Dietary diversity and frailty among older Chinese people: evidence from the Chinese Longitudinal Healthy Longevity Study

Xiao Meng Wang, Wen Fang Zhong, Zhi Hao Li, Pei Liang Chen, Yu Jie Zhang, Jiao Jiao Ren, Dan Liu, Qiao Qiao Shen, Pei Yang, Wei Qi Song, Fen Liang, Ying Nan, Jia Xuan Xiang, Yin Ru Wu, Yue Bin Lv, Xiang Gao, Virginia Byers Kraus, Xiao Ming Shi, Chen Mao

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background: Dietary diversity is widely advocated as a means to promote health, but little is known regarding whether the beneficial effects still apply in older adults. Objective: To examine the association between the dietary diversity score (DDS) and frailty among older Chinese adults. Methods: A total of 13,721 adults aged ≥65 y without frailty at baseline were enrolled. The DDS at baseline was constructed based on 9 items of a food frequency questionnaire. We used 39 self-reported health items to construct a frailty index (FI), with FI ≥ 0.25 indicating frailty. Cox models with restricted cubic splines were used to evaluate the dose–response relationships of DDS (continuous) with frailty. In addition, Cox proportional hazard models were used to examine the association between DDS (categorized as scores ≤4, 5–6, 7, and ≥8) and frailty. Results: During the mean follow-up of 5.94 y, 5250 participants met the criteria for frailty. Each 1-unit increase in DDS corresponded to a 5% lower risk of frailty (hazard ratio [HR]; 0.95; 95% CI: 0.94, 0.97]. Compared with participants with DDS ≤4 points, those with a DDS of 5–6, 7, and ≥8 points exhibited a lower frailty risk, with HRs of 0.79 (95% CI: 0.71, 0.87), 0.75 (95% CI: 0.68, 0.83), and 0.74 (95% CI: 0.67, 0.81), respectively (P-trend < 0.001). Protein-rich food items, such as meat; eggs; and beans, were associated with protective effects against frailty. In addition, a significant association was observed between higher consumption of 2 high-frequency foods, tea and fruits, and lower risk of frailty. Conclusions: A higher DDS was associated with a lower risk of frailty among older Chinese adults. This study highlights the importance of a diverse diet as a potential modifiable behavioral factor for preventing frailty in older Chinese adults.

Original languageEnglish (US)
Pages (from-to)383-391
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume117
Issue number2
DOIs
StatePublished - Feb 2023

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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