Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

Abstract

Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.4) years; 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60; 95% CI = 0.42−0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42; 95% CI = 0.24−0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.

Myoprotective Whole Foods, Muscle Health and Sarcopenia: A Systematic Review of Observational and Intervention Studies in Older Adults

“…Nineteen observational studies examined the association between whole foods, muscle-related outcomes and sarcopenia in older adults (aged ≥ 50 years). Of these, three studies examined the relationship between meat intake (red meats, poultry, and processed meats) and muscle mass and function [ 21 , 22 , 23 ]; five examined the intake of fruit and vegetables in relation to sarcopenia and muscle function [ 24 , 25 , 26 , 27 , 28 ], and eight studies investigated the link between multiple whole foods and various muscle-related outcomes [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. The individual whole foods were: fatty fish, white fish and shellfish, legumes, soy, nuts and seeds, eggs, and the components of the Nordic Dietary Score (NDS), including Nordic cereal (rye, oats, barley) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

“…To assess diet, ten studies used food frequency questionnaires (FFQ) [ 24 , 27 , 29 , 30 , 31 , 33 , 34 , 35 , 37 , 38 ], four studies employed diet histories [ 21 , 23 , 25 , 39 ], one used 3-day diet record [ 36 ], one 24-h dietary recall [ 22 ], two used lifestyle questionnaire [ 26 , 32 ], and one study used a single question for a specific food group [ 28 ]. Muscle-related outcomes varied across the studies; six examined muscle mass (total, lean, appendicular, skeletal muscle index, etc.)…”

“…[ 21 , 22 , 31 , 36 , 37 , 38 ], nine examined muscle function (functional tasks, Short Physical performance Battery (SPPB), gait speed, TUG, chair rise, balance, Senior Fitness Tet, etc.) [ 23 , 25 , 26 , 27 , 30 , 33 , 36 , 37 , 39 ], seven investigated muscle strength (grip strength, knee extension strength) [ 21 , 26 , 29 , 32 , 35 , 37 , 39 ], and only three studies examined the relationship between sarcopenia and whole foods [ 24 , 28 , 34 ].…”

“…Table S3 shows the risk of bias scores for each study across nine criteria (e.g., study design, participants, diet quality (assessment), outcome measurements, analysis), and the overall quality rating (risk of bias score) based on the NOS tool. Ten studies (53%) [ 21 , 22 , 23 , 27 , 28 , 31 , 34 , 35 , 37 , 39 ] had low risk of bias (score range +4 to +8), and eight studies (42%) [ 24 , 25 , 29 , 30 , 32 , 33 , 36 , 38 ] had medium risk of bias (score range 0 to +3). One study had high risk of bias (score −4) [ 26 ].…”

“…One study had high risk of bias (score −4) [ 26 ]. Per exposure (whole foods), three studies with meat had low risk of bias [ 21 , 22 , 23 ]; five studies with fruit and vegetables had medium (three studies) [ 24 , 25 , 28 ], low (two study) [ 27 , 28 ], or high (one study) [ 26 ] risk of bias; eight studies with multiple whole foods had medium (five studies) [ 29 , 30 , 32 , 33 , 36 ] or low (three studies) [ 31 , 34 , 35 ] risk of bias; and three studies with semi-solid dairy/cheeses had low (two studies) [ 37 , 39 ] or medium (one study) risk of bias [ 38 ] ( Table S3 ).…”