Abstract
Objectives
Emerging evidence suggests that overall dietary quality is important for the prevention of disability, which maybe be due to protective effects on cardiovascular risk factors. Few studies have investigated adherence to a DASH diet and disability and muscle strength prospectively, particularly among Puerto Rican adults. This study examined the relationship between a DASH dietary index and incidence of disability and change in muscle strength over 5 years of follow up.
Methods
Data are from the Boston Puerto Rican Health Study, a prospective cohort of Puerto Rican adults aged 45 to 75 y (n = 1408). The DASH dietary quality index (DASH) was derived from averaged dietary data assessed by validated food frequency questionnaire at baseline and 2-y follow up. Self-reported disability included activities of daily living (ADL) and instrumental ADL assessed at baseline, 2-y and 5-y follow up. Hand grip measures were obtained using a hand dynamometer at baseline, 2-y and 5-y follow up. Cox Proportional Hazards models were adjusted for sex, age, cardiovascular disease, smoking status, educational attainment, alcohol consumption, physical activity, hypertension, diabetes, cholesterol concentration, C-reactive protein and body mass index. Multivariable linear regression was used to model changes in handgrip. Interactions by sex, age and diabetes status were examined.
Results
The prevalence of ADL and IADL disability at baseline was 70.8% and 48.6%. Mean change in handgrip from baseline to 5 y was −2.19 kg. Interactions by age, sex and diabetes status were not significant. Participants with higher adherence to the DASH diet had lower incidence of impaired ADL (HR = 0.95, 95% CI: 0.92, 0.99) and IADL disability (HR = 0.96, 95% CI: 0.93, 0.98). The relationship between the DASH dietary index and change in handgrip measures from baseline to 5-y follow up approached significance (β = 0.14 ± 0.08, P = 0.07).
Conclusions
These findings suggest that higher adherence to a DASH diet may reduce risk of disability and mitigate muscle strength loss among Puerto Rican adults. This may be an important intervention strategy for prevention of disability in this population.
Funding Sources
National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases.