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Association between Healthy Eating Index-2015 and physical frailty among the United States elderly adults: the National Health and Nutrition Examination Survey (NHANES) 2011–2014

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Abstract

Background

Diet plays an important role in the development of age-related chronic diseases. However, the association between diet quality assessed by Healthy Eating Index (HEI)-2015, the latest version of HEI, and physical frailty among the general United States (US) elderly adults remains unclear.

Aims

The present study aims to explore the association between HEI-2015 and physical frailty in elderly adults using data from National Health and Nutrition Examination Survey (NHANES) 2011–2014.

Methods

HEI-2015 scores were calculated from 2 days 24-h recall interviews. Physical frailty status was assessed by four criteria developed by Fried et al.: exhaustion, weakness, low body mass, and low physical activity, and then categorized into robust (0 criteria), pre-frail (1–2 criteria), or frail (3–4 criteria). The binary and multinomial logistic regressions were used to examine the odds of frailty status.

Results

A total of 2345 participants aged 60 years or older were included. According to the 4-items frailty criteria, 51.1% participants were robust, 42.1% were pre-frail, and 6.8% were frail. Compared to the lowest HEI-2015 quartile, the elderly adults in the higher quartile had a lower odds of physical frailty (P < 0.05). Regarding the frailty criterion separately, higher HEI-2015 was associated with lower odds of exhaustion, weakness, low physical activity and unintentional weight loss, respectively (P < 0.05). Among 13 HEI-2015 components, adherence to the recommended intake of whole fruits and total vegetables components were less likely to be physically frail (P < 0.05).

Conclusion

Higher HEI-2015 was inversely associated with lower odds of physical frailty in the US elderly adults.

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Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable.

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Acknowledgements

We thank the public availability of NHANES data and thank all NHANES participants and staff for their valuable efforts.

Funding

This work was not specifically funded.

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Authors and Affiliations

  1. School of Public Health, Xi’an Jiaotong University, 76 West Yanta Road, Xi’an, 710061, China

    Yameng Fan, Yinyin Zhang, Jiaqiao Li, Yamei Liu, Long Zhou & Yan Yu

  2. Department of Cardiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China

    Long Zhou

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Contributions

YY, LZ and YMF contributed to the study design. LZ, YMF and YYZ preformed the data analysis. YMF wrote the manuscript. JQL and YML critically revised and edited the manuscript for important intellectual content. All authors reviewed and approved the final manuscript.

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Correspondence to Long Zhou or Yan Yu.

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Fan, Y., Zhang, Y., Li, J. et al. Association between Healthy Eating Index-2015 and physical frailty among the United States elderly adults: the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Aging Clin Exp Res 33, 3245–3255 (2021). https://doi.org/10.1007/s40520-021-01874-3

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  • DOI: https://doi.org/10.1007/s40520-021-01874-3

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