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. 2021 Dec;33(12):3245-3255. doi: 10.1007/s40520-021-01874-3. Epub 2021 May 12.

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.

Keywords: Diet quality; Elderly adults; Frailty; HEI-2015.

MeSH terms

  • Aged
  • Diet
  • Diet, Healthy
  • Exercise
  • Frail Elderly
  • Frailty* / epidemiology
  • Humans
  • Nutrition Surveys
  • United States