Dietary Patterns and Frailty in Older Korean Adults: Results from the Korean Frailty and Aging Cohort Study.

There are few studies on dietary patterns and frailty in Asians, and the results are controversial. Therefore, this study examined the association between dietary patterns and frailty in older Korean adults using the Korean Frailty and Aging Cohort Study (KFACS). The sample consisted of 511 subjects, aged 70-84 years, community-dwelling older people from the KFACS. Dietary data were obtained from the baseline study (2016-2017) using two nonconsecutive 24-h dietary recalls, and dietary patterns were extracted using reduced rank regression. Frailty was measured by a modified version of the Fried Frailty Phenotype (FFP) in both the baseline (2016) and the first follow-up study (2018). A logistic regression analysis was used to examine the association between dietary patterns and frailty status in 2018. The "meat, fish, and vegetables" pattern was inversely associated with pre-frailty (OR = 0.41, 95% CI = 0.21-0.81, p for trend = 0.009) and exhaustion (OR = 0.41, 95% CI = 0.20-0.85, p for trend = 0.020). The "milk" pattern was not significantly associated with frailty status or the FFP components. In conclusion, a dietary pattern with a high consumption of meat, fish, and vegetables was associated with a lower likelihood of pre-frailty.

Association of serum vitamin D with frailty in older Korean adults.

OBJECTIVES: The association between serum levels of vitamin D and frailty in older Korean adults was examined. STUDY DESIGN: Cross-sectional study. Older people living in the community across 10 study centers throughout South Korea. The baseline data (2016-2017) of 2872 participants aged 70-84 years in the Korean Frailty and Aging Cohort Study were evaluated. MAIN OUTCOME MEASURES: Serum vitamin D level was assessed with an electro-chemiluminescence immunoassay. Frailty was defined using Fried's frailty index. A multinomial logistic regression analysis was used to examine the association between serum levels of vitamin D and frailty. RESULTS: The percentages of those with serum vitamin D levels of <25 nmol/L, 25-49 nmol/L, 50-74 nmol/L, and ≥75 nmol/L were 4.1 %, 37.0 %, 37.8 %, and 21.0 %, respectively. The prevalence of frailty was 9.7 %. Those with lower serum vitamin D levels, compared with ≥75 nmol/L, tended to have higher odds of being frail than being non-frail (OR: 1.58, 95 % CI: 1.05-2.39 for 50-74 nmol/L; OR: 1.49, 95 % CI: 0.98-2.26 for 25-49 nmol/L; OR: 1.37, 95 % CI: 0.65-2.88 for <25 nmol/L). Among the components of frailty, low grip strength was significantly associated with lower serum levels of vitamin D. CONCLUSIONS: Low serum levels of vitamin D are associated with an increased likelihood of frailty in community-dwelling older adults, suggesting a potentially protective role of vitamin D against frailty.

Diet quality and osteosarcopenic obesity in community-dwelling adults 50 years and older.

OBJECTIVES: To examine the association between diet quality and osteosarcopenic obesity (OSO), low bone and muscle mass with concurrent high fat mass, in middle-aged and older adults. STUDY DESIGN: Data were from a cross-sectional study of 2579 men and 3550 women aged 50 years and older who completed the Korea National Health and Nutritional Examination Survey from 2008 to 2010. MAIN OUTCOME MEASURES: Data were collected using 24-h dietary recall, and diet quality was determined by the Diet Quality Index-International (DQI-I), on which higher scores denote better quality. Body composition was evaluated by dual-energy x-ray absorptiometry. The association between dietary quality and the number of body composition abnormalities (including OSO) was analyzed by multinomial logistic regression, adjusting for covariates. RESULTS: In women, after controlling for covariates, higher scores on the DQI-I were associated with a significantly lower number of phenotypes associated with adverse body composition. Those in the highest tertile group of DQI-I were less likely to have OSO compared with those in the lowest tertile (odds ratio=0.54, 95% confidence interval: 0.32-0.92). In men, DQI-I scores were not associated with the number of body composition abnormalities. CONCLUSIONS: Middle-aged and older women who eat a healthier diet, as determined by a high DQI-I score, are less likely to have multiple body composition abnormalities.

Association of serum vitamin D with osteosarcopenic obesity: Korea National Health and Nutrition Examination Survey 2008-2010.

BACKGROUND: Serum vitamin D levels have been reported to be associated with individual components of body composition. However, the relationship between serum vitamin D and combined indices of adverse body composition is largely unknown. This cross-sectional study examined the association between serum vitamin D and osteosarcopenic obesity in a nationally representative sample of middle-aged and older adults. METHODS: We analysed the Korea National Health and Nutrition Examination Surveys (IV and V) conducted in 2008-2010, consisting of 5908 (2485 men, 3423 women) aged ≥ 50 years. Serum vitamin D levels were determined by radioimmunoassay, and body composition was evaluated by dual-energy x-ray absorptiometry. The association between serum vitamin D levels and the number of abnormalities in body composition, including osteosarcopenic obesity, a low bone and muscle mass with concurrent high fat mass, was analysed by multinomial logistic regression adjusting for covariates. RESULTS: In men, after controlling for covariates, higher vitamin D levels were associated with a significantly reduced likelihood of the number of phenotypes of adverse body composition (P for trend < 0.05). Those in the highest tertile group of serum vitamin D levels, compared with those in the lowest tertile, were less likely to have adverse body composition, numbering one (odds ratio [OR] = 0.67, 95% confidence interval [CI]: 0.49, 0.92), two (OR = 0.49, 95% CI: 0.33, 0.73), and three (osteosarcopenic obesity; OR = 0.42, 95% CI: 0.26, 0.67). In women, those in the highest tertile group of serum vitamin D levels, compared with those in the lowest tertile, were less likely to have osteosarcopenic obesity (OR = 0.55, 95% CI: 0.33, 0.93). Vitamin D deficiency (<20 ng/mL) in men was significantly associated with an increased likelihood of a higher number of adverse body composition, especially for osteosarcopenic obesity (OR = 2.08, 95% CI: 1.42, 3.03). Vitamin D deficient women, compared with those having normal levels of serum vitamin D, were also more likely to demonstrate osteosarcopenic obesity (OR = 1.99, 95% CI: 1.30, 3.05). CONCLUSIONS: A high serum vitamin D level in mid- and late-life was associated with reduced odds of multiple adverse body composition, especially osteosarcopenic obesity, suggesting potential health benefits of maintaining adequate levels of vitamin D.

