Supplementary Material

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Abstract

Background: It is accepted that malnutrition is involved in the pathophysiology of frailty. However, the relationship between dietary animal-derived protein (DAP) intake and the prevalence of frailty is still unclear. Using data from the FRAIL Project, we aimed to determine whether DAP consumption is associated with frailty in community-dwellers aged 65 years and older.

Methods: In this cross-sectional study involving only participants older than 65 years, DAP intake was evaluated through specific items of the Mini-Nutritional Assessment (MNA). Frailty status was assessed according to the Cardiovascular Health Study (CHS) model, which consists of five items (unintentional weight loss, weakness, slow gait speed, exhaustion, low physical activity). Frailty was defined as the presence of at least 3 criteria, and pre-frailty as the presence of 1 or 2.

Results: Among the 407 participants enrolled (mean age 77.9 ± 4.5 years; 51.6% women) the prevalence of frailty was 9.3%, and of pre-frailty 26.5%. Daily DAP consumption was reported by 206. Multinomial logistic regression analysis, adjusted for potential confounders, showed that higher DAP intake was associated with a significant reduction in frailty (odds ratio, OR = 0.41; 95% confidence intervals, CIs: 0.160.98) and pre-frailty (OR = 0.46; 95%CI: 0.270.79).

Conclusion: Daily animal protein intake is associated with a lower prevalence of frailty in communitydwelling older subjects, suggesting that a diet rich in animal proteins could be useful in preventing frailty. Simple specific questions drawn from the MNA may be an effective tool to gather useful information on protein consumption in elderly people and on their nutritional risk of being frail.