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Association between both total baseline urinary and dietary polyphenols and substantial physical performance decline risk in older adults: A 9-year follow-up of the InCHIANTI study

  • Published:
The journal of nutrition, health & aging

Abstract

Importance

The decline in physical performance that occurs in many older subjects is a strong predictor of falls, hospitalization, institutionalization and mortality. Polyphenols are bioactive compounds that may play a preventive role against physical performance decline due to their antioxidant and anti-inflammatory properties.

Objective

To investigate the association between total urinary polyphenols (TUP) and total dietary polyphenols (TDP) and substantial physical performance decline over a nine-year period among older subjects.

Methods

This longitudinal study included 368 participants aged 65 years or older from the InCHIANTI (Invecchiare in Chianti) study, an Italian population-based cohort. TUP and TDP concentrations were assessed at baseline using the Folin-Ciocalteau (F-C) assay and a validated food frequency questionnaire, respectively. Physical performance was objectively measured at baseline and at nine-year follow-up using the Short Physical Performance Battery (SPPB). A substantial decline in physical performance was considered as a decrease of three or more points in the SPPB score.

Results

At the nine-year follow-up assessment, 71 participants had suffered a substantial decline in physical performance. In the fully adjusted logistic regression model, participants in the highest TUP tertile had a lower risk of substantial decline in physical performance than those in the lowest tertile (OR, 0.40; 95% CI, 0.17–0.93; P trend=0.033). However, no significant association between TDP intake and physical performance decline was observed.

Conclusion

This study shows that high TUP concentrations, a biomarker of polyphenol-rich exposure, were associated with lower risk of substantial decline in physical performance in community-dwelling older subjects over a nine-year period. These results suggest that a polyphenol-rich diet may play a role in protecting against physical performance decline in older people.

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Abbreviations

TUP:

total urinary polyphenols

TDP:

total dietary polyphenols

InCHIANTI:

Invecchiare in Chianti

F-C:

Folin-Ciocalteau

SPPB:

Short Physical Performance Battery

OR:

odds ratio

CI:

confidence interval

GAE:

gallic acid equivalents

BMI:

body mass index

MMSE:

Mini-Mental State Examination

CES-D:

Center for Epidemiologic Studies Depression Scale

ADL:

activities of daily living

IADL:

instrumental activities of daily living

SD:

standard deviation

IQR:

interquartile range

References

  1. Guralnik JM, Ferrucci L, Simonsick EM, et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995;332, 556–561.

    Article  CAS  PubMed  Google Scholar 

  2. Cooper R, Kuh D, Cooper C, et al. Objective measures of physical capability and subsequent health: a systematic review. Age Ageing 2011;40, 14–23.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cooper R, Kuh D, Hardy R, et al. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 2010;341,c4467.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49, M85–94.

    Article  Google Scholar 

  5. Applegate WB, Blass JP, Williams TF. Instruments for the functional assessment of older patients. N Engl J Med 1990;322, 1207–1214.

    Article  CAS  PubMed  Google Scholar 

  6. Ostir GV, Volpato S, Fried LP, et al. Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women’s Health and Aging Study. J Clin Epidemiol 2002;55, 916–921.

    Article  PubMed  Google Scholar 

  7. Milaneschi Y, Tanaka T, Ferrucci L. Nutritional determinants of mobility. Curr Opin Clin Nutr Metab Care 2010;13, 625–629.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. May AM, Struijk EA, Fransen HP,et al. The impact of a healthy lifestyle on Disability-Adjusted Life Years: a prospective cohort study. BMC Med 2015;13, 287.

    Article  Google Scholar 

  9. Milaneschi Y, Bandinelli S, Corsi AM, et al. Mediterranean diet and mobility decline in older persons. Exp Gerontol 2011;46, 303–308.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zbeida M, Goldsmith R, Shimony T, et al. (Mediterranean diet and functional indicators among older adults in non-Mediterranean and Mediterranean countries. J Nutr Health Aging 2014;18, 411–418.

    Article  CAS  PubMed  Google Scholar 

  11. Pallauf K, Giller K, Huebbe P, et al. Nutrition and healthy ageing: calorie restriction or polyphenol-rich «MediterrAsian» diet? Oxid Med Cell Longev; 2013, 707421.

