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Background Nutritional intake could influence the development of frailty. The aim was to evaluate the associations between dietary iron intakes and changes in dietary iron intakes with frailty. Methods Cross-sectional analyses involved 785 men with Fried frailty phenotype (FP) and 758 men with Rockwood frailty index (FI) data aged 75 years and over at nutrition assessment from the Concord Health and Ageing in Men Project (CHAMP) prospective cohort study. Of these, 563 men who were FP robust or pre-frail, and 432 men who were FI non-frail were included in the longitudinal analyses over 3 years. Dietary intake was assessed at both timepoints using a validated diet history questionnaire. Dietary calculation was used to derive haem iron and non-haem iron intakes from total iron intakes. The associations were evaluated through binary logistic regression. Results Incidence of FP frailty was 15.3% (n = 86). In longitudinal analyses, maintaining total iron intakes (medium tertile -2.61-0.81mg/d), increases in total iron and non-haem iron intakes (high tertiles ≥0.82mg/d and ≥0.80mg/d), and changes in non-haem iron intake (1mg increment) were associated with reduced risks of incident FP frailty (OR: 0.47 [95% CI: 0.24, 0.93, p = .031], OR 0.48 [95% CI: 0.23, 0.99, p = .048], OR 0.41 [95% CI: 0.20, 0.88, p = .022] and OR 0.89 [95% CI: 0.82, 0.98, p = .017]). Conclusion Maintaining or increases in dietary total iron, and increases or changes in dietary non-haem iron intakes over three years were associated with reduced incidence of FP frailty in older men.

Changes in Dietary Total and Nonheme Iron Intake Is Associated With Incident Frailty in Older Men: The Concord Health and Aging in Men Project