This study examined the relationship between the consumption of plant-based diet and frailty in older Chinese adults.

Prospective cohort study

Community-based setting in 22 provinces of China.

The final sample included data from 3990 older adults from 2011–2014 from the Chinese Longitudinal Healthy Longevity Survey

A plant-based diet index (PDI) was calculated based on a qualitative food frequency questionnaire. Frailty was defined using modified Fried criteria. A Generalized Estimating Equation was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for frailty. We further performed subgroup analyses stratified by sex and lifestyle factors.

557 cases of frailty were observed. After adjustment for covariates, the RR for frailty of a high PDI was 0.792 (95% CI: 0.644–0.973), relative to a low PDI. During follow-up, compared with respondents with a continually low PDI, the respondents with a continually high PDI had a significantly reduced risk of frailty (RR = 0.683, 95% CI: 0.514–0.908). In further subgroup analysis, a consistently high PDI over time resulted in a significantly reduced risk of frailty for male (RR = 0.591, 95% CI: 0.391–0.893); for never smokers (RR = 0.670, 95% CI: 0.458–0.979); for people who did never consume alcohol (RR = 0.654, 95% CI: 0.454–0.941); and for people with current or former exercise habits (RR = 0.488, 95% CI: 0.313–0.762).

Plant-based diet was associated with low risk of frailty in men and in older adults with healthy lifestyle. These findings stress that plant-based diet should be recommended as a dietary strategy to prevent and reduce frailty in older adults; in addition, more dietary interventions along with lifestyle modification should be adopted to promote successful ageing, especially for women.