Dietary Intake and Their Associations with Cardiometabolic Health and Frailty

Abstract

Worldwide there is an ageing population. Older adults are susceptible to poor nutritional intake that could influence health outcomes. The aim was to investigate the associations between dietary intake with cardiometabolic health and frailty in older adults. Chapter One provides the context for this research. Chapter Two describes the methodological approaches used to address the research questions. Chapter Three demonstrated that a higher protein to non-protein ratio dietary pattern was negatively associated with intakes of energy, saturated fat, free sugar, sodium, and discretionary foods in older adults aged 65-75 years from the Nutrition for Healthy Living (NHL) Study. Chapters Four, Five, Seven, and Eight involved older men aged ≥ 75 years from the Concord Health and Ageing in Men Project (CHAMP). Chapters Four and Five showed that higher haem iron intake was associated with increased major adverse cardiovascular events (MACE), all-cause mortality, congestive cardiac failure (CCF), and coronary revascularisation over 5 years, whilst maintenance or increases in total iron intakes, and increases or higher positive changes in non-haem iron intakes were associated with reduced risks of incident frailty over 3 years in older men. Chapter Six showed that the Mediterranean dietary pattern had the most cardiometabolic health benefits without harm in the short-term in older adults aged ≥ 65 years. Chapters Seven and Eight showed that closer alignment to the ‘vegetables-legumes-seafood’ dietary pattern was associated with reduced MACE, and CCF over 5 years, and reduced prevalence of frailty, whilst closer alignment with the ‘discretionary-starchy vegetables-processed meats’ dietary pattern was associated with increased MACE, and all-cause mortality over 5 years, and increased prevalence of pre-frailty in older men. Chapter Nine concludes this thesis with the key findings and directions for future research.