Background Substantial evidence supports the inverse association between adherence to healthy dietary patterns and frailty risk. However, the role of plant-based diets, particularly their quality, is poorly known. Objective To examine the association of two plant-based diets with incidence of physical frailty in middle-aged and older adults. Design Prospective cohort. Setting United Kingdom Subjects 24,996 individuals aged 40–70 years, followed from 2009–12 to 2019–22. Methods Based on at least two 24-h diet assessments, we built two diet indices: (i) the healthful Plant-based Diet Index (hPDI) and (ii) the unhealthful Plant-based Diet Index (uPDI). Incident frailty was defined as developing ≥3 out of 5 of the Fried criteria. We used Cox models to estimate relative risks (RR), and their 95% confidence interval (CI), of incident frailty adjusted for the main potential confounders. Results After a median follow-up of 6.72 years, 428 cases of frailty were ascertained. The RR (95% CI) of frailty was 0.62 (0.48–0.80) for the highest versus lowest tertile of the hPDI and 1.61 (1.26–2.05) for the uPDI. The consumption of healthy plant foods was associated with lower frailty risk (RR per serving 0.93 (0.90–0.96)). The hPDI was directly, and the uPDI inversely, associated with higher risk of low physical activity, slow walking speed and weak hand grip, and the uPDI with higher risk of exhaustion. Conclusions In British middle-age and older adults, greater adherence to the hPDI was associated with lower risk of frailty, whereas greater adherence to the uPDI was associated with higher risk.

中文翻译：

---

植物性饮食的质量和衰弱发生率：对英国生物银行参与者的前瞻性分析

背景 大量证据支持坚持健康饮食模式与虚弱风险之间呈负相关。然而，植物性饮食的作用，尤其是其质量，却鲜为人知。目的探讨两种植物性饮食与中老年人身体虚弱发生率的关系。设计未来队列。 2009-12 年至 2019-22 年对英国受试者 24,996 名 40-70 岁的受试者进行了跟踪调查。方法 基于至少两次 24 小时饮食评估，我们建立了两个饮食指数：(i) 健康植物性饮食指数 (hPDI) 和 (ii) 不健康植物性饮食指数 (uPDI)。事件衰弱被定义为在 Fried 标准的 5 项中达到 ≥ 3 项。我们使用 Cox 模型来估计针对主要潜在混杂因素调整的事件脆弱性的相对风险 (RR) 及其 95% 置信区间 (CI)。结果中位随访6.72年，确诊衰弱病例428例。 hPDI 最高与最低三分位相比，虚弱的 RR (95% CI) 为 0.62 (0.48–0.80)，uPDI 为 1.61 (1.26–2.05)。食用健康植物性食品与较低的虚弱风险相关（每份 RR 0.93 (0.90–0.96)）。 hPDI 与体力活动低、步行速度慢和握力弱的较高风险直接相关，而 uPDI 则相反，而 uPDI 与疲惫风险较高相关。结论 在英国中年和老年人中，更严格地遵守 hPDI 与较低的虚弱风险相关，而更严格地遵守 uPDI 与更高的风险相关。