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25.07.2017 | Original Contribution | Ausgabe 7/2018 Open Access

European Journal of Nutrition 7/2018

Dietary patterns and changes in frailty status: the Rotterdam study

European Journal of Nutrition > Ausgabe 7/2018
Sandra C. M. de Haas, Ester A. L. de Jonge, Trudy Voortman, Jolien Steenweg-de Graaff, Oscar H. Franco, M. Arfan Ikram, Fernando Rivadeneira, Jessica C. Kiefte-de Jong, Josje D. Schoufour
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Electronic supplementary material

The online version of this article (doi:10.​1007/​s00394-017-1509-9) contains supplementary material, which is available to authorized users.
Sandra C. M. de Haas and Ester A. L. de Jonge contributed equally to this manuscript.



To determine the associations between a priori and a posteriori derived dietary patterns and a general state of health, measured as the accumulation of deficits in a frailty index.


Cross-sectional and longitudinal analysis embedded in the population-based Rotterdam Study (n = 2632) aged 45 years. Diet was assessed at baseline (year 2006) using food frequency questionnaires. Dietary patterns were defined a priori using an existing index reflecting adherence to national dietary guidelines and a posteriori using principal component analysis. A frailty index was composed of 38 health deficits and measured at baseline and follow-up (4 years later). Linear regression analyses were performed using adherence to each of the dietary patterns as exposure and the frailty index as outcome (all in Z-scores).


Adherence to the national dietary guidelines was associated with lower frailty at baseline (β −0.05, 95% CI −0.08, −0.02). Additionally, high adherence was associated with lower frailty scores over time (β −0.08, 95% CI −0.12, −0.04). The PCA revealed three dietary patterns that we named a “Traditional” pattern, high in legumes, eggs and savory snacks; a “Carnivore” pattern, high in meat and poultry; and a “Health Conscious” pattern, high in whole grain products, vegetables and fruit. In the cross-sectional analyses adherence to these patterns was not associated with frailty. However, adherence to the “Traditional” pattern was associated with less frailty over time (β −0.09, 95% CI −0.14, −0.05).


No associations were found for adherence to a “healthy” pattern or “Carnivore” pattern. However, Even in a population that is relatively young and healthy, adherence to dietary guidelines or adherence to the Traditional pattern could help to prevent, delay or reverse frailty levels.

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