Adherence to the Mediterranean Diet and frailty criteria in an old population with metabolic syndrome: A cross-sectional analysis

Objectives: Frailty has emerged as a key indicator of biological aging. This study aimed to assess the relationship between MedDiet adherence and frailty prevalence in the context of metabolic syndrome (MetS). Design: Cross-sectional study. Baseline data from PREDIMED-Plus trial SETTING: Primary car...

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Authors: Torrego-Ellacuría, Macarena, Cuesta-Triana, Federico, Ortiz-Ramos, María, Martínez-González, Miguel Ángel, Corella, Dolores, Vázquez-Lorente, Héctor, Fitó, Montserrat, Martínez, José Alfredo, Tojal-Sierra, Lucas, Wärnberg, Julia, Vioque, Jesús, Romaguera, Dora, López-Miranda, José, Estruch, Ramon, Tinahones, Francisco J, Santos-Lozano, José Manuel, Serra-Majem, J. Luís, Bueno-Cavanillas, Aurora, Tur, Josep A., Romero Vigara, Juan Carlos, Pintó, Xavier, Gaforio, José J, Vidal, Josep, Mas-Fontao, Sebastián, Daimiel, Lidia, Chiva-Blanch, Gemma, Basterra-Gortari, Javier, Gutierrez, Liliana, Sorlí, José V., Minguella Muñoz, Elisa, García-Rios, Antonio, Bernabé Casanova, Andrea, Gómez-Gracia, Enrique, Zulet, Maria Angeles, Nafría, Mar, Casas, Rosa, Garrido-Garrido, Eva María, Goicolea-Güemez, Leire, Gómez-Pérez, Ana M, Ruiz-Canela, Miguel, Megias, Isabel, Valero-Barceló, Carmen, Montenegro Calvo, Marina, Peña-Orihuela, Patricia J., Tercero Maciá, Cristina, Razquín, Cristina, Babio, Nancy, Sala de Vedruna, Adriana, Barabash, Ana, Matía-Martín, Pilar
Format: article
Publication Date:2026
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/26501
Online Access:https://hdl.handle.net/20.500.13003/26501
Access Level:Open access
Keyword:Frailty
Diet, Mediterranean
Metabolic Syndrome
Obesity
Overweight
Fragilidad
Dieta Mediterránea
Síndrome Metabólico
Obesidad
Sobrepeso
Mediterranean diet
Metabolic syndrome
Prefrailty
Description
Summary:Objectives: Frailty has emerged as a key indicator of biological aging. This study aimed to assess the relationship between MedDiet adherence and frailty prevalence in the context of metabolic syndrome (MetS). Design: Cross-sectional study. Baseline data from PREDIMED-Plus trial SETTING: Primary care health, 23 recruitment sites (2013-2016). Participants: A total of 6874 participants with overweight/obesity and ≥3 MetS components. Measurements: Adherence to the MedDiet: 17-item MedDiet score. Frailty and prefrailty (3 or 1-2 criteria): modified Fried Frailty Index (FFI), considering exhaustion, physical activity and functional capacity. Main independent variable was analysed: as a continuous variable (range: 0-17); in quartiles of adherence using univariate and multivariate logistic regression models adjusted for potential confounders. Results: Prefrailty and frailty prevalence were 49.7% and 2.9%, respectively. Compared to those with the lowest MedDiet adherence (0-6), participants with the highest adherence (11-17) had significantly lower odds of meeting frailty criteria. Fully adjusted models showed ORs of 0.479 (p = 0.097) for frailty, 0.705 (p = 0.001) for prefrailty, and 0.694 (p = 0.001) for frailty or prefrailty in participants with higher/greater MedDiet adherence. Each 1-point increase in the 17-item score was associated with an OR ranging from 0.878 to 0.977 (p < 0.05 for all comparisons, except functional capacity: p = 0.100). When adherence was dichotomized, the adjusted ORs ranged from 0.406 to 0.834 (p < 0.05 for all comparisons). Conclusions: Higher adherence to MedDiet was associated with a lower prevalence of frailty and prefrailty in older adults with overweight/obesity and MetS, reinforcing its potential role in promoting healthy aging despite cardiometabolic comorbidities.

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