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Increased Frailty Risk Among OAs With Poor Diet

July 29, 2019

Older adults with a poor diet and low vegetable protein intake are at an increased risk of becoming frail as they age, according to a new study. Researchers published their findings online in the Journal of the American Geriatrics Society. 

For the study, a team of researchers, led by Linda Hengeveld, MSC, and colleagues, examined associations of diet quality indicators with 4-year incidence of frailty in older adults. The prospective cohort study included community-dwelling older adults, aged 70 to 81 years.

The study authors measured frailty and dietary intake through various methods. During the first follow-up period, participants received a food frequency questionnaire to assess dietary intake over the preceding year.

Indicators of diet quality include the Healthy Eating Index (categorized as poor, medium, and good), energy intake, and protein intake (a priori adjusted for energy intake using the nutrient residual model).

The researchers measured frailty status by using Fried's five‐component frailty phenotype and categorized into “robust” (0 components present), “pre‐frailty” (1 ‐ 2 components present), or “frail” (3‐5 components present).

During the 4‐year follow‐up, 277 of the 2154 participants, robust or pre‐frail at baseline, developed frailty, and 629 of the 1020 participants, robust at baseline, developed pre‐frailty or frailty,” the researchers found.

Following adjustment for confounders, such as energy intake among the robust and pre-frail cohort, participants consuming poor‐ and medium‐quality diets had a higher frailty incidence than those consuming good‐quality diets (hazard ratio [HR] = 1.92 [95% confidence interval {CI} = 1.17‐3.17] and HR = 1.40 [95% CI = 0.99‐1.98], respectively). The researchers noted that there were no associations for energy or protein intake observed and competing risk analyses yielded similar results. Finally, among the robust cohort, participants with lower vegetable protein intake had a higher “pre-frailty or frailty” incidence.  

“Poorer overall diet quality and lower vegetable protein intake may increase the risk of becoming frail in old age,” the study authors concluded. “We found no association for intakes of energy, total protein, or animal protein.

Julie Gould 


Hengeveld LM, Wijnhoven HAH, Olthof MR, et al. Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study [published online July 2, 2019]. J Am Geriatr Soc. doi:

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