Consumption of meat in relation to physical functioning in the Seniors-ENRICA cohort

Background: Meat is an important source of high-quality protein and vitamin B but also has a relatively high content of saturated and trans fatty acids. Although protein and vitamin B intake seems to protect people from functional limitations, little is known about the effect of habitual meat consumption on physical function. The objective of this study was to examine the prospective association between the intake of meat (processed meat, red meat, and poultry) and physical function impairment in older adults. Methods: Data were collected for 2982 participants in the Seniors-ENRICA cohort, who were aged ≥60 years and free of physical function impairment. In 2008-2010, their habitual diet was assessed through a validated computer-assisted face-to-face diet history. Study participants were followed up through 2015 to assess self-reported incident impairment in agility, mobility, and performance-based lower-extremity function. Results: Over a median follow-up of 5.2 years, we identified 625 participants with impaired agility, 455 with impaired mobility, and 446 with impaired lower-extremity function. After adjustment for potential confounders, processed meat intake was associated with a higher risk of impaired agility (hazard ratio [HR] for highest vs. lowest tertile: 1.33; 95% confidence interval [CI]: 1.08-1.64; p trend = 0.01) and of impaired lower-extremity function (HR for highest vs. lowest tertile: 1.31; 95% CI: 1.02-1.68; p trend = 0.04). No significant associations were found for red meat and poultry. Replacing one serving per day of processed meat with one serving per day of red meat, poultry, or with other important protein sources (fish, legumes, dairy, and nuts) was associated with lower risk of impaired agility and lower-extremity function. Conclusions: A higher consumption of processed meat was associated with a higher risk of impairment in agility and lower-extremity function. Replacing processed meat by other protein sources may slow the decline in physical functioning in older adultsThis work was supported by grants from the Instituto de Salud Carlos III, State Secretary of R+D+I of Spain and FEDER/FSE (FIS 13/0288, 16/609 and 16/1512), and the European Union: FP7-HEALTH-2012-Proposal No: 305483-2, "Utility of omic-based biomarkers in characterizing older individuals at risk for frailty, its progression to disability and general consequences to health and wellbeing - The FRAILOMIC Initiative"; EU H2020- Project ID: 635316, " Ageing Trajectories of Health: Longitudinal Opportunities and Synergies- The ATHLOS project"; and the JPI HDHL: "Salivary Markers of Diet and Health- The SALAMANDER project"

Dietary fat intake and risk of disabling hearing impairment: a prospective population-based cohort study

Purpose: To examine the associations of specific dietary fats with the risk of disabling hearing impairment in the UK Biobank study. Methods: This cohort study investigated 105,592 participants (47,308 men and 58,284 women) aged ≥ 40 years. Participants completed a minimum of one valid 24-h recall (Oxford Web-Q). Dietary intake of total fatty acids, polyunsaturated fatty acids (PUFA), saturated fatty acids (SFA), and monounsaturated fatty acids (MUFA) was assessed at baseline. Functional auditory capacity was measured with a digit triplet test (DTT), and disabling hearing impairment was defined as a speech reception threshold in noise > − 3.5 dB in any physical exam performed during the follow-up. Results: Over a median follow-up of 3.2 (SD: 2.1) years, 832 men and 872 women developed disabling hearing impairment. After adjustment for potential confounders, including lifestyles, exposure to high-intensity sounds, ototoxic medication and comorbidity, the hazard ratios (HRs), and 95% confidence interval (CI) of disabling hearing function, comparing extreme quintiles of intakes were 0.91 (0.71–1.17) for total fat, 1.09 (0.83–1.44) for PUFA, 0.85 (0.64–1.13) for SFA and 1.01 (0.74–1.36) for MUFA among men. Among women, HRs comparing extreme intakes were 0.98 (0.78–1.24) for total fat, 0.69 (0.53–0.91) for PUFA, 1.26 (0.96–1.65) for SFA, and 0.91 (0.68–1.23) for MUFA. Replacing 5% of energy intake from SFA with an equivalent energy from PUFA was associated with 25% risk reduction (HR: 0.75; 95% CI: 0.74–0.77) among women. Conclusions: PUFA intake was associated with decreased risk of disabling hearing function in women, but not in menUK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Government, British Heart Foundation, Cancer Research UK, and Diabetes UK. This work was supported by FIS grants 19/319 and 20/1040, (Instituto de Salud Carlos III, State Secretary of R + D + I and FEDER/FSE

