Association Between the Prevalence of Frailty and Doubly Labeled Water-Calibrated Energy Intake Among Community-Dwelling Older Adults
- 3 June 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences
- Vol. 76 (5), 876-884
- https://doi.org/10.1093/gerona/glaa133
Abstract
Background Appropriate energy intake (EI) is essential to prevent frailty. Because self-reported EI is inaccurate and has systematic errors, adequate biomarker calibration is required. This study examined the association between doubly labeled water (DLW)-calibrated EI and the prevalence of frailty among community-dwelling older adults. Method A cross-sectional study was performed using baseline data of 7,022 older adults aged ≥65 years in the Kyoto-Kameoka Study. EI was evaluated using a validated food frequency questionnaire (FFQ), and calibrated EI was obtained from a previously established equation using the DLW method. Physical and comprehensive frailty were defined by the Fried phenotype (FP) model and the Kihon Checklist (KCL), respectively. We used multivariable-adjusted restricted cubic spline logistic regression analysis. Results The prevalence of physical frailty was 14.8% and 13.6% in women and men, respectively. The spline models showed significant reverse J-shaped or U-shaped relationships between the prevalence of physical or comprehensive frailty against the DLW-calibrated EI, respectively. The lowest prevalence of both types of frailty was found at 1,900–2,000 kcal/d in women and 2,400–2,500 kcal/d in men, which corresponded to approximately 40 kcal/d/kg IBW (ideal body weight = 22 × height2) with DLW-calibrated EI. Uncalibrated EI underestimated approximately 20% compared with calibrated EI; underestimated EI were attenuated by calibration approach. Conclusions This study suggests that low EI has a greater detrimental effect compared with excessive EI, particularly on physical frailty. Using biomarkers to calibrate EI holds promise for providing accurate energy requirements to establish guidelines used in public health and clinical nutrition.Keywords
Funding Information
- JSPS KAKENHI (24240091, 15H05363)
- Kyoto Prefecture Community-based Integrated Elderly Care Systems Promotion Organization
- Long-term Care Insurance and Planning Division of the Health and Welfare Bureau for the Elderly
- Ministry of Health, Labour and Welfare
- WHO Collaborating Centre on Community Safety Promotion
- Ajinomoto Co., Inc.
This publication has 38 references indexed in Scilit:
- Validity of U.S. Nutritional Surveillance: National Health and Nutrition Examination Survey Caloric Energy Intake Data, 1971–2010PLOS ONE, 2013
- Frailty Consensus: A Call to ActionJournal of the American Medical Directors Association, 2013
- Biomarker-calibrated dietary energy and protein intake associations with diabetes risk among postmenopausal women from the Women's Health InitiativeThe American Journal of Clinical Nutrition, 2011
- Quantification of the effect of energy imbalance on bodyweightThe Lancet, 2011
- Biomarker-calibrated Energy and Protein Consumption and Cardiovascular Disease Risk Among Postmenopausal WomenEpidemiology, 2011
- Frailty, Body Mass Index, and Abdominal Obesity in Older PeopleThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2009
- Biomarker-calibrated Energy and Protein Consumption and Increased Cancer Risk Among Postmenopausal WomenAmerican Journal of Epidemiology, 2009
- Use of Recovery Biomarkers to Calibrate Nutrient Consumption Self-Reports in the Women's Health InitiativeAmerican Journal of Epidemiology, 2008
- Interindividual variability in sleeping metabolic rate in Japanese subjectsEuropean Journal of Clinical Nutrition, 2007
- The problem of profound mismeasurement and the power of epidemiological studies of diet and cancerNutrition and Cancer, 1988