The Association Between Dietary Patterns And Frailty In Patients With Chronic Heart Failure

Background:Chronic Heart Failure(CHF)is the final stage of cardiovascular diseases.The combination of chronic inflammatory response,insulin resistance and mitochondrial dysfunction can increase the risk of muscle mass loss and frailty.The patient with CHF more likely to be frailty and frailty can predict the prognosis of patients with CHF.Foreign research shows that adherence to a healthy dietary pattern may prevent the occurrence of frailty.Due to dietary patterns are affected by regional difference,dietary habits and cooking styles,it is necessary to carry out studies to examine the relationship of dietary patterns with incident frailty in Chinese patients with CHF.So as to provide professional dietary guidance and support for clinical medical staff,maintain nutritional balance,and be away from the frailty.Objective:To evaluate the prevalence,clinical influence of frailty of patients with CHF;To identify the dietary patterns of patients with CHF;To investigate the correlation between each dietary score and risk of frailty in Chinese patients with CHF.Methods:A total of 212 chronic heart failure patients were recruited from Intensive Care Unit of a Grade Ⅲ cardiovascular hospital in Beijing between September 2019 to February 2021.Dietary patterns and frailty were measured by Food Frequency Questionnaire and Frailty Phenotype.Data were analyzed with SPSS 21.0 by The corresponding statistical methods.Results:Among 212 patients with CHF,the prevalence of frailty was 23.11%,28.17%in women and 20.57%in men.The place of residence,loosening of teeth,body mass index were statistically different between the frailty and non-frailty groups.In the frailty group,the intake of proteins,carbohydrate energy ratio,cholesterol vitamin A,eggs and fish-shrimp were lower than the non-frailty group,statistically significant."Five dietary patterns were identified in this study:"egg-milk-miscellaneous beans dietary pattern","fish-shrimp-poultry meat dietary pattern","cereals-potato-bean products dietary pattern","fungi-vegetables dietary pattern",and "poultry dietary pattern".The results of univariate analysis of the factors influencing dietary patterns showed that age,residence,smoking history and ejection fraction had effects on the compliance of dietary pattern of egg-milk-miscellaneous beans.Age,occupation,exercise,and NYHA had an impact on the compliance of the dietary pattern of fish-shrimp-poultry meat.Gender,payment methods,and the number of complications had influence on the compliance of the dietary pattern of cereals-potato-bean products.Occupation,the course of disease and the use of cardiac agents had influence on the compliance of the dietary pattern of fungi-vegetables.Occupation,loosening of teeth,plasma albumin level had an impact on poultry dietary pattern compliance.The results of univariate analysis showed that the subjects with high adherence to the dietary patterns of "egg-milk-miscellaneous beans dietary pattern" and "poultry dietary pattern" had a significant difference in the prevalence of frailty compared with the subjects with low adherence(P=0.039,P=0.034).Logistic regression analysis showed that "egg-milk-miscellaneous beans dietary pattern" was consistently negatively correlated with frailty in the three adjustment models,without adjusting the confounding factors(OR=0.219,95%CI:0.073-0.654);after adjusting the age and sex(OR=0.165,95%CI:0.052-0.518);after adjusting for age,sex,BMI,physical exercise and number of complications(OR=0.154,95%CI:0.047-0.500);The poultry dietary pattern was negatively associated with frailty risk when not adjusted for confounders(OR:0.200,95%CI:0.061-0.653),but was not associated with frailty after adjusting for age and sex(P=0.164).Conclusion:The prevalence of frailty in CHF patients was 23.11%,and it should be concerned by health professionals;"egg-milk-miscellaneous beans dietary pattern"may be related to the occurrence of frailty,and medical personnel could recommend"egg-milk-miscellaneous beans dietary pattern" in patients with CHF as a healthy dietary pattern to prevent the occurrence of frailty.