Effects Of Dietary Diversity And Dietary Patterns On Frailty And Gender Differences Study

BackgroundIn the context of world population aging and "Healthy China 2030",how to improve the health of the elderly to achieve healthy aging has become an important area of current research.As a highly age-related clinical syndrome,frailty is prevalent among the elderly and affects their health.Although frailty leads to many adverse health outcomes,it has been shown to be modifiable and reversible.Therefore,finding a modifiable factor and intervening to delay,stop,or even reverse frailty is of great significance for healthy aging.Among the various factors,diet has been recognized as a modifiable determinant of health.Current research evidence on the effects of dietary diversity and dietary patterns on frailty is insufficient.ObjectivesTo study the current status of frailty in Chinese elderly people,to explore the relationship between dietary diversity,dietary patterns and frailty,and the moderating role of gender in the influence of diet-related factors on frailty,and to provide a scientific basis for frailty prevention and intervention.MethodsThis study was based on the Chinese Longitudinal Healthy Longevity Survey(CLHLS)database and included older adults aged 60 years or older as the study population.Frailty was measured by the Frailty Index,dietary diversity was obtained by dietary diversity score,and the dietary patterns of older adults were identified by principal component analysis.First,the current status of frailty among older adults was analyzed descriptively using the 2018 CLHLS database,and adjusted frailty rates and differences under different demographic characteristics were analyzed by constructing generalized ordered logit models and F-tests while adjusting for other control variables.Afterwards,the CLHLS cohort data from 2014-2018 were used to analyze dietary diversity and dietary patterns at baseline(2014)as well as to analyze the effect of changes in dietary diversity at baseline and at follow-up on frailty(2018)and the moderating role of gender in the relationship,through multifactorial logistic regression.ResultsThe study found that 11.18%of Chinese older adults aged 60 years and older were frail;after adjusting for other control variables,generalized ordered logit results showed that the prevalence of frailty was higher in women than in men(women:11.99%,men:10.41%;P=0.019).The prevalence of frailty increased with increasing age,and the difference between groups gradually increased.The prevalence of frailty was only 8.03%in elderly people between the ages of 60 and 70 years,and up to 38.84%at the age of 100 years and above.Logistic regression results showed that the intake of fish,pickles,sugar,garlic,nuts,and algae and mushroom foods were negatively associated with the risk of frailty.After adjusting for other control variables,it was found that while high dietary diversity at baseline had no effect on frailty(OR=0.81,95%CI:0.61-1.08),maintaining high dietary diversity over time reduced the likelihood of frailty(OR=0.59,95%CI:0.39-0.90).Three dietary patterns were identified in this study:milk-nut-algae-garlic dietary pattern,egg-bean-sugar-pickle dietary pattern,and vegetable-fruit-meat-fish dietary pattern.Regression results showed that a preference for the egg-bean-sugar-pickle dietary pattern and the vegetable-fruit-meat-fish dietary pattern reduced the risk of frailty(OR=0.66,95%CI:0.44-0.97;OR=0.54,95%CI:0.44-0.80).The moderating effect of gender showed that long-term dietary diversity,preference for egg-bean-sugar-pickle dietary pattern,and preference for vegetable-fruit-meat-fish dietary pattern did not differ in men and women in reducing the risk of frailty,whereas the protective effect of preference for milknut-algae-garlic dietary pattern on the risk of frailty was more pronounced in women.Conclusions11.18%of Chinese people aged 60 years or older were in a frailty state.The prevalence of frailty varied by gender,age,place of residence,and household income subgroups.Older adults who maintained a long-term high dietary diversity and preferred egg-bean-sugar-pickle dietary pattern,and vegetable-fruit-meat-fish dietary pattern had a lower risk of frailty.The protective effect of a milk-nut-algae-garlic dietary pattern on frailty risk may be more pronounced in women.