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目的 探讨城市社区老年人膳食多样性和身体活动与衰弱及衰弱前期的关系。方法 于2022年8月至2023年6月，在山东省东营胜利胜东医院招募943名65岁及以上的社区老年人。采用面对面问卷调查收集主要食物摄入和身体活动信息，用Fried量表进行衰弱和衰弱前期评估，采用膳食多样性评分对膳食多样性进行评估。使用Wilcoxon、卡方检验或方差分析进行组间比较，趋势性检验采用Cochran-Armitage或Jonckheere-Terpstra检验。采用偏比例Logistic回归模型分析膳食多样性、主要食物摄入和身体活动与衰弱和衰弱前期之间的关系。结果 与非衰弱组相比，衰弱组和衰弱前期组的膳食多样性评分降低，新鲜蔬菜每日摄入次数减少，大豆和坚果每周摄入次数减少；每周散步/遛弯/慢步走、参加体育锻炼和家务劳动的次数和时间均明显减少。调整年龄、性别、文化程度、婚姻状况、吸烟、饮酒和服用膳食补充剂等因素后，慢性病数量增加(OR=1.22,95%CI 1.21～1.32)是衰弱的危险因素，膳食多样性评分增加(OR=0.90, 95%CI 0.85～0.96)、每周散步/遛弯/慢步走次数增加(OR=0.89, 95%CI 0.87～0.92)、每周家务劳动次数增加(OR=0.97, 95%CI 0.95～0.99)和散步/遛弯/慢步走时间(≥60 min/d)(OR=0.58, 95%CI 0.42～0.81)是衰弱的保护因素。膳食多样性和身体活动对衰弱的影响存在交互作用。结论 膳食多样性和身体活动与社区老年人衰弱及衰弱前期有关，增加膳食多样性、每周散步次数和时间以及家务劳动次数可降低老年人衰弱的发生风险。
Abstract：OBJECTIVE To explore the relationship between dietary diversity, physical activity, and frailty/prefrailty among community-dwelling older adults.METHODS From August 2022 to June 2023, 943 individuals aged 65 years and older living in community were recruited at Shengli Shengdong Hospital in Dongying, Shandong Province. Face-to-face questionnaires were used to collect information on main food intake and physical activity. Frailty and prefrailty were assessed using the Fried frailty phenotype. Dietary diversity was evaluated using the dietary diversity score(DDS). Group comparisons were performed using Wilcoxon, Chi-square, or ANOVA tests, while trend tests were conducted using Cochran-Armitage or Jonckheere-Terpstra tests. Partial proportional Logistic regression models were used to analyze the relationships between dietary diversity, main food intake, physical activity, and frailty/prefrailty.RESULTSCompared to non-frailty group, a significantly decrease in DDS, frequencies of fresh vegetables, soybeans and nuts intakes, and frequencies and durations of walking, exercise, and housework was observed in prefrailty group and frailty group. After adjusting for age, sex, education level, marital status, smoking, alcohol consumption, and dietary supplement use, an increased number of chronic diseases was a risk factor for frailty(OR=1.22, 95%CI 1.21-1.32), while increased DDS(OR=0.90, 95%CI 0.85-0.96), higher frequencies of weekly walking(OR=0.89, 95%CI 0.87-0.92), housework(OR=0.97, 95%CI 0.95-0.99), and higher duration of walking(≥60 min/d)(OR=0.58, 95%CI 0.42-0.81) were protective factors against frailty. There was an interaction between dietary diversity and physical activity on frailty.CONCLUSION Dietary diversity and physical activity are associated with frailty and prefrailty among the elderly in the community. Increasing dietary diversity, the frequency and duration of weekly walks, and the frequency of housework can reduce the risk of frailty among the elderly.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2025.06.003
中图分类号:R153.3
引用信息:
[1]张晓娜,贾珊珊,黄静,等.城市社区老年人膳食多样性和身体活动与衰弱及衰弱前期的关系[J].卫生研究,2025,54(06):893-899+907.DOI:10.19813/j.cnki.weishengyanjiu.2025.06.003.
基金信息:
中央财政项目-合理膳食与营养健康(No.131031107000150007); 中国老年人膳食营养状况研究(No.150052); 中国石化集团胜利油田科研项目基金(No.GKY2301-11)