The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study

The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study Narae Yang, Yunhwan Lee, Mi Kyung Kim, Kirang Kim This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1164783/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The relationship between macronutrients and frailty is unclear. Previous studies have confirmed the relationships between energy and protein intake and physical frailty, while few studies have examined the role of carbohydrate or fat intake in the prevalence of frailty. The aim of this study is to investigate the relationship of energy and macronutrients with physical frailty in the Korean elderly population who had a high proportion of energy intake from carbohydrates. Methods: This study included 954 adults aged 70 to 84 years who have completed the assessment of frailty and 24-h recall upon enrolment in the Korean Frailty and Aging Cohort Study and have no extreme intake under 400 kcal (n = 2). The relationship between energy or macronutrients and frailty was evaluated using multivariate logistic regression models and multivariate nutrient density models. Results: In the subjects with low energy intake (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 1.34–6.45) and total subjects (OR = 2.01, 95% CI = 1.03–3.93), consuming carbohydrates above the acceptable macronutrient distribution range (65% of energy) was related to a higher risk of frailty. Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05, 95% CI = 1.00–1.09; 5%, OR = 1.26, 95% CI = 1.02–1.56; 10%, OR = 1.59, 95% CI = 1.03–2.43). Conclusions: This study showed that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor for reducing the risk of frailty. Geriatrics & Gerontology frailty macronutrients carbohydrates protein fat older adults Background Life expectancy has been steadily increasing [ 1 ]. It is estimated to be 65.2 years for those born in 2000 and 71.9 years for those born in 2016 [ 1 ]. However, the healthy life expectancy (HALE) without disability for those born in 2016 is 64.6 years, indicating a gap between life expectancy and HALE [ 1 ]. The gap between life expectancy and HALE means an unhealthy survival period, and closing this gap has recently become a global goal [ 2 ]. Since mobility and disability are factors that affect life satisfaction and quality of life, it is necessary to manage these factors to increase HALE [ 3 , 4 ]. The state of reduced reserve capacity and vulnerability to stress can be defined as frailty, which has been reported to be related to a high risk of falls, hospitalization, disability, and death [ 5 – 8 ]. Nutritional, physical, and medical interventions could prevent or delay the deterioration of physiological function related to physical frailty [ 9 – 11 ]. Moreover, even in the already frail state, it is possible to recover to the prefrail stage depending on the intervention and nutritional intake level [ 12 ], so the need for intervention is emphasized at all stages of prevention, delay, and recovery of physical frailty in the elderly. Since the Fried frailty index examines the physical functions, such as muscle strength [ 7 ], previous research has mainly focused on protein as a nutritional factor related to frailty [ 12 – 24 ]. In a multicenter cross-sectional study conducted on 2,108 elderly people living in a community in Japan, higher protein intake was negatively related to frailty prevalence [ 22 ]. The relationship between relative protein intake and frailty has also been investigated in other studies, for example, 1 g/kg body weight (BW) [ 18 ] and 1.1 g/kg BW [ 23 ] were related to low prevalence of frailty. The Korean Nutrition Society recommends a total protein intake of 55 g for men and 45 g for women or 0.91 g/kg for individuals aged ≥65 years, which is established as the minimum amount of protein that an adult should consume to maintain nitrogen balance. However, the recommended protein intake (0.91 g/kg BW) is the minimum value for maintaining nitrogen balance in adults and does not reflect the metabolic characteristics of older adults, so consuming at least 1.0 g/kg of protein has been recommended [ 25 – 27 ], and 1.2 g/kg BW is also proposed by the Korean Geriatrics Society and the Korean Nutrition Society to prevent sarcopenia [ 28 ]. However, inconsistent results have been found regarding the relationship between protein intake and frailty and muscle strength [ 12 – 24 ]. Moreover, insufficient energy intake leads to a decrease in protein synthesis even if amino acids are adequately provided. Therefore, a sufficient energy intake is an important nutritional factor in the prevention of frailty [ 29 ]. The study have also reported that low energy intake increased the risk of frailty, but discrepancies of the results also exist [ 18 , 20 , 21 ]. Carbohydrate intake is positively related to the prevalence of metabolic syndrome and diabetes [ 30 , 31 ], and since these chronic diseases are factors influencing the prevalence of frailty, not only protein but also carbohydrates and fats should be considered integrally. Studies have shown that the Korean elderly population consumed more than the acceptable macronutrient distribution range (AMDR) in carbohydrate energy consumption [ 32 – 34 ]. Therefore, understanding the high carbohydrate diet affecting frailty