Abstract MP36: Association Between The Quality Of Plant-based Diets And Risk Of Frailty

Importance: The Mediterranean diet, and other dietary patterns rich in fruits and vegetables, have been linked to lower risk of frailty in older adults. However, not all plant-based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant-based dietary patterns in frailty risk. Objective: To assess the association between plant-based diet quality and risk of frailty. Design, setting, and participants: Prospective cohort with 82,234 women aged ≥60y from the Nurses’ Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to -June 23, 2021. Exposures: Dietary data were collected every 4-y using a validated semi-quantitative food frequency questionnaire. The plant-based diet quality was assessed with 2 indices (range 18 - 90 points).: a) Healthful Plant-Based Diet Index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, sweets/desserts) and animal foods received reverse scores; and b) Unhealthful Plant-Based Diet Index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Main outcomes: Frailty incidence was assessed every 4 years, being defined as having ≥3 of the following 5 criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses, and weight loss ≥5%. Methods: Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs), and their 95% confidence interval (CI). Results: We identified 12,910 incident cases of frailty over 1,176,401 person-year follow-up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (HR for the highest vs. lowest quintile: 0.69, 95% CI: 0.65-0.73; p-trend Conclusions and relevance: A healthful plant-based diet was associated with lower risk of frailty whereas an unhealthful plant-based diet was associated with higher risk.