Adherence to the mediterranean diet and physical activity in relation to sarcopenia: a cross-sectional epidemiological cohort study

Background: Adoption of healthy lifestyle habits has been proposed as successful strategies to counteract sarcopenia. Aims: To explore the association of physical activity (PA) and adherence to the mediterranean diet (MD), individually and synergically, with sarcopenia. Methods: The present cross-sectional study examined data of the Toledo Study of Healthy Ageing. Data of community-dwelling adults aged 65 + years were analyzed. Sarcopenia was defined according to the Foundation for the National Institutes of Health, standardized to our population (sFNIH) and the European Working Group on Sarcopenia (EWGSOP2). PA levels (Physical Activity Scale for the Elderly, PASE) and adherence to the MD (MEDiterranean Diet Adherence Screener-MEDAS) were estimated using self-reported instruments. Binary regression models were conducted to test associations. Results: Data of 1457 individuals (mean age 74.68 ± 5.77 years; 54.91% women) were analyzed. Among them, 331 (22.72%, sFNIH) and 202 (13.86%, EWGSOP2) met sarcopenia criteria. PA levels (ORs: 0.91-0.95, p < 0.05) and adherence to the MD (ORs: 0.82-0.86, p < 0.05) were significantly and negatively associated with the prevalence of sarcopenia, regardless of the definition used. Nevertheless, no significant interactions were observed among healthy lifestyle habits. According to sarcopenia-related domains, PA levels and adherence to the MD were negatively associated with dynapenia, meanwhile, PA levels were associated with low lean mass (sFNIH) and adherence to the MD was inversely associated with poor mobility. Conclusions: PA and adherence to the MD are independently associated with sarcopenia. Moreover, specific associations were observed between sarcopenia domains. Nevertheless, no significant interaction was observed between them.