Leptin concentration and risk of impaired physical function in older adults: the Seniors-ENRICA cohort

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The version of record Alberto Lana, Ellen Struijk, Pilar Guallar-Castillón, Jose María Martín-Moreno, Fernando Rodríguez Artalejo, Esther Lopez-Garcia; Leptin concentration and risk of impaired physical function in older adults: the Seniors-ENRICA cohort. Age Ageing 45.6 (2016): 819-826 is available online at: http://dx.doi.org/ 10.1093/ageing/afw142Leptin resistance, which may develop during the aging process, stimulates the production of proinflammatory cytokines and insulin resistance that could impair the muscle function. However, the role of leptin on physical functioning among older adults has not yet been elucidated. Objective: To examine the association between serum leptin levels and physical function impairment in older adults. Design and setting: Prospective study of 1,556 individuals aged ≥60 years from the Seniors-ENRICA cohort, who were free of physical function limitation at baseline. Main outcome measure: Serum leptin was measured in 2008-2010, and incident functional limitation was assessed through 2012. Self-reported limitations in agility and mobility were assessed with the Rosow and Breslau scale, limitation in the lower extremity function was measured with the Short Physical Performance Battery, and impairment in the overall physical performance with the physical component summary of the SF-12. Results: After adjustment for potential confounders, and compared to individuals in the lowest quartile of leptin concentration, those in the highest quartile showed increased risk of impaired physical function; the odds ratio (95% confidence interval) and p-trend was: 1.95 (1.11-3.43), p=0.006 for self-reported impaired mobility; 1.76 (1.08-2.87), p=0.02 for self-reported impaired agility; 1.48 (1.02-2.15), p=0.04 for limitation in the lower extremity function; and 1.97 (1.20-3.22), p=0.01 for decreased overall physical performance. These associations were only modestly explained by C-reactive protein and insulin resistance. Moreover, the associations held across groups with varying health status and were independent of estimated total body fat. Conclusions: Higher leptin concentration was associated with increased risk of impaired physical function. Preserving metabolic function during the old age could help delaying physical function declineThis work was supported by FIS grants 12/1166 and 13/0288 (Instituto de Salud Carlos III, State Secretary of R+D+I, and FEDER/FSE), the CIBERESP, the FRAILOMIC Initiative (FP7-HEALTH-2012-Proposal no. 305483-2) and the ATHLOS project (EU H2020- Project ID: 635316

Protein intake and risk of frailty among older women in the Nurses' Health Study

Background: There is evidence that an overall healthy diet is associated with lower risk of frailty. However, the effect of diet composition, specifically the role of protein intake on frailty, is mostly unclear. The aim of this study was to evaluate the intake of protein, including total, plant, animal, and dairy protein, in relation to frailty incidence in a large cohort of older women. Methods: We analysed data from 85 871 women aged ≥60 participating in the Nurses' Health Study. Intake of protein was measured nine times during follow-up from 1980 until 2010. Frailty was defined as having at least three of the following five criteria from the Fatigue, Resistance, Ambulation, Illnesses and Loss of Weight (FRAIL) scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss of ≥5%. The occurrence of frailty was assessed every 4 years from 1992 up to 2014. Results: During follow-up, we identified 13 279 incident cases of frailty. Women with a higher intake of plant protein had a lower risk of developing frailty after adjustment for all relevant confounders [relative risks across quintiles of consumption: 1.00, 0.94, 0.89, 0.86, and 0.86; P-trend < 0.001]. In contrast, those with a higher intake of animal protein intake had a higher risk of frailty [relative risks across quintiles of consumption: 1.00, 0.98, 0.99, 1.00, and 1.07; P-trend 0.04]. The intake of total and dairy protein showed no significant association with frailty in the full model. Substituting 5% of energy from plant protein intake at the expense of animal protein, dairy protein, or non-dairy animal protein was associated with 38% (29%, 47%), 32% (21%, 42%), and 42% (33%, 50%) reduced risk of frailty. Conclusions: A higher intake of plant protein, but not animal or dairy protein, was associated with a lower risk of frailty. Substitution of plant protein for animal protein, especially non-dairy animal protein, was associated with lower risk of frailty. Keywords: Diet; Elderly; Frailty; Protei

Metabolic syndrome and Growth Differentiation Factor 15 in older adults

This is a pre-print of an article published in GeroScience. The final authenticated version is available online at: https://doi.org/10.1007/s11357-021-00370-wGrowth Differentiation Factor 15 (GDF-15) is a cytokine produced in response to tissue injury and inflammatory states that may capture distinct pathways between the risk factors aggregated within metabolic syndrome (MS) and the development of diabetes and cardiovascular disease. Objective: To study the association of MS and its components with GDF-15 among older adults, examining the roles of body fat distribution, glucose metabolism, and inflammation. Methods: Data were taken from the Seniors-ENRICA-2 study in Spain, which included 1938 non-institutionalized individuals aged ≥65 years free of diabetes and cardiovascular disease. MS was defined as the presence of ≥3 of the following components: high waist circumference, elevated fasting blood glucose levels, raised blood pressure, increased triglyceride levels; and low serum high-density lipoprotein (HDL) cholesterol. Statistical analyses were performed with linear regression models and adjusted for potential sociodemographic and lifestyle confounders. Results: MS was associated with higher GDF-15 levels (fully adjusted mean increase [95% confidence interval] = 9.34% [5.16,13.7]). The MS components showing the strongest associations were high waist circumference (6.74% [2.97,10.6]), elevated glucose levels (4.91% [0.77,9.23]), and low HDL-cholesterol (8.13% [3.51,13.0]). High waist-to-hip ratio (7.07% [2.63,11.7]), urine albumin (12.1% [2.57,22.5]), and C-reactive protein (10.4% [3.89,17.3]) were also associated with increased GDF-15. Conclusion: MS was associated with higher GDF-15 levels in older adults. Abdominal obesity, hyperglycemia -possibly linked to microvascular disease, as inferred from elevated urine albumin-, low HDL-cholesterol, and inflammation were the main drivers of this associationThis work was supported by the Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE (FIS grants 18/287, 19/319); grant 2020/017 from the National Plan on Drug Addiction (Ministry of Health), and the MITOFUN project grant from the Fundación Francisco Soria Melguiz

