{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:06:33Z","timestamp":1790888793124,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014440","name":"Ministerio de Ciencia, Innovaci\u00f3n y Universidades","doi-asserted-by":"publisher","award":["RYC\u20102018\u2010025069\u2010I"],"award-info":[{"award-number":["RYC\u20102018\u2010025069\u2010I"]}],"id":[{"id":"10.13039\/100014440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1 CA186107"],"award-info":[{"award-number":["UM1 CA186107"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UO1 grant"],"award-info":[{"award-number":["UO1 grant"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,12]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The Mediterranean diet and other dietary patterns rich in fruits and vegetables have been linked to lower risk of frailty in older adults. However, not all plant\u2010based diets are necessarily healthful, and no previous study has evaluated the role of the quality of plant\u2010based dietary patterns in frailty risk. Our aim was to assess the association between plant\u2010based diet quality and risk of frailty.<\/jats:p><\/jats:sec>Methods<\/jats:title>Prospective cohort consisted with 82\u00a0234 women aged \u226560\u00a0years from the Nurses' Health Study, who were followed from 1990 through 2014. The dates of analysis were April 14 to June 23, 2021. Dietary data were collected every 4\u00a0years using a validated semi\u2010quantitative food frequency questionnaire. The plant\u2010based diet quality was assessed with two indices (range 18\u201390 points): (a) healthful plant\u2010based diet index (hPDI), where healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils and tea\/coffee) received positive scores, while less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets\/desserts) and animal foods received reverse scores; and (b) unhealthful plant\u2010based diet index (uPDI) where positive scores were given to less healthy plant foods and reverse scores to healthy plant foods and animal foods. Frailty incidence was assessed every 4\u00a0years, being defined as having three or more of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having \u22655 illnesses and weight loss \u22655%. Multivariable\u2010adjusted Cox proportional\u2010hazards models were used to estimate hazard ratios (HRs) and their 95% confidence interval (CI).<\/jats:p><\/jats:sec>Results<\/jats:title>We identified 12\u00a0910 incident cases of frailty over 1\u00a0176\u00a0401 person\u2010year follow\u2010up. In the multivariable analysis, the hPDI was inversely associated with the risk of frailty (hazard ratio [HR] for the highest vs. lowest quintile: 0.77, 95% confidence interval: 0.72\u20130.81; P<\/jats:italic> trend <0.001). In addition, a 10\u2010unit increment in the hPDI was associated with a relative 15% lower risk of frailty. Conversely, a direct association was found between the uPDI and risk of frailty (HR highest vs. lowest quintile: 1.24 [1.17, 1.32], P<\/jats:italic> trend <0.001). These associations were consistent for each frailty criterion, among participants with no frailty criteria at baseline, after excluding participants with diabetes, cancer and cardiovascular disease at baseline, for alternative versions of the plant\u2010based diet indices (PDIs), in subgroup analysis by categories of potential confounders, and in latency analysis.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A healthful plant\u2010based diet was associated with lower risk of frailty whereas an unhealthful plant\u2010based diet was associated with higher risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13077","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T06:00:26Z","timestamp":1664517626000},"page":"2854-2862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Association between the quality of plant\u2010based diets and risk of frailty"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9127-2586","authenticated-orcid":false,"given":"Mercedes","family":"Sotos\u2010Prieto","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Autonomous University of Madrid Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health) Madrid Spain"},{"name":"Department of Environmental Health Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"IMDEA\u2010Food Institute CEI UAM+CSIC Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen A.","family":"Struijk","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Autonomous University of Madrid Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health) Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa T.","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Nutrition Simmons University Boston MA USA"},{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Rodr\u00edguez\u2010Artalejo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Autonomous University of Madrid Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health) Madrid Spain"},{"name":"IMDEA\u2010Food Institute CEI UAM+CSIC Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C.","family":"Willett","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank B.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"Channing Division of Network Medicine, Department of Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Lopez\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, School of Medicine Autonomous University of Madrid Madrid Spain"},{"name":"CIBERESP (CIBER of Epidemiology and Public Health) Madrid Spain"},{"name":"IMDEA\u2010Food Institute CEI UAM+CSIC Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2018.02.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31788-4"},{"key":"e_1_2_8_4_1","unstructured":"U.S. Department of AgricultureandU.S. Department of Health and 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