    Google Scholar 

  12. Zamora-Ros R, Rabassa M, Llorach R, et al. Application of Dietary Phenolic Biomarkers in Epidemiology: Past, Present, and Future. J Agric Food Chem 2012;60, 6648–6657.

    Article  CAS  PubMed  Google Scholar 

  13. Zamora-Ros R, Rabassa M, Cherubini A, et al. Comparison of 24-h volume and creatinine-corrected total urinary polyphenol as a biomarker of total dietary polyphenols in the Invecchiare InCHIANTI study. Anal Chim Acta 2011;704, 110–115.

    Article  CAS  PubMed  Google Scholar 

  14. Ferrucci L, Bandinelli S, Benvenuti E, et al. Subsystems contributing to the decline in ability to walk: bridging the gap between epidemiology and geriatric practice in the InCHIANTI study. J Am Geriatr Soc 2000;48, 1618–1625.

    Article  CAS  PubMed  Google Scholar 

  15. Zuniga K, McAuley E. Considerations in selection of diet assessment methods for examining the effect of nutrition on cognition. J Nutr Health Aging 2015;19, 333–340

    Article  CAS  PubMed  Google Scholar 

  16. Pisani P, Faggiano F, Krogh V, et al. Relative validity and reproducibility of a food frequency dietary questionnaire for use in the Italian EPIC centres. Int J Epidemiol 1997;26 Suppl 1, S152–S160.

    Article  PubMed  Google Scholar 

  17. Zamora-Ros R, Rabassa M, Cherubini A, et al. High concentrations of a urinary biomarker of polyphenol intake are associated with decreased mortality in older adults. J Nutr 2013;143, 1445–1450.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. U. S. Department of Agriculture. Database for the Isoflavone Content of Selected foods. USDA. Beltsville: MD, 2008.

    Google Scholar 

  19. U. S. Department of Agriculture. Database for the Proanthocyanidin Content of Selected foods. USDA. Beltsville: MD, 2004.

    Google Scholar 

  20. U. S. Department of Agriculture. Database for the Flavonoid Content of Selected Foods. USDA. Beltsville: MD, 2011.

    Google Scholar 

  21. Neveu V, Perez-Jimenez J, Vos F, et al. Phenol-Explorer: an online comprehensive database on polyphenol contents in foods. Database (Oxford); 2010, bap024.

    Google Scholar 

  22. Milaneschi Y, Bandinelli S, Corsi AM, et al. Personal mastery and lower body mobility in community-dwelling older persons: the Invecchiare in Chianti study. J Am Geriatr Soc 2010;58, 98–103.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Penninx BW, Guralnik JM, Ferrucci L, et al. Depressive symptoms and physical decline in community-dwelling older persons. JAMA 1998;279, 1720–1726.

    Article  CAS  PubMed  Google Scholar 

  24. Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993;25, 71–80.

    Article  CAS  PubMed  Google Scholar 

  25. Salvini S. A food composition database for epidemiological studies in Italy. Cancer Lett 1997;114, 299–300.

    Article  CAS  PubMed  Google Scholar 

  26. Pahor M, Chrischilles EA, Guralnik JM, et al. Drug data coding and analysis in epidemiologic studies. Eur J Epidemiol 1994;10, 405–411.

    Article  CAS  PubMed  Google Scholar 

  27. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16, 31–41.

    Article  CAS  PubMed  Google Scholar 

  28. Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12, 189–198.

    Article  CAS  PubMed  Google Scholar 

  29. Beekman AT, Deeg DJ, Van Limbeek J, et al. Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands. Psychol Med 1997;27, 231–235.

    Article  CAS  PubMed  Google Scholar 

  30. Katz S, Ford AB, Moskowitz RW, et al. Studies of Illness in the Aged. The Index of Adl: A Standardized Measure of Biological and Psychosocial Function. JAMA 1963;185, 914–919.

    Article  CAS  PubMed  Google Scholar 

  31. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9, 179–186.

