Adherence to the Mediterranean diet in Turkish hospitalized older adults and its association with hospital clinical outcomes

Aim: To identify the Mediterranean diet adherence in Turkish older inpatients and its relation to clinical outcomes. Methods: A total of 200 hospitalized patients over 60 years old (mean age; 72.9 +/- 8.5 years, 59.5% female) were included in the study. Beside evaluating the demographic properties, they were evaluated by Elderly Dietary Index (EDI), Mini-nutritional assessment-short form (MNA-SF), and FRAIL index. Length of hospital stay, need of intensive care, and hospital clinical outcomes were also recorded. Results: According to the EDI scoring, the rate of unhealthy diets among study population was 91.5% and 56% of the patients were frail and 17% were malnourished. EDI score was significantly and positively correlated with height (rho=0.183), weight (rho=0.142), MNA-SF score (rho=0.204), glomerular filtration rate (GFR) (rho=0.152), and alanine-aminotransferase (ALT) (rho=0.278) levels (p = 0.009; 0.046; 0.004; 0.032; and <0.001, respectively). EDI scores were higher in male and married patients when compared to female and widow ones (p = 0.001 and 0.023, respectively). There was a negative, moderate, and statistically significant correlation between EDI score and length of hospital stay in patients hospitalized for infectious diseases (rho:-0.510; p = 0.036). EDI score was also significantly related to frailty status (p = 0.017) and malnutrition (p = 0.026). The EDI score was found to be an independent parameter for frailty in a regression analysis model (OR=0.826;%95 CI: 0.713-0.959; p = 0.012). Conclusion: It was shown that hospitalized older adults had a low adherence to the Mediterranean diet. Unhealthy diet group might be associated with poor clinical outcomes such as malnutrition, frailty, increased length of hospital stay, and recurrent emergency department admissions.