Quality Specific Associations of Carbohydrate Consumption and Frailty Index

Abstract

Background: The quality of carbohydrate consumed may influence the risk of frailty. In this study, we tested the hypothesis that indices of carbohydrate intake are associated with trajectories of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Methods: Cross sectional and longitudinal analyses were conducted in 1024 BLSA participants to examine the association between usual intake of carbohydrate and frailty index. Seven measures of carbohydrate consumption were estimated using data derived from Food Frequency Questionnaires (FFQs) and examined in association with a 43-item Frailty Index (FI). Results: In cross-sectional analyses, there was a significant, positive association between higher tertiles of total carbohydrate, glycemic load, and non-whole grains and FI. Conversely, higher tertiles of fiber-to-carbohydrate ratio was associated with lower FI. These differences persisted over the follow-up period of up to 13.8 years. Women in the highest tertile of the fiber-to-carbohydrate ratio showed a less steep increase in FI over time. Conclusions: Carbohydrate intake was positively associated with increased frailty risk in the BLSA participants, whereas a higher fiber-to-carbohydrate ratio was related to reduced risk for frailty.

Association between nut consumption and frailty in the elderly: a large sample cross‐sectional study

“…44 Moreover, a diet rich in fibre, exemplified by nuts, has been reported to decelerate the progression of ageing frailty, as evidenced in the Baltimore Longitudinal Study of Aging. 45 Also, high concentrations of urinary total polyphenols were found in relation with lower prevalence of frailty and prefrailty within a geriatric population. This leads to the deduction that a diet abundant in polyphenols, typified by foods such as nuts, may serve as a robust safeguard against the emergence of frailty.…”

“…And a cross‐sectional study involving 18,278 participants found that increasing omega‐3 polyunsaturated fatty acids, which are derived mainly from walnuts, particularly α‐linolenic acid, can effectively prevent low grip strength 44 . Moreover, a diet rich in fibre, exemplified by nuts, has been reported to decelerate the progression of ageing frailty, as evidenced in the Baltimore Longitudinal Study of Aging 45 . Also, high concentrations of urinary total polyphenols were found in relation with lower prevalence of frailty and prefrailty within a geriatric population.…”

Macronutrients intake and physical frailty in Korean older adults: A cohort‐based cross‐sectional study

“…Previous studies have reported that high carbohydrate intake was associated with frailty, elevated inflammatory responses in the skeletal muscle, 25,26 and chronic low levels of inflammation that contribute to sarcopenia 27 . Frailty has been reported to be associated with higher oxidative stress and lower antioxidant markers in the body 28 .…”

Associations between Low-Carbohydrate Diets and Low-Fat Diets with Frailty in Community-Dwelling Aging Chinese Adults

“…For example, the Mediterranean diet was protective in maintaining a lower FI [ 12 ]; three dietary patterns summarized based on Japanese older adults, including salt and pickles, sugar and a fat- and protein-rich dietary pattern, were associated with FI [ 13 ]; the results from Chinese older adults also found that the egg–bean–pickle–sugar pattern and fruit–vegetable–meat–fish pattern reduced frailty incidence [ 14 ]. A recent study demonstrated that dietary carbohydrates were positively associated with increased frailty risk in Baltimore participants [ 15 ]; thus, lower carbohydrate consumption may prevent frailty. The low-carbohydrate diet (LCD) score, with lower daily carbohydrate and higher protein and fat intake, has been associated with mortality [ 16 ], diabetes [ 17 ], cognition in the elderly [ 18 ] and weight loss [ 19 ].…”

“…Notably, frailty was described using the frailty phenotype, which focuses on five physical factors, including unintentional weight loss, self-reported exhaustion, weakness (grip strength), slow walking speed and low physical activity, and not FI, which emphasizes accumulated health deficits [ 20 ]. Although low carbohydrate intake has been suggested as a frailty prevention strategy, currently relevant studies are limited to certain Western countries, such as the US [ 15 ] and France [ 20 ]. The results regarding the association of the LCD score with frailty risk are still considerably lacking in the Chinese context.…”