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Abstract：
Understanding the interaction between dietary patterns and nutritional status in influencing health outcomes is crucial, especially in vulnerable populations. Our study investigates the impact of adherence to the Mediterranean diet (MD) and nutritional status on inflammatory markers (CRP) and the length of stay (LOS) in hospitalized frail elderly patients.
METHODS: We conducted two-way ANOVA and multiple regression analysis to evaluate the effects of nutritional status and MD adherence on the CRP levels and LOS in a cohort of 117 frail elderly patients aged 65 years or older. Patients with cancer or acute infection were excluded. Adherence to the MD was assessed using the 14-item PREDIMED questionnaire.
RESULTS: Significant interactions were found between nutritional status and MD adherence for both the CRP and LOS. The patients with low-level MD adherence and a poor nutritional status exhibited higher CRP levels and longer hospital stays compared to those with high MD adherence. Specifically, a statistically significant interaction was observed for the CRP (F (1, 113) = 7.36, p = 0.008) and LOS (F (1, 113) = 15.4, p < 0.001), indicating the protective effect of high-level MD adherence. Moderation analysis confirmed that high-level MD adherence mitigates the adverse effects of malnutrition on both the inflammatory response and LOS.
CONCLUSIONS: These findings highlight the importance of promoting the MD, particularly in malnourished elderly patients, to improve health outcomes and reduce hospitalization duration. Further longitudinal studies are warranted to establish causality and explore the underlying mechanisms.
METHODS: We conducted two-way ANOVA and multiple regression analysis to evaluate the effects of nutritional status and MD adherence on the CRP levels and LOS in a cohort of 117 frail elderly patients aged 65 years or older. Patients with cancer or acute infection were excluded. Adherence to the MD was assessed using the 14-item PREDIMED questionnaire.
RESULTS: Significant interactions were found between nutritional status and MD adherence for both the CRP and LOS. The patients with low-level MD adherence and a poor nutritional status exhibited higher CRP levels and longer hospital stays compared to those with high MD adherence. Specifically, a statistically significant interaction was observed for the CRP (F (1, 113) = 7.36, p = 0.008) and LOS (F (1, 113) = 15.4, p < 0.001), indicating the protective effect of high-level MD adherence. Moderation analysis confirmed that high-level MD adherence mitigates the adverse effects of malnutrition on both the inflammatory response and LOS.
CONCLUSIONS: These findings highlight the importance of promoting the MD, particularly in malnourished elderly patients, to improve health outcomes and reduce hospitalization duration. Further longitudinal studies are warranted to establish causality and explore the underlying mechanisms.
摘要：
了解膳食模式和营养状况在影响健康结果方面的相互作用至关重要，特别是在弱势群体中。我们的研究调查了住院虚弱的老年患者坚持地中海饮食（MD）和营养状况对炎症标志物（CRP）和住院时间（LOS）的影响。
方法：我们进行了双向方差分析和多元回归分析，以评估117名65岁或以上的体弱老年患者的营养状况和MD依从性对CRP水平和LOS的影响。排除患有癌症或急性感染的患者。使用14项PREDIMED问卷评估对MD的依从性。
结果：在CRP和LOS的营养状况和MD依从性之间发现了显著的交互作用。与MD依从性高的患者相比，MD依从性低且营养状况差的患者表现出更高的CRP水平和更长的住院时间。具体来说,观察到CRP（F（1，113）=7.36，p=0.008）和LOS（F（1，113）=15.4，p<0.001）的统计学显着相互作用，表明高水平MD依从性的保护作用。适度分析证实，高水平的MD依从性可以减轻营养不良对炎症反应和LOS的不利影响。
结论：这些发现强调了促进MD的重要性，尤其是营养不良的老年患者，改善健康结果并减少住院时间。需要进一步的纵向研究来建立因果关系并探索潜在的机制。
方法：我们进行了双向方差分析和多元回归分析，以评估117名65岁或以上的体弱老年患者的营养状况和MD依从性对CRP水平和LOS的影响。排除患有癌症或急性感染的患者。使用14项PREDIMED问卷评估对MD的依从性。
结果：在CRP和LOS的营养状况和MD依从性之间发现了显著的交互作用。与MD依从性高的患者相比，MD依从性低且营养状况差的患者表现出更高的CRP水平和更长的住院时间。具体来说,观察到CRP（F（1，113）=7.36，p=0.008）和LOS（F（1，113）=15.4，p<0.001）的统计学显着相互作用，表明高水平MD依从性的保护作用。适度分析证实，高水平的MD依从性可以减轻营养不良对炎症反应和LOS的不利影响。
结论：这些发现强调了促进MD的重要性，尤其是营养不良的老年患者，改善健康结果并减少住院时间。需要进一步的纵向研究来建立因果关系并探索潜在的机制。
