Dietary profiling of physical frailty in older age phenotypes using a machine learning approach: the Salus in Apulia Study

Abstract

Purpose Growing awareness of the biological and clinical value of nutrition in frailty settings calls for further efforts to investigate dietary gaps to act sooner to achieve focused management of aging populations. We cross-sectionally examined the eating habits of an older Mediterranean population to profile dietary features most associated with physical frailty. Methods Clinical and physical examination, routine biomarkers, medical history, and anthropometry were analyzed in 1502 older adults (65 +). CHS criteria were applied to classify physical frailty, and a validated Food Frequency Questionnaire to assess diet. The population was subdivided by physical frailty status (frail or non-frail). Raw and adjusted logistic regression models were applied to three clusters of dietary variables (food groups, macronutrients, and micronutrients), previously selected by a LASSO approach to better predict diet-related frailty determinants. Results A lower consumption of wine (OR 0.998, 95% CI 0.997–0.999) and coffee (OR 0.994, 95% CI 0.989–0.999), as well as a cluster of macro and micronutrients led by PUFAs (OR 0.939, 95% CI 0.896–0.991), zinc (OR 0.977, 95% CI 0.952–0.998), and coumarins (OR 0.631, 95% CI 0.431–0.971), was predictive of non-frailty, but higher legumes intake (OR 1.005, 95%CI 1.000–1.009) of physical frailty, regardless of age, gender, and education level. Conclusions Higher consumption of coffee and wine, as well as PUFAs, zinc, and coumarins, as opposed to legumes, may work well in protecting against a physical frailty profile of aging in a Mediterranean setting. Longitudinal investigations are needed to better understand the causal potential of diet as a modifiable contributor to frailty during aging.

The role of zinc on nutritional status, sarcopenia, and frailty in older adults: a scoping review

“…A majority of the studies (88%) 16–29 , 32–49 , 51–53 , 56 , 57 , 59–61 , 63 , 64 were published after 2010, with the earliest publication being in 2001. 50 The studies were conducted primarily in Europe (n = 18), 17 , 18 , 22 , 26 , 28 , 29 , 32 , 33 , 41–43 , 46 , 48 , 51 , 56 , 58–60 15 were conducted in Asia. 23 , 24 , 27 , 30 , 35 , 36 , 38 , 39 , 45 , 47 , 49 , 57 , 61 , 63 , 64 Seven studies each were from North America 19 , 25 , 31 , 44 , 52 , 53 , 62 and Australasia, 20 , 21 , 37 , 40 , 50 , 54 , 55 and the remaining 2 st...…”

“…Most studies included both male and female older adults (n = 42) 16–19 , 22 , 23 , 25–28 , 30–49 , 51–61 , 64 ; 7 were restricted to 1 sex. 20 , 21 , 24 , 29 , 50 , 62 , 63 The definition of the older population differed among studies: participants were ≥50 years in 5 studies, 17 , 23 , 37 , 52 , 53 ≥60 years in 11 studies, 16 , 18 , 25 , 26 , 29 , 35 , 38 , 42 , 44 , 57 , 59 ≥65 years in 23 studies, 19 , 22 , 24 , 27 , 28 , 31–34 , 39 , 41 , 43 , 45 , 47–49 , 51 , 54–56 , 58 , 62 , 63 and ≥70 years in 7 studies. 20 , 21 , 30 , 36 , 40 , 50 ...…”

Association between Lifelines Diet Score (LLDS) and some novel anthropometric indices, including Body Roundness Index (BRI), A Body Shape Index (ABSI), Visceral Adiposity Index (VAI), and Body Adiposity Index (BAI), in Iranian women: a cross-sectional study

“…The possible mechanisms responsible for the positive association between healthy dietary patterns, including LLDS and better anthropometric indices, were investigated in several prior studies [ 31 , 36 , 37 ]. A healthy diet rich in vegetables, fruits, nuts, whole grains, and unsaturated fatty acids, including Polyunsaturated Fatty Acids (PUFA) and Monounsaturated Fatty Acids (MUFA), was reported to reduce the risk of mortality [ 38 ], as well as physical frailty [ 39 ], and improve weight and anthropometric indices by regulating energy hemostasis, upregulating PPAR-α expression, inducing fatty acid β-oxidation, inhibiting the expression of lipogenesis genes, and increasing insulin sensitivity [ 36 , 37 , 40 , 41 ]. However, an unhealthy diet rich in sweetened beverages, saturated fatty acids existing in butter and hard margarines, and red and processed meats was suggested to worsen anthropometric indices by increasing circulating leptin concentrations, decreasing the lipid handling capacity of adipocytes through suppression of fat oxidation, and exacerbating insulin resistance because of its higher glycemic index components and lower fiber content [ 36 , 42 – 47 ].…”

Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study

“…The inflammatory potential of a diet have direct and indirect effects on low muscle mass, grip strength, and muscle mass, through one and the other, in aging ( 49 ). The consumption of ultra-processed foods is strongly associated with frailty risk in older adults ( 50 ). An anti-inflammatory diet may indirectly reduce the risk of physical disabilities or frailty, by slowing age-related sarcopenia and muscle wasting ( 50 ).…”

“…The consumption of ultra-processed foods is strongly associated with frailty risk in older adults ( 50 ). An anti-inflammatory diet may indirectly reduce the risk of physical disabilities or frailty, by slowing age-related sarcopenia and muscle wasting ( 50 ). Promoting an anti-inflammatory diet has the potential to prevent sarcopenia early in life.…”