Nut consumption and cognitive function: a systematic review

Los patrones dietéticos ricos en antioxidantes podrían contribuir a la prevención y el tratamiento de las fases previas de demencia. Los frutos secos tienen una apreciable carga antioxidante y hay evidencia de sus efectos beneficiosos sobre la incidencia de varias enfermedades crónicas y las tasas de mortalidad general. Además, son ricos en ácidos grasos polinsaturados, que también parecen desempeñar un papel positivo en la neurogénesis. El objetivo de esta revisión fue resumir la evidencia de los estudios relacionados con los efectos del consumo de frutos secos sobre la función cognitiva en personas adultas. Se realizó una búsqueda sistemática de artículos publicados en PubMed, Scopus y Web of Science. Un total de 19 artículos cumplieron los criterios de inclusión (siete transversales, cuatro de cohortes y ocho experimentales), que fueron extraídos y revisados de forma independiente por dos revisores. La evidencia proveniente de los estudios transversales y de cohortes resultó incierta, por la disparidad de resultados y su riesgo de sesgo. Sin embargo, en la mayoría de estudios experimentales se observó un efecto protector del consumo de frutos secos sobre alguna dimensión de la función cognitiva, y la calidad metodológica de estos fue aceptable. Además, los efectos parecen independientes del tipo de fruto seco, la cantidad ingerida, la edad y el estado basal de los consumidores. En Resumen, estos resultados sugieren que incluir el consumo diario moderado de algún fruto seco en la dieta saludable de las personas adultas podría tener efectos beneficiosos sobre su función cognitiva. No obstante, son necesarios más estudios observacionales longitudinales y experimentales bien diseñados, que proporcionen firmeza a esta evidencia, hasta la fecha sugestiva y de una calidad moderadamente baja.Antioxidant-rich diet patterns could contribute to the prevention and treatment of early stages of dementia. Nuts have an appreciable antioxidant load and there is evidence of their positive effects on several chronic diseases incidence and death rates. Moreover, they are rich in polyunsaturated fatty acids, which might also play a positive role in neurogenesis. The aim of this systematic review was to summarize the evidence from studies related to the effects of nut consumption on cognitive function among adults. We conducted a systematic search of articles published in PubMed, Scopus and Web of Science. A total of 19 articles met the inclusion criteria (seven cross-sectional, four prospective cohorts and eight experimental); these were independently extracted and reviewed by two reviewers. The evidence from the cross-sectional and cohort studies was uncertain, due to the disparity of results and risk of bias. However, in most experimental studies a protective effect of nut consumption on some dimension of cognitive function was observed and the methodological quality of these studies was acceptable. In addition, the effects appear to be independent of nut type, amount of intake, age and baseline status of subjects. In summary, these results suggest that the inclusion of daily nut consumption in the healthy diet pattern of adults could have positive effects on their cognitive function. Nevertheless, more well-designed longitudinal and experimental studies are needed to provide strength to this suggestive evidenc

Association between speech reception threshold in noise and multimorbidity: The UK Biobank Study

Objective. To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. Study Design. Cross-sectional study. Setting. The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. Methods. Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < −5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ −5.5 to ≤ −3.5 dB SNR) and poor hearing function (SRTn > −3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. Results. Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08- 1.18), and with poor SRTn was 1.25 (1.14-1.37). Conclusion. Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbiditiesThis work was supported by Instituto de Salud Carlos III through the FIS project 20/01040 (Instituto de Salud Carlos III, State Secretary of R + D + I), and co‐funded by a European Regional Development Fund, “A way of shaping Europe.” Ellen A. Struijk holds a Ramón y Cajal contract (RYC‐ 2021‐031146‐I) from the Ministry of Science, Innovation and Universities and FEDER/FS

Consumption of food fried in olive oil and unhealthy aging in a Mediterranean country

Fried food has usually shown neutral or detrimental effects on many chronic diseases, possibly depending on the type of food fried and the frying oil, but its relationship with unhealthy aging is unknown. We examined how changes in fried food consumption over a 3-year period were linked to unhealthy aging over 3 and 6 years. Methods: Prospective cohort study in Spain with 2043 individuals aged ≥60 years, recruited in 2008–2010 and followed-up to 2012 and 2015. Fried food consumption was ascertained with a validated diet history, and unhealthy aging was measured with a 52-item health deficit accumulation index. Results: Compared with participants who reduced fried food consumption, those who increased it showed less deficit accumulation over 3 years (multivariable β [95% confidence interval]: −1.45 [−2.30, −0.61]), but not over 6 years of follow-up. More 3-year deficit accumulation was observed when replacing 100 g/day of fried food with an equal amount of non-fried food (1.48 [0.59, 2.37]); corresponding values in substitution analyses were 2.03 [1.03, 3.03] for fried protein-rich food, 10.76 [5.20, 16.33] for fried eggs, and 2.06 [0.68, 3.43] for fried fish. Also, increased olive oil intake was significantly associated with less 3-year deficit accumulation (total olive oil: −1.14 [−2.07, −0.21], and olive oil with non-fried food: −0.99 [−1.89, −0.08]). Conclusions: In a Mediterranean country, where olive oil is the most common frying medium, increased fried food consumption was associated with delayed unhealthy aging over 3 years of follow-up; consumption of olive oil and fried protein-rich food (especially eggs and fish) were its main drivers. However, these associations did not generally remain after 6 yearsThis work was supported by Instituto de Salud Carlos III, State Secretary of R+D+I, and FEDER/FSE (FIS grants 16/609, 16/1512, 18/287, and 19/319); JPI-A Healthy Diet for a Healthy Life, State Secretary of R+D+I (the Salamander Project, grant number PCIN-2016-145); and the Cátedra de Epidemiología y Control del Riesgo Cardiovascular at UAM (grant number 820024

