Macronutrients, diet quality, and frailty in older men

James M. Shikany, Elizabeth Barrett-Connor, Kristine E. Ensrud, Peggy M. Cawthon, Cora E. Lewis, Thuy Tien L. Dam, Jackilen Shannon, David T. Redden

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Background. Frailty, a phenotype of multisystem impairment and expanding vulnerability, is associated with higher risk of adverse health outcomes not entirely explained by advancing age. We investigated associations of macronutrients, dietary fiber, and overall diet quality with frailty status in older community-dwelling men. Methods. Participants were 5,925 men aged ≥65 years enrolled in the Osteoporotic Fractures in Men (MrOS) study at six U.S. centers. Diet was assessed at baseline with a food frequency questionnaire. We assessed frailty status (robust, intermediate, or frail) at baseline and at a second clinic visit (a mean of 4.6 years later) using a slightly modified Cardiovascular Health Study frailty index. We used multinomial logistic regression to assess associations between macronutrient intake, dietary fiber, and the Diet Quality Index Revised with frailty status at baseline and at the second clinic visit. Results. At baseline, 2,748 (46.4%) participants were robust, 2,681 (45.2%) were intermediate, and 496 (8.4%) were frail. Carbohydrate, fat, protein, and dietary fiber showed no consistent associations with frailty status. Overall diet quality exhibited fairly consistent associations with frailty status. The Diet Quality Index Revised was inversely associated with frail status relative to robust status at the baseline visit (odds ratio for Q5 vs Q1 = 0.44, 95% confidence interval: 0.30, 0.63; p for trend <. 0001) and at the second clinic visit (odds ratio for Q5 vs Q1 = 0.18, 95% confidence interval: 0.03, 0.97; p for trend =. 0180). Conclusions. Overall diet quality was inversely associated with prevalent and future frailty status in this cohort of older men.

Original languageEnglish (US)
Pages (from-to)695-701
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number6
StatePublished - Jun 2014

Bibliographical note

Funding Information:
Funding This work was supported by the National Institutes of Health: the National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583); the National Institute on Aging (U01 AG18197, U01 AG027810); the National Center for Research Resources (UL1 RR024140); and the National Institutes of Health Roadmap for Medical Research.


  • Epidemiology
  • Frailty
  • Nutrition


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