as it was evidenced by several other studied while a revision of dietary protein intake recommendations for OA should be conducted in order to help them maintain optimal health and foster successful aging. Funding Sources None