Mediterranean diet and physical functioning trajectories in Eastern Europe: Findings from the HAPIEE study

BackgroundUnhealthy diet may increase the risk of impaired physical functioning in older age. Although poor diet and limited physical functioning both seem to be particularly common in Eastern Europe, no previous study has assessed the relationship between these two factors in this region. The current analysis examined the association between overall diet quality and physical functioning in Eastern European populations.MethodsWe used data on 25,504 persons (aged 45–69 years at baseline) who participated in the Health Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study. Dietary assessment at baseline used food frequency questionnaire, and the overall diet quality was evaluated by the Mediterranean diet score (MDS). Physical functioning (PF) was measured by the physical functioning subscale (PF-10) of the 36-item Short-Form Health Survey at baseline and three subsequent occasions over a 10-year period. The cross-sectional and longitudinal relationships between the MDS and PF were examined simultaneously using growth curve models.ResultsMen and women with higher adherence to the Mediterranean diet had significantly better PF at baseline; after multivariable adjustment, the regression coefficient per 1-unit increase in the MDS was 0.39 (95% CI: 0.25, 0.52) in men and 0.50 (0.36, 0.64) in women. However, we found no statistically significant link between baseline MDS and the subsequent slope of PF decline in neither gender; the coefficients were -0.02 (-0.04, 0.00) in men and -0.01 (-0.03, 0.02) in women.DiscussionOur results do not support the hypothesis that the Mediterranean diet has a substantial impact on the trajectories of physical functioning, although the differences existing at baseline may be related to dietary habits in earlier life.

研究背景：不良饮食可能增加老年时期身体机能受损的风险。尽管饮食质量不佳与身体机能受限在东欧地区尤为普遍，但此前尚无研究探讨该区域内这两类因素间的关联。本分析针对东欧人群，考察了整体饮食质量与身体机能之间的关联。
研究方法：本研究纳入参与东欧健康、酒精与社会心理因素研究（Health Alcohol and Psychosocial factors in Eastern Europe, HAPIEE）的25504名受试者，其基线年龄为45~69岁。基线阶段通过食物频率问卷开展饮食评估，并以地中海饮食评分（Mediterranean Diet Score, MDS）评估整体饮食质量。身体机能（Physical functioning, PF）采用36项简明健康调查问卷（36-item Short-Form Health Survey）的身体机能子量表（PF-10），分别在基线及后续三次随访节点进行测量，总随访周期达10年。本研究采用增长曲线模型，同时分析了MDS与PF之间的横断面及纵向关联。
研究结果：基线时，地中海饮食依从性更高的男性与女性，其身体机能水平显著更优；经多变量校正后，MDS每升高1个单位，男性的回归系数为0.39（95%CI：0.25, 0.52），女性为0.50（95%CI：0.36, 0.64）。但研究未发现基线MDS与后续身体机能下降斜率间存在统计学显著关联，男性的系数为-0.02（95%CI：-0.04, 0.00），女性为-0.01（95%CI：-0.03, 0.02）。
讨论：本研究结果不支持“地中海饮食对身体机能轨迹具有显著影响”这一假说，尽管基线时的机能差异可能与早年的饮食习惯有关。