Diet with a combination of high protein and high total antioxidant capacity is strongly associated with low prevalence of frailty among old Japanese women: a multicenter cross-sectional study

Abstract

BackgroundThe intake of protein and antioxidants has been inversely associated with frailty, individually. However, to our knowledge, no study has evaluated these associations in considering antioxidants or protein intakes as respective confounders. Further, the cooperative effect of dietary protein and antioxidants on frailty has not been investigated. Therefore, we examined the association of high protein and high dietary total antioxidant capacity (TAC) with frailty under the adjustment for dietary TAC or protein intake, respectively. The association between the combination of high dietary protein and high dietary TAC and frailty was also investigated.MethodsA total of 2108 grandmothers or acquaintances of dietetic students aged 65 years and older participated in this cross-sectional multicenter study conducted in 85 dietetic schools in Japan. Dietary variables, including protein intake, and dietary TAC were estimated from a validated brief-type self-administered diet history questionnaire. Frailty was defined as a score of three or more points obtained from the following four components: slowness and weakness (two points), exhaustion, low physical activity, and unintentional weight loss.ResultsMedian (interquartile range) age of the present subjects was 74 (71–78) years. Multivariate adjusted ORs (95% CIs) for frailty in the highest compared to the lowest tertile were 0.66 (0.49, 0.87) for total protein intake (P for trend = 0.003) and 0.51 (0.37, 0.69) for dietary TAC (P for trend <0.0001) after adjustment for dietary TAC or total protein intake, respectively. The OR of frailty for the group with both the highest tertiles of total protein intake and dietary TAC was markedly lower (multivariate adjusted OR [95% CIs]: 0.27 [0.16, 0.44]; P <0.0001) compared to the group with the lowest tertile of protein intake and the lowest tertile of dietary TAC.ConclusionsBoth protein intake and dietary TAC were independently inversely associated with frailty among old Japanese women. Further, a diet with the combination of high dietary protein and high dietary TAC was strongly inversely associated with the prevalence of frailty in this population. To select food combinations that allow for an increase of both protein and antioxidants in diet according to the local food culture and dietary habits may be an effective strategy for frailty prevention.

The association between dietary protein intake, energy intake and physical frailty: results from the Rotterdam Study

“…Although the association between protein intake and muscular health has been extensively studied, associations with frailty are limited (14,(19)(20)(21)(22) . Our unadjusted results showed that frail participants consumed on average 7•8 g less protein/d than non-frail participants.…”

“…Dietary protein stimulates skeletal protein synthesis and insufficient supply can affect muscle integrity (17,18) . Nevertheless, although several, not all observational, studies report a beneficial association of protein intake with frailty (14,(19)(20)(21)(22) , inconsistencies could be caused by other factors that may influence the Abbreviations: BW, body weight; MET, metabolic equivalent of task; RDA, recommended daily allowance; RS, Rotterdam Study. association, such as physical activity (23)(24)(25) and protein source (i.e.…”

Decline in independence after three years and its association with dietary patterns and frailty factors in community-dwelling older people: an analysis by sex and age stage

“…In a study with Japanese participants, a Japanese-type dietary pattern with low consumption of animal protein, such as beef and pork, and high consumption of rice, miso soup, and sh, was found to be related to a healthy life expectancy with independence [11]. However, an analysis of older females alone showed that a high-protein (total and animal protein) diet is related to the prevention of frailty onset, independent of the intake of total antioxidant capacity [8].…”

“…Nutrition and diet are highly associated with the risk of frailty in older people [6,7]. In terms of single nutrients, the intake of proteins that maintain muscle strength [8] and n-3 fatty acids [9] related to cognitive functions are related to frailty prevention. Because healthy diets combine multiple foods, many studies have reported that healthy eating patterns are related to the prevention of frailty in older people [7].…”

“…Frailty is also associated with the total antioxidant capacity derived from dietary sources, such as coffee, vegetables, and fruits [8]. In a study with Japanese participants, a Japanese-type dietary pattern with low consumption of animal protein, such as beef and pork, and high consumption of rice, miso soup, and sh, was found to be related to a healthy life expectancy with independence [11].…”