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Peer-reviewedCC BY-NC-ND 4.0BMC Geriatrics

Association of dietary diversity with frailty and pre-frailty in a general Japanese population: the Hisayama Study

  • Yasumi Kimura1,2
  • Emi Oishi2,3,4
  • Satoko Sakata2,3,4
  • Yoshihiko Furuta2,4
  • Jun Hata3,5
  • Takanori Honda2
  • Mao Shibata2,3
  • Tomoyuki Ohara2,6
  • Kazuhiro Uchida7
  • Tetsuro Ago3,4
  • Toshiharu Ninomiya2,3
7 affiliations
  1. 1Department of Health and Nutrition, Faculty of Health Sciences, Hiroshima Shudo University, Hiroshima, Japan
  2. 2Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan
  3. 3Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  4. 4Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  5. 5Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  6. 6Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  7. 7Department of Health Promotion, School of Health and Nutrition Sciences, Nakamura Gakuen University, Fukuoka, Japan
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Abstract

Background: Frailty and pre-frailty are characterized by a decline in life functions, including physical and mental vitality, for which dietary habits play an important role. This study aimed to examine the association of dietary diversity with frailty and pre-frailty in a community-dwelling older Japanese population.

Methods: Food intake was assessed using a food frequency questionnaire, and the dietary diversity score (DDS) was calculated based on the number of days per week that each of the 12 food groups was consumed. A total of 1,388 participants (628 men and 760 women) aged 65 and older were divided into five groups according to the quintile of DDS. Frailty status was assessed according to the revised Japanese version of the Cardiovascular Health Study criteria. A multinomial logistic regression analysis was used to estimate odds ratios with 95% confidence intervals (CIs) for having frailty and pre-frailty according to the DDS.

Results: The overall prevalence rates were 6.7% (n = 93) with frailty and 47.5% (n = 659) with pre-frailty. Higher DDS was significantly associated with a lower likelihood of frailty and pre-frailty. The multivariable-adjusted odds ratio for having frailty and pre-frailty in individuals in the highest quintile of DDS was 0.36 (95% CI, 0.16–0.81) for frailty, and 0.53 (95% CI, 0.35–0.81) for pre-frailty. Further adjustment for intakes of energy, protein, and calcium found that 60.2% and 33.5% of the association of DDS with frailty and pre-frailty could be explained by these factors.

Conclusions: Dietary diversity is associated with a lower likelihood of having frailty and pre-frailty, which may be partly attributable to the intake of energy, protein, and calcium.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08072-8.

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Cite

BibTeXRIS
BibTeX
@article{kimura2026association,
  title = {{Association of dietary diversity with frailty and pre-frailty in a general Japanese population: the Hisayama Study}},
  author = {Yasumi Kimura and Emi Oishi and Satoko Sakata and Yoshihiko Furuta and Jun Hata and Takanori Honda and Mao Shibata and Tomoyuki Ohara and Kazuhiro Uchida and Tetsuro Ago and Toshiharu Ninomiya},
  journal = {BMC Geriatrics},
  year = {2026},
  month = aug,
  doi = {10.1186/s12877-026-08072-8},
  url = {https://doi.org/10.1186/s12877-026-08072-8},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Association of dietary diversity with frailty and pre-frailty in a general Japanese population: the Hisayama Study
AU  - Yasumi Kimura
AU  - Emi Oishi
AU  - Satoko Sakata
AU  - Yoshihiko Furuta
AU  - Jun Hata
AU  - Takanori Honda
AU  - Mao Shibata
AU  - Tomoyuki Ohara
AU  - Kazuhiro Uchida
AU  - Tetsuro Ago
AU  - Toshiharu Ninomiya
PY  - 2026
DA  - 2026/08/01
JO  - BMC Geriatrics
DO  - 10.1186/s12877-026-08072-8
UR  - https://doi.org/10.1186/s12877-026-08072-8
AB  - Background: Frailty and pre-frailty are characterized by a decline in life functions, including physical and mental vitality, for which dietary habits play an important role. This study aimed to examine the association of dietary diversity with frailty and pre-frailty in a community-dwelling older Japanese population.  Methods: Food intake was assessed using a food frequency questionnaire, and the dietary diversity score (DDS) was calculated based on the number of days per week that each of the 12 food groups was consumed. A total of 1,388 participants (628 men and 760 women) aged 65 and older were divided into five groups according to the quintile of DDS. Frailty status was assessed according to the revised Japanese version of the Cardiovascular Health Study criteria. A multinomial logistic regression analysis was used to estimate odds ratios with 95% confidence intervals (CIs) for having frailty and pre-frailty according to the DDS.  Results: The overall prevalence rates were 6.7% (n = 93) with frailty and 47.5% (n = 659) with pre-frailty. Higher DDS was significantly associated with a lower likelihood of frailty and pre-frailty. The multivariable-adjusted odds ratio for having frailty and pre-frailty in individuals in the highest quintile of DDS was 0.36 (95% CI, 0.16–0.81) for frailty, and 0.53 (95% CI, 0.35–0.81) for pre-frailty. Further adjustment for intakes of energy, protein, and calcium found that 60.2% and 33.5% of the association of DDS with frailty and pre-frailty could be explained by these factors.  Conclusions: Dietary diversity is associated with a lower likelihood of having frailty and pre-frailty, which may be partly attributable to the intake of energy, protein, and calcium.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08072-8.
SN  - 1471-2318
ER  -