Fruit and vegetable intake and risk of frailty in women 60 years old or older

Background: Prior research has suggested that the antioxidative and anti-inflammatory potential of fruits and vegetables may ameliorate aging-related frailty. Objective: We sought to prospectively examine the association between fruit and vegetable intake and incident frailty in older women. Design: We followed 78,366 nonfrail women aged ≥60 y from the Nurses' Health Study from 1990 to 2014. In this analysis, the primary exposure was the intake of total fruits and vegetables, assessed with an FFQ administered 6 times during follow-up. Frailty was defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, poor strength, low aerobic capacity, having ≥5 illnesses, and ≥5% weight loss. Cox models adjusted for potential confounders were used to estimate HRs and 95% CIs for the association between fruit and vegetable intake and incident frailty. Results: In total, 12,434 (15.9%) incident frailty cases were accrued during follow-up. Total fruit and vegetable intakes were associated with a lower risk of frailty (adjusted HR comparing 7+ servings/d compared with <3 servings/d: 0.92; 95% CI: 0.85, 0.99). The inverse association appeared to be stronger for those with physical activity above the median (P-interaction < 0.05). Among physically active women, compared with those who consumed <3 servings/d, the HR for 7+ servings/d was 0.68 (95% CI: 0.57, 0.81). Conclusion: Higher fruit and vegetable intake was associated with a lower risk of frailty in this cohort of US women aged ≥60 y. Because of limited evidence on intakes of fruits and vegetables and the development of frailty, more data are needed to confirm our resultsSupported by the Instituto de Salud Carlos III, State Secretary of R + D + I of Spain and FEDER/FSE grants FIS 16/1512, 13/609, and 19/319; the Joint Programming Initiative: A Healthy Diet for a Healthy Life, SALAMANDER project; and NIH grant UM1 CA18610

Plasma acylcarnitines and risk of lower-extremity functional impairment in older adults: a nested case–control study

Elevated concentrations of acylcarnitines have been associated with higher risk of obesity, type 2 diabetes and cardiovascular disease. The aim of the present study was to assess the association between L-carnitine and acylcarnitine profiles, and 2-year risk of incident lower-extremity functional impairment (LEFI). This case–control study is nested in the Seniors-ENRICA cohort of community-dwelling older adults, which included 43 incident cases of LEFI and 86 age- and sex- matched controls. LEFI was assessed with the Short Physical Performance Battery. Plasma L-carnitine and 28 acylcarnitine species were measured. After adjusting for potential confounders, medium-chain acylcarnitines levels were associated with 2-year incidence of LEFI [odds ratio per 1-SD increase: 1.69; 95% confidence interval: 1.08, 2.64; p = 0.02]. Similar results were observed for long-chain acylcarnitines [odds ratio per 1-SD increase: 1.70; 95% confidence interval: 1.03, 2.80; p = 0.04]. Stratified analyses showed a stronger association between medium- and long-chain acylcarnitines and incidence of LEFI among those with body mass index and energy intake below the median value. In conclusion, higher plasma concentrations of medium- and long-chain acylcarnitines were associated with higher risk of LEFI. Given the role of these molecules on mitochondrial transport of fatty acids, our results suggest that bioenergetics dysbalance contributes to LEFIThis work was supported by FIS Grant 16/1512 (Instituto de Salud Carlos III, State Secretary of R+D+I, and FEDER/FSE). This work utilized the Metabolomics Core Services supported by Grant U24 DK097153 of NIH Common Funds Project to the University of Michigan. The funding agencies had no role in study design, data analysis, interpretation of results, manuscript preparation or in the decision to submit this manuscript forpublicatio