Mediterranean diet vs. Ultra-processed foods: Impact on frailty in older adults

Increased adherence to the Mediterranean diet and reduced intake of ultra-processed foods may reduce the risk of frailty and cardiometabolic disease in older adults.

Study: Mediterranean diet and ultra-processed food intake in older Australian adults: associations with frailty and cardiometabolic disease. Image credits: Olena Yakobchuk / Shutterstock.com

A recent one Nutrients The study develops nutritional indices of ultra-processed foods (UPF) and the Mediterranean Diet Score (MDS) and evaluates whether these scores were associated with frailty and cardiometabolic diseases in older adults.

What is the optimal diet for the elderly?

Increasing life expectancy, combined with reduced fertility, has significantly increased the number of older adults worldwide. This phenomenon is called population aging, which has significantly increased the economic burden.

Two modeling studies based on US and Australian data predicted continued increases in healthcare spending due to aging issues. Increased incidence of multimorbidity and non-communicable diseases in older populations is common in high-, middle- and low-income countries, reducing quality of life and increasing healthcare expenditure.

The incidence of many age-related diseases, which are not communicable, is often associated with changes in dietary and lifestyle patterns. To date, little research has been done into the influence of nutrition on the health status of the elderly.

One study found that low vegetable and fiber intake worsened total disability in people over age 70. Several studies have also identified several barriers that prevent healthy eating in older adults.

The Mediterranean Diet (MedDiet) has been shown to reduce cognitive impairment, all-cause mortality, depression and cardiovascular disease, in addition to improving healthy aging. The MedDiet is usually a plant-based diet with moderate amounts of fish, meat and seafood.

Although several scoring systems have been developed to assess the level of adherence to MedDiet, these studies primarily included younger populations without considering older individuals.

Higher intake of energy-dense UPFs, which are generally low in nutrients, increases the risk of overweight, obesity and all-cause mortality. However, additional studies are needed to assess the impact of UPF intake in the elderly population.

Interestingly, a previous study hypothesized that the highly palatable, convenient, and extended shelf life of UPFs could benefit older adults who are energy deprived, experience decreased appetite, and are at higher risk for frailty and malnutrition.

About the study

In the current study, MedDiet and UPF scoring instruments were developed to assess the dietary habits of community-dwelling older Australian adults who participated in the ASPirin in Reducing Events in the Elderly (ASPREE)/ASPREE Longitudinal Study of Older Persons (ALSOP) -to research. The association between MedDiet and UPF scores, as well as the prevalence of cardiometabolic diseases and frailty, was evaluated.

A total of 16,703 Australian participants aged 70 years and over were recruited for the current study. Individuals diagnosed with dementia at baseline, who lacked functional independence, or had a history of cerebrovascular or cardiovascular disease were excluded from the analysis.

Medical and social histories were obtained at baseline and follow-up, along with lifestyle data and anthropometric measurements. Both UPF and MedDiet scores were generated independently using the 54-item Food Frequency Questionnaire (FFQ).

Various morbidities, such as dyslipidemia based on cholesterol and triglyceride levels, type 2 diabetes mellitus (T2DM) based on blood glucose levels, hypertension and chronic kidney disease (CKD) based on estimated glomerular filtration rate (eGFR) levels in urine, were investigated. evaluated based on dietary patterns. The frailty index was calculated, after which the study participants were classified as non-frail, pre-frail or frail.

Findings of the study

The median age of participants was 76.9 years, of whom 54.4% were female and 45.6% male. Compared to male participants, women were more likely to be older and home alone, and less likely to be current drinkers and to have 13 or more years of education.

Women also showed higher body mass index (BMI) values ​​than men with increased rates of central adiposity and dyslipidemia, as well as a reduced incidence of type 2 diabetes. Importantly, there were a greater number of pre-frail and vulnerable women in the study cohort than men.

Plant-based, non-meat, non-seafood protein and dairy consumption contributed to the total ASPREE-MDS. Women showed marginally higher vegetable, dairy and seafood scores than men. Higher ASPREE-MDS represented greater adherence to MedDiet.

The ASPREE-UPF score showed that men consume more bread, savory snacks, processed meats and sweetened/processed drinks. A very weak positive relationship between ASPREE-MDS and ASPREE-UPF was observed, indicating that improved MedDiet adherence correlates with a significant reduction in UPF consumption.

Higher adherence to the MedDiet, which was sex-dependent, reduced the risk of developing chronic kidney disease, hypertension, pre-frailty and frailty. In comparison, UPF consumption, which was relatively common among the elderly, was associated with an increased risk of frailty, but with a lower risk of hypertension.

Conclusions

In relatively healthy community-dwelling older adults, a very weak relationship was observed between MedDiet adherence and UPF intake. Nevertheless, higher MedDiet adherence and reduced UPF intake improved frailty, hypertension, and chronic kidney disease. In the future, more research is needed to identify the causal relationship between UPF and frailty.