    Article  CAS  PubMed  Google Scholar 

  32. Kwon S, Perera S, Pahor M, et al. What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study). J Nutr Health Aging 2009;13, 538–544.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Perera S, Mody SH, Woodman RC, et al. Meaninful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc 2006;54,743–749.

    Article  PubMed  Google Scholar 

  34. Rabassa M, Cherubini A, Zamora-Ros R, et al. Low Levels of a Urinary Biomarker of Dietary Polyphenol are Associated with Substantial Cognitive Decline Over a 3-Year Period in Older Adults: The Invecchiare in Chianti Study. J Am Geriatr Soc 2015;63, 938–946.

    Article  PubMed  Google Scholar 

  35. Urpi-Sarda M, Andres-Lacueva C, Rabassa M, et al. The Relationship Between Urinary Total Polyphenols and the Frailty Phenotype in a Community-Dwelling Older Population: The InCHIANTI Study. J Gerontol A Biol Sci Med Sci; 2015; 63, 938–946.

    Google Scholar 

  36. Gramza-Michalowska A. Caffeine in tea camellia sinensis—content, absorption, benefits and risks of consumption. J Nutr Health Aging 2014;18, 143–149.

    Article  CAS  PubMed  Google Scholar 

  37. Manach C, Williamson G, Morand C, et al. Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies. Am J Clin Nutr 2005;81, 230S–242S.

    CAS  PubMed  Google Scholar 

  38. Cassidy A, Mukamal KJ, Liu L, et al. High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation 2013;127, 188–196.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. van Dam RM, Naidoo N, Landberg R. Dietary flavonoids and the development of type 2 diabetes and cardiovascular diseases: review of recent findings. Curr Opin Lipidol 2013;24, 25–33.

    Article  PubMed  Google Scholar 

  40. Geybels MS, Verhage BAJ, Arts IC, et al. Dietary Flavonoid Intake, Black Tea Consumption, and Risk of Overall and Advanced Stage Prostate Cancer. Am J Epidemiol 2013;177, 1388–1398.

    Article  PubMed  Google Scholar 

  41. Zamora-Ros R, Jimenez C, Cleries R, et al. Dietary flavonoid and lignan intake and mortality in a Spanish cohort. Epidemiology 2013;24, 726–733.

    Article  PubMed  Google Scholar 

  42. Zamora-Ros R, Forouhi NG, Sharp SJ, et al. The Association Between Dietary Flavonoid and Lignan Intakes and Incident Type 2 Diabetes in European Populations: The EPIC-InterAct Study. Diabetes care 2013;36, 3961–3970.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Obrenovich ME, Nair NG, Beyaz A, et al. The role of polyphenolic antioxidants in health, disease, and aging. Rejuvenation Res 2010;13, 631–643.

    Article  CAS  PubMed  Google Scholar 

  44. Uysal U, Seremet S, Lamping JW, et al. Consumption of polyphenol plants may slow aging and associated diseases. Curr Pharm Des 2013;19, 6094–6111.

    Article  CAS  PubMed  Google Scholar 

  45. Rolland Y, Czerwinski S, Abellan Van Kan G, et al. Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 2008;12, 433–450.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Charles AL, Meyer A, Dal-Ros S, et al. Polyphenols prevent ageing-related impairment in skeletal muscle mitochondrial function through decreased reactive oxygen species production. Exp Physiol 2013;98, 536–545.

    Article  CAS  PubMed  Google Scholar 

  47. Chung S, Yao H, Caito S, et al. Regulation of SIRT1 in cellular functions: role of polyphenols. Arch Biochem Biophys 2010;501, 79–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Grosso G, Stepaniak U, Topor-Madry R, et al. Estimated dietary intake and major food sources of polyphenols in the Polish arm of the HAPIEE study. Nutrition 2014;30, 1398–1403.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to C. Andres-Lacueva.

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Rabassa, M., Zamora-Ros, R., Andres-Lacueva, C. et al. Association between both total baseline urinary and dietary polyphenols and substantial physical performance decline risk in older adults: A 9-year follow-up of the InCHIANTI study. J Nutr Health Aging 20, 478–484 (2016). https://doi.org/10.1007/s12603-015-0600-2

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  • DOI: https://doi.org/10.1007/s12603-015-0600-2

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