Vegetable and fruit intake and injurious falls risk in older women: a prospective cohort study

Abstract

The role of vegetable and fruit intake in reducing falls risk in elderly populations is uncertain. This study examined the associations of vegetable and fruit intake with falls-related hospitalisations in a prospective cohort study of elderly women (n 1429, ≥70 years), including effects on muscular function, which represented a potential causal pathway. Muscular function, measured using grip strength and timed-up-and-go (TUG), and vegetable and fruit intake, quantified using a validated FFQ, were assessed at baseline (1998). Incident falls-related hospitalisation over 14·5-year follow-up was captured by the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Falls-related hospitalisation occurred in 568 (39·7 %) of women. In multivariable-adjusted models, falls-related hospitalisations were lower in participants consuming more vegetables (hazard ratio (HR) per 75 g serve: 0·90 (95 % CI 0·82, 0·99)), but not fruit intake (per 150 g serve: 1·03 (95 % CI 0·93, 1·14)). Only total cruciferous vegetable intake was inversely associated with falls-related hospitalisation (HR: per 20 g serve: 0·90 (95 % CI 0·83, 0·97)). Higher total vegetable intake was associated with lower odds for poor grip strength (OR: 0·87 (95 % CI 0·77, 0·97)) and slow TUG (OR: 0·88 (95 % CI 0·78, 0·99)). Including grip strength and TUG in the multivariable-adjusted model attenuated the association between total vegetable intake and falls-related hospitalisations. In conclusion, elderly women with higher total and cruciferous vegetable intake had lower injurious falls risk, which may be explained in a large part by better physical function. Falls reduction may be considered an additional benefit of higher vegetable intake in older women.

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 ).…”