Mediterranean Diet and Musculoskeletal-Functional Outcomes in Community-Dwelling Older People: A Systematic Review and Meta-Analysis

• Published in: The Journal of nutrition, health & aging Vol. 22; no. 6; pp. 655 - 663
• Main Authors: Silva, Roberta, Pizato, N., da Mata, F., Figueiredo, A., Ito, M., Pereira, M. G.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-06-2018; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Aging; Cohort Studies; Cross-Sectional Studies; Diet; Diet, Mediterranean; Evidence-based medicine; Frailty; Frailty - diet therapy; Frailty - prevention & control; Geriatrics/Gerontology; Humans; Independent Living; Longitudinal Studies; Low density lipoprotein; Medicine; Medicine & Public Health; Meta-analysis; Middle Aged; Musculoskeletal Diseases - diet therapy; Musculoskeletal Diseases - prevention & control; Neurosciences; Nutrition; Older people; Primary Care Medicine; Quality of Life Research; Sarcopenia; Sarcopenia - diet therapy; Sarcopenia - prevention & control; Systematic review; frailty; functional disability; systematic review; Mediterranean diet; elderly; sarcopenia
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-017-0993-1

Background
Population aging is increasing and this process together with its characteristics influence the prevalence and incidence of chronic conditions and musculoskeletal-functional outcomes such as frailty, functional disability and sarcopenia. Nutritional strategies focused on dietary patterns, such as a Mediterranean diet, can be protective from these outcomes.
Purpose
To investigate the association between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling older people.
Methods
We systematically reviewed electronic databases (MEDLINE, EMBASE, and others) and grey literature for articles investigating the relationship between adherence to a Mediterranean diet and frailty, functional disability and sarcopenia in community-dwelling people aged 60 and over. Study selection, quality of study assessment and data extraction were conducted independently by two authors. Random effects meta-analyses were performed, and pooled Odds Ratios (OR) were obtained.
Results
After the literature search, screening and eligibility investigation, we included 12studies, with a total of 20,518 subjects. A higher adherence to a Mediterranean diet was found to be inversely associated with frailty (OR 0.42, 95% CI: 0.28-0.65, I2=24.9%, p=0.262) and functional disability (OR 0.75, 95% CI: 0.61-0.93, I2=0.0%, p=0.78). Highly different study characteristics prevented us from performing a meta-analysis for sarcopenia. Cohort data indicated no association between adherence to a Mediterranean diet and sarcopenia; however, cross-sectional results showed a positive relationship.
Conclusion
A Mediterranean diet is protective of frailty and functional disability, but not of sarcopenia. More longitudinal studies are needed to understand the relationship between a Mediterranean diet and sarcopenia.