Specifically, the study states that "greater adherence to the Mediterranean diet is associated with a lower prevalence of frailty and pre-frailty in older adults with overweight or obesity and metabolic syndrome, providing additional evidence of the protective role of this traditional dietary pattern in healthy ageing".
"Statistical data show that eating following a Mediterranean pattern helps protect health and reduces the risk of developing certain problems in the future - such as high cardiovascular risk - compared with not following it", the researchers explain. In practical terms, this means following a diet in which key foods such as fruit, vegetables, legumes, fish and olive oil are essential components.
The Mediterranean diet, therefore, contributes to reducing the risk of frailty in terms of energy levels, physical activity and functional capacity, especially at advanced ages and in people who are overweight and affected by metabolic syndrome.
But what exactly is frailty?
The study defines frailty as "a state of physiological vulnerability associated with a higher risk of disability, hospitalisation and mortality in older adult populations". Consequently, "with demographic ageing and the rise of risk factors such as obesity and metabolic syndrome, identifying preventive strategies is a public health priority".
With this aim, the research was carried out to assess the relationship between adherence to the Mediterranean diet and the prevalence of frailty in older adults with components of metabolic syndrome. The cross-sectional study was based on a large community cohort with multiple recruitment sites between 2013 and 2016.
Data were obtained from PREDIMED-Plus , a Spanish multicentre study involving 23 centres, in which the University of Valencia is represented with the second highest number of participants. PREDIMED-Plus is a benchmark study in nutrition and health, designed to evaluate the effects of dietary and lifestyle interventions on the prevention of chronic diseases and overall health in large populations.
Scientific methodology
The study included 6,874 participants who were overweight or obese and met at least three criteria for metabolic syndrome. A 17-item score was used to measure adherence to the Mediterranean diet. Frailty and pre-frailty were defined using a modified version of the Fried index, incorporating criteria such as exhaustion, physical activity and functional capacity.
The main results were:
1. The combined prevalence of pre-frailty and frailty was high, with almost 49.7% of participants showing pre-frailty and 2.9% showing frailty across the whole sample.
2. Compared with participants with lower adherence to the Mediterranean diet (scores 0-6), those with higher scores (11-17) were less likely to meet criteria for frailty or pre-frailty.
3. Each one-point increase in the adherence index was associated with a significant reduction in the odds of frailty or pre-frailty, even after controlling for variables such as age, sex and other metabolic risk factors.
4. Adjusted models showed odds ratios (ORs) of less than 1 among those with better adherence, highlighting the potential protective effect - a health "shield" - of a Mediterranean dietary pattern rich in fruits, vegetables, olive oil, legumes and fish.
ORs are a measure used to assess whether a factor (in this case, diet) is related to risk; an OR of less than 1 means that the factor reduces the likelihood of developing a disease or adverse condition. Therefore, the better the adherence to the diet, the lower the risk.
Implications for public health
The study reinforces the importance of healthy eating as a central element in promoting healthy ageing, particularly in individuals with metabolic comorbidities. The Mediterranean diet has already been linked to a reduced risk of cardiovascular disease and diabetes, and it now also appears to help slow the development of frailty states associated with advanced age and metabolic syndrome.
These findings are highly relevant for public health policies, which may make key decisions on dietary interventions aimed at increasing adherence to the Mediterranean diet. Their impact could be significant in reducing the burden of frailty in populations with metabolic risk factors, helping to lower the demand for healthcare services and to improve quality of life in old age.
Article reference: Corella D, Sorlí JV, Valero C, et al. "Adherence to the Mediterranean Diet and frailty criteria in an old population with metabolic syndrome: A cross-sectional analysis". The Journal of Nutrition, Health and Aging Volume 30, Issue 2, February 2026, 100757. https://doi.org/10.1016/j.jnha.2025.100757
