Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults

Abstract

Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82–24.21) and in women (OR = 11.54, 95% (CI) (2.02–65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.

Validity and reliability of a food frequency questionnaire for community dwelling older adults in a Mediterranean country: Lebanon

“…We included a randomly selected group of 50 and 100 participants respectively, aged 60 years and older, belonging to 2 of the 8 governorates of Lebanon. Individuals who were totally dependent, with known active cancer disease, undergoing dialysis, with advanced liver disease, with major hearing and visual problems, or receiving artificial nutritional support were not included in the study [ 27 ].…”

Fatty Acids and Frailty: A Mendelian Randomization Study

“…A populationbased cohort study suggested that the animal protein intake was significantly associated with a higher FI in adults (aged ≥55 years) of normal body weight, and saturated fatty acids tended to be associated with a higher FI in the same population [28]. The observational study revealed that a Westernized-type dietary pattern (characterized by the highest saturated fats) was strongly associated with a higher frailty prevalence, whereas Mediterranean-type dietary pattern (characterized by relatively low intake of meat, egg, fish, and dairy products) was inversely associated with the prevalence of frailty [29]. Another cohort study also revealed that a Westernized dietary pattern (characterized by a high intake of refined bread, whole dairy products, and red and processed meat, as well as low consumption of fruit and vegetables) tended to be associated with a higher risk of frailty [30].…”

Association between Lebanese Mediterranean Diet and Frailty in Community-Dwelling Lebanese Older Adults—A Preliminary Study

“…Fried et al (2001) [ 5 ] described frailty as “a biologic syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems, and causing vulnerability to adverse outcomes”. In Lebanon, it was estimated that 15% of Lebanese OAs are considered frail in a national sample [ 6 ]; frailty prevalence increases up to 36.4% among those living in rural communities. Furthermore, a systematic review observed that frailty prevalence in low- and middle-income countries is 12.7% [ 7 ].…”

“…Preventing frailty is an important factor for ensuring successful aging [ 17 ], and recent evidence established that nutrition is an important factor affecting its development [ 18 , 19 ]. In particular, adherence to a Mediterranean diet (MeDi) has been shown to reduce the incidence of frailty among OA in several Mediterranean countries like Italy [ 20 ], Spain [ 21 ], Germany [ 22 ], France [ 23 ], and Greece [ 24 ], whereas studies in Lebanon, a country on the East Basin of the Mediterranean, are still scarce [ 6 ].…”

“…Furthermore, although dairy products are considered a detrimental food component in other indices and their consumption should be limited, they are regarded as favorable foods in the LMD [ 33 , 35 ]. Although the only Lebanese study that examined the association of dietary patterns and frailty used three dietary patterns based on 20 predefined categories based on similarities in nutrient composition and consumption characteristics [ 6 ], the relationship between the LMD and frailty remains to be examined. Accordingly, our objective was to explore the association between the apriori dietary index-LMD and frailty, in a sample of community-dwelling Lebanese OA.…”