Association between healthy diet and exercise and greater muscle mass in older adults.

OBJECTIVES: To examine the association between healthy diet and exercise, individually and combined, and low muscle mass in older Korean adults. DESIGN: Population-based cross-sectional study from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys from 2008 to 2011. SETTING: Community. PARTICIPANTS: Nationally representative sample aged 65 and older (1,486 men, 1,799 women) in the Republic of Korea. MEASUREMENTS: A food frequency questionnaire was used to determine frequency of food group consumption (meat, fish, eggs, legumes; vegetables; fruits). Participation in exercise (aerobic and resistance) was based on self-report. Combined healthy lifestyle factors were calculated as the number of recommendations met regarding consumption of food groups and exercise performed. Appendicular skeletal muscle mass (ASM) was measured using dual-energy X-ray absorptiometry, and low muscle mass was defined using the variable of ASM adjusted for weight. Logistic regression analysis was performed to examine the association between healthy lifestyle factors and low muscle mass, adjusting for sociodemographic characteristics and health-related variables. RESULTS: In women, after controlling for covariates, vegetable consumption (odds ratio (OR)=0.52, 95% confidence interval (CI)=0.30-0.89) and aerobic exercise (OR=0.62, 95% CI=0.39-1.00) were inversely associated with low muscle mass. Also, the odds of low muscle mass was lower in women with three or more healthy lifestyle factors versus none (OR=0.45, 95% CI=0.23-0.87). In men, there were no associations between food group consumption and exercise and low muscle mass. CONCLUSION: Older women who exercise and consume a healthy diet have lower odds of low muscle mass. Engaging in multiple healthy behaviors may be important in preventing low muscle mass in late life.

Association of vegetables and fruits consumption with sarcopenia in older adults: the Fourth Korea National Health and Nutrition Examination Survey.

BACKGROUND: several studies have found nutrients, including antioxidants, to be associated with sarcopenia. However, whether specific foods, such as vegetables and fruits, are associated with sarcopenia has not been studied. OBJECTIVE: to examine the association of the frequency of vegetables and fruits consumption with sarcopenia in older people. METHODS: this study used cross-sectional data from the Fourth Korea National Health and Nutrition Examination Survey in 2008-09. Subjects were community-dwelling 823 men and 1,089 women aged ≥65 years. Frequency of food group consumption was obtained by using the food frequency questionnaire. Body composition was measured with the dual-energy X-ray absorptiometry and sarcopenia was defined as appendicular lean mass adjusted for height and fat mass. Logistic regression was used to assess the association of the frequency of food group consumption with sarcopenia, controlling for sociodemographics and health-related variables. RESULTS: dietary intake of vegetables, fruits and both vegetables and fruits was associated with a significantly reduced risk of sarcopenia after controlling for covariates in men (P = 0.026 for trend, P = 0.012 for trend, P = 0.003 for trend, respectively). Men in the highest quintile, compared with those in the lowest quintile, of vegetables [odds ratio (OR) = 0.48; 95% confidence interval (CI): 0.24-0.95], fruits (OR = 0.30; 95% CI: 0.13-0.70) and vegetables and fruits consumption (OR = 0.32; 95% CI: 0.16-0.67) demonstrated a lower risk of sarcopenia. In women, high consumption of fruits demonstrated a lower risk of sarcopenia (OR = 0.39; 95% CI: 0.18-0.83). CONCLUSION: frequent vegetables and fruits consumption was inversely associated with sarcopenia in older adults.

Under-reporting of Energy Intake from 24-hour Dietary Recalls in the Korean National Health and Nutrition Examination Survey.

OBJECTIVES: Chronic degenerative diseases are closely related to daily eating habits, nutritional status, and, in particular, energy intake. In clarifying these relationships it is very important for dietary surveys to report accurate information about energy intake. This study attempted to identify the prevalence of the under-reporting of energy intake and its related characteristics based on the Korean National Health and Nutrition Examination Survey conducted in the years 2007-2009. METHODS: The present study analyzed dietary intake data from 15,133 adults aged ≥19 years using 24-hour dietary recalls. Basal metabolic rates were calculated from the age- and gender-specific equations of Schofield and under-reporting was defined as an energy intake <0.9, represented by the ratio of energy intake to estimated basal metabolic rate. RESULTS: Under-reporters (URs) accounted for 14.4% of men and 23.0% of women and the under-reporting rate was higher in the age group 30-49 years for both men and women. The results from an analysis of the age-specific socioeconomic characteristics of participants classified as URs showed that under-reporting was high in women living alone and in women with only elementary school education or no education. The results from an analysis of the health-specific characteristics of URs showed that a large proportion of URs had poor self-rated health or were obese, or both, compared with non-URs. The proportion of participants who consumed less than the estimated average requirements for nutrients was significantly higher in URs compared with non-URs. CONCLUSION: The under-reporting of energy intake was associated with age, gender, education level, income level, household status (single-person or multi-person), self-rated health, physical activity, and obesity.