Dietary patterns and frailty: a systematic review and meta-analysis

Context: Assessing the relationship between single nutrients and frailty fails to take into consideration the interactions between nutrients. An increasing number of investigations in recent years have evaluated the association between dietary patterns and frailty. Objective: This systematic review and meta-analysis was conducted to summarize the association between dietary patterns and frailty. Data Sources: PubMed, Scopus, and Google Scholar were searched for epidemiological studies published up to April 2018 that assessed the association between dietary patterns and frailty. Study Selection: Cohort or cross-sectional studies that examined dietary patterns via an a priori or an a posteriori method in relation to risk of frailty without considering any specific age range were included. Studies were excluded if they examined single nutrients, single foods, or single food groups. Data Extraction: Pooled effect sizes of eligible studies and their corresponding 95% CIs were estimated using random-effects models. When publication bias was present, trim and fill analysis was conducted to adjust the pooled effect. Results: A total of 13 studies with 15 effect sizes were identified. Results from 9 cohort and cross-sectional studies were included in the meta-analysis. Higher adherence to a healthy dietary pattern was associated with lower odds of frailty (odds ratio = 0.69; 95% CI, 0.57-0.84; P < 0.0001; I-2 = 92.1%; P for heterogeneity < 0.0001). Conclusions: The findings suggest that a diet high in fruit, vegetables, and whole grains may be associated with reduced risk of frailty. Nevertheless, additional longitudinal studies are needed to confirm the association of dietary patterns with frailty.