Dietary flavonoid intake and frailty in middle-aged and older U.S. adults with prediabetes or diabetes - observational population-based study

Q: What was the primary goal of this study?

To investigate the relationship between dietary flavonoid intake and frailty risk in U.S. adults with prediabetes or diabetes.

Q: How were dietary flavonoid intake and frailty measured?

Dietary flavonoid intake was assessed using 24-hour dietary recalls, and frailty was evaluated with a 53-item frailty index.

Sep 30, 2026

Uploaded by Mafia Boss

The study examines how dietary flavonoid intake relates to frailty risk among U.S. adults with prediabetes or diabetes, where the flavonoid–frailty link has remained unclear. Using NHANES data from 2007–2008, 2009–2010, and 2017–2018, 24-hour dietary recalls estimated flavonoid intake and a 53-item frailty index quantified frailty. Multivariable logistic regression with restricted cubic spline models evaluated both linear and non-linear associations. Higher total flavonoid intake was linked to a lower frailty risk, with an L-shaped pattern.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Abbreviations

Background

Methods

Study design and population

® Observational Study Dietary flavonoid intake and frailty in middle-aged and older U.S. adults with prediabetes or diabetes A population-based study Jiajia Zhang, MDa , Tongfa Shang, MDa , Xiaochong Hou, MDb , Jiasheng Li, MDc , Xiaoxia Zhang, MDa ,* | Abstract
The relationship between flavonoids and frailty in individuals with prediabetes or diabetes remains unclear. This study aimed to investigate the relationship between dietary flavonoid intake and frailty risk in U.S. adults with prediabetes or diabetes. This study used data from the 2007–2008, 2009–2010, and 2017–2018 cycles of the National Health and Nutrition Examination Survey. Dietary flavonoid intake was assessed via 24-hour dietary recalls, and frailty was evaluated using a 53-item frailty index. Multivariate-adjusted logistic regression models were employed to assess the association between dietary flavonoid intake and frailty risk. Restricted cubic spline models were used to evaluate the potential non-linear relationships. The study enrolled a total of 2558 adults (aged ≥ 40 years) with diabetes or pre-diabetes. Participants in the highest tertile of total flavonoid intake exhibited a 32%(odds ratio [OR] = 0.68, 95% confidence interval [CI]: 0.48–0.96) lower risk of frailty compared to those in the lowest tertile. Among flavonoid subclasses, anthocyanidins and flavones were also significantly associated with lower frailty risk, with ORs and 95% CIs of 0.64 (0 .48–0.85) and 0.70 (0 .52–0.94) for the highest tertile compared with the lowest tertile, respectively. Restricted cubic spline analysis revealed an L-shaped relationship between total flavonoid intake and risk of frailty in patients with prediabetes or diabetes (P nonlinearity < .001) . In contrast, anthocyanidins (P nonlinearity = .167) and flavones (P nonlinearity = .092) demonstrated linear dose-response relationships with frailty risk in this population. Higher dietary flavonoid intake, particularly anthocyanidins and flavones, was significantly associated with lower frailty risk in adults with prediabetes or diabetes. | | --- | | Abbreviations: ADA = American Diabetes Association, BCAA = branched-chain amino acids, BMI = body mass index, CI = confidence interval, HbA1c = hemoglobin A1c, NHANES = National Health and Nutrition Examination Survey, OR = odds ratio, RCS = restricted cubic spline. | | Keywords: diabetes, dietary flavonoids, dose–response relationship, frailty, NHANES, prediabetes | 1. Background Frailty, a geriatric syndrome characterized by reduced physiological resilience and increased vulnerability to stressors,[1] is particularly prevalent in adults with glucose metabolism disorders. Emerging evidence indicates that individuals with prediabetes or diabetes have a significantly higher risk of frailty than those with normal glycemic control. [2,3] This increased susceptibility is likely mediated through multiple pathways, including chronic low-grade inflammation, oxidative stress, and metabolic dysregulation, which are all well-established features of dysglycemia. [4] Frailty further increases the risk of adverse outcomes in prediabetic and diabetic populations, including fragility fractures, functional disability, cardiovascular events, and premature mortality.[5–7] Given this substantial burden, identifying modifiable protective factors against frailty in this population represents an urgent research priority. Flavonoids, a diverse group of polyphenols abundant in fruits, vegetables, and other plant-based foods, exhibit potent anti-inflammatory and antioxidant properties that may have various health benefits. [8] Emerging evidence suggests that flavonoids may play a protective role against metabolic diseases. [9, 10] Several observational studies have reported inverse associations between dietary flavonoid intake and frailty in adults. [11–13] However, the specific impact of flavonoids in populations with impaired glucose metabolism remains underexplored. Utilizing

FAQs

What was the primary goal of this study?

To investigate the relationship between dietary flavonoid intake and frailty risk in U.S. adults with prediabetes or diabetes.

How were dietary flavonoid intake and frailty measured?

Dietary flavonoid intake was assessed using 24-hour dietary recalls, and frailty was evaluated with a 53-item frailty index.

What association did the study find between total flavonoid intake and frailty risk?

Participants in the highest tertile of total flavonoid intake had a 32% lower odds of frailty versus the lowest tertile, and restricted cubic spline analysis suggested an L-shaped relationship.

Sep 30, 2026

Uploaded by Mafia Boss