in the elderly is crucial. To our knowledge, only a few studies have investigated the relationship between high carbohydrate diet and frailty. Furthermore, the elderly is at risk of low energy and food intake due to anorexia of aging, chronic diseases, decreased physical activity, and decreased masticatory function [ 35 , 36 ], but these characteristics of the elderly are not considered, and simply high intake levels of quantity tend to be recommended to prevent frailty [ 25 – 27 ]. However, additional information is necessary to confirm the intake level of macronutrients related to the prevalence of frailty in subjects with low energy intake. Therefore, the aim of this study is to identify energy and macronutrient intake level that may be related to the frailty status among the older adults who tended to have a high energy intake from carbohydrates in Korea. Methods Study population Data were retrieved from the baseline surveys of the Korean Frailty and Aging Cohort Survey (KFACS), which were conducted from May to November 2016 [ 37 , 38 ]. KFACS enrolled 1,559 Korean community-dwelling elderly people aged 70 to 84 years. The participants were recruited according to age- and gender-specific strata, and the surveys were conducted across eight university-affiliated hospitals and two public health centers. Out of 1,559 individuals, 1,002 attended the nutrition sub-cohort. Forty-eight participants were excluded from the analysis, especially those with an energy intake under 400 kcal (n = 2), and the missing values for the components of frailty (n = 46) were also excluded. The final analytical sample included 954 subjects. This study was performed in accordance with the Declaration of Helsinki, and it was approved by the Institutional Review Board of Dankook University, Hanyang University, and Kyung Hee University. Written informed consent was obtained from all participants. General characteristics Information on age, sex, educational attainment, house income, living situation (living alone or not), physician-diagnosed chronic disease (hypertension, dyslipidemia, or type 2 diabetes), number of prescription drugs, chewing status, and smoking status was obtained after face-to-face interviews. Height and weight were measured by a trained staff. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m 2 ). BMI was categorized as underweight (<18.5 kg/m 2 ), normal weight (≥18.5 to <23 kg/m 2 ), overweight (≥23 to <25 kg/m 2 ), and obese (≥25 kg/m 2 ) according to the Asia-Pacific classification of BMI [ 39 ]. Definition of frailty We used a modified version of the Fried frailty phenotype [ 7 , 40 ], which has the following five components: unintended weight loss, weakness (poor grip strength), self-assessed exhaustion, slow walking speed, and low physical activity. Weakness was measured using a hand dynamometer (Takei TKK 5401, Takei Scientific Instruments, Tokyo, Japan). The grip strength of each hand was measured, and the measurement was repeated after 3 min; the highest value among the averages of each measurement was used for analysis. Exhaustion was assessed using the Center for Epidemiological Studies-Depression scale. Walking speed was measured while walking 4 m at a normal rhythm. Physical activity was measured using the International Physical Activity Questionnaire–Short Form (Korean version) [ 41 ]. Table 1 shows the information of components and criteria for adding 1 point. The frailty scores ranged from 0 to 5, and frailty status was categorized as robust (0), prefrail (1–2), and frail (3–5). Table 1 Fried frailty index and criteria for adding 1 point. Components Criteria for adding 1 point Unintended weight loss [ 40 ] Unintended weight loss of 4.5 kg or more in the last year Weakness [ 40 ] Grip strength lower than 26 kg for men and lower than 18 kg for women Exhaustion [ 42 ] “I felt that everything I did was an effort” or “I could not get going” was yes for three or more days in a week Slow walking speed [ 40 ] Walking speed below 1 m/s after walking 4 m at a normal rhythm Low physical activity [ 43 ] Metabolic equivalent of task in minutes per week (MET-min/week) was below 494.65 kcal for men and below 283.50 kcal for women Dietary intake assessment The interviewers were trained with the standardized protocol for the 24-h recall method. Interviews were conducted based on home visiting, and visual aids, which were developed by the Korea Disease Control and Prevention Agency, were used to estimate the quantity of the food consumed during a day. Nutrient intake was calculated using the 24-h recall dietary assessment system of the National Institute of Health and the Korea Disease Control and Prevention Agency [ 44 ]. Total energy and macronutrient intake Total energy was calculated as the sum of carbohydrate (4 kcal * g/d), protein (4 kcal * g/d), and fat (9 kcal * g/d) kcal. Carbohydrates, protein, and fat were expressed as the percentage of energy to evaluate the adequacy of macronutrient intake using the AMDR (carbohydrate, 55–65%; protein, 7–20%; fat, 15–30%) [ 32 ]. The participants were categorized by the AMDR of each macronutrient. The estimated energy requirement (EER) was calculated using the formula for estimating the energy requirements suggested by the Dietary Reference Intakes for Koreans {men: 662 − 9.53 × age + value of physical activity level (PA) [15.91 × weight (kg) + 539.6 × height (m)]; women: 354 − 6.91 × age + PA [9.36 × weight+ 726 × height (m)]}. The PA value was determined for all subjects to be 1.11 for men and 1.12 for women in consideration of the PA from the International PA Questionnaire [ 32 ]. Energy intake was dichotomized at the cut-off point of EER. The relationship of protein intake with the prevalence of prefrailty and frailty was identified using four types of cutoffs: (1) AMDR (7–20% of energy from protein) [ 32 ], (2) the age- and gender-specific recommended nutrient intake (RNI) (elder men, 55 g/d; elder women, 45 g/d) [ 32 ], (3) the RNI cut-off for dietary protein (0.91 g/kg BW/d) [ 32 ], and (4) cut-off suggested by the Korean Geriatrics Society and the Korean Nutrition Society for the prevention of sarcopenia (1.2 g/kg BW/d) [ 28 ]. Blood tests Blood samples were taken after an 8-h fast and were brought to a commercial laboratory. The serum levels of triglycerides, HDL cholesterol, LDL cholesterol, FBS, HbA1c, and hs-CRP were measured. Statistical analysis Energy intake (kcal/d, 100 kcal/d) and each macronutrient intake (g/d, 10 g/d, % from energy, kcal/d, and 100 kcal/d) were used as continuous variables, and energy and macronutrient cutoffs were used as categorical variables. Categorical variables were presented as n (%), whereas continuous variables were presented as means ± standard deviations or means ± standard errors. P-values for the differences in frail status were obtained using a chi-square test or Fisher’s exact test for qualitative variables or analysis of variance for continuous variables. The differences among the groups were determined using the Scheffé post hoc test. The p-values for differences between the frail status were obtained using the Cochran–Mantel–Haenszel test for qualitative variables or the general linear model for continuous variables. Values were adjusted for age and sex. Adjusted multinomial logistic regression analysis was conducted to compare the energy and macronutrient intake of frail and prefrail older adults with those of the robust older adults. We tried to confirm the relationship between the prevalence of frail status and sufficient energy intake, but because of the small number of subjects with sufficient energy intake, irregularities appeared in the Hessian matrix, and the validity was uncertain, so those with sufficient energy intake were excluded from the multinomial logistic regression analysis. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were derived, after adjusting for age, sex, education attainment, house income, living situation (alone or not), hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, and PA in Model 1. Model 2 was adjusted for Model 1 covariates and total energy. Multivariate nutrient density models were conducted to examine the relationship between macronutrients and frailty status in total subjects as well as subjects who consumed the unmet intake with the standard energy intake criteria. Detailed information on the multivariate nutrient density models is available elsewhere [ 45 ]. Briefly, in logistic regression analysis, total energy intake and macronutrient of interest were included as independent variables, and frail status was included as a dependent variable. With the total energy intake adjusted, the increase in the energy of the macronutrient of interest can be interpreted as a decrease in the iso-energy of other nutrients not included in the model. For example, to examine the substitution of fat with carbohydrates, the model includes carbohydrates, protein, total energy intake, and covariates but excludes fat. The OR for carbohydrates represents substituting fat with the same energy from carbohydrates. All statistical analyses were conducted using the IBM SPSS Statistics 25.0 Program (IBM SPSS INC, Armonk) and were tested at a P-value below 0.05. Results Of the 1,002 participants recruited to KFACS, 954 (95%) had complete data for all the variables of interest. Table 2 shows the relationship between the aspects of general characteristics and frailty status. The participants had an average age of 76.3 years (70–84). The proportion of women was 51.7%, of which 10.9% were frail and 50.2% prefrail. After adjusting for age and sex, frail older adults were less educated, had low income, and presented with a high prevalence of physician-diagnosed hypertension. Frail older adults also had lower HDL cholesterol and marginally higher triglyceride levels. The proportion of polypharmacy and chewing discomfort according to frail status were significantly different, showing a higher proportion in frail older adults. The level of PA was lower in frail older adults than in prefrail and robust older adults. Table 2 The relationship between the aspects of general characteristics and frailty status 1) All Robust Prefrail Frail p 2) p 3) (n=371) (n=479) (n=104) Age (year) 76.3 ± 3.9 75.5 ± 3.7 a 76.4 ± 3.9 b 78.7 ± 3.8 c <0.001 - Sex, n (%) Men 461(48.3) 232(61.2) 202(42.9) 27(26.0) <0.001 - Women 493(51.7) 147(38.8) 269(57.1) 77(74.0) Educational attainment, n (%) ≤ 6 years 436(45.8) 121(32.0) 229(48.6) 86(82.7) <0.001 <0.001 ≥ 7 years 517(54.2) 257(68.0) 242(51.4) 18(17.3) House income (per a month), n (%) Unknown 80(8.4) 24(6.3) 41(8.7) 15(14.4) <0.001 <0.001 < 1 million won 388(40.7) 123(32.5) 198(42.0) 67(64.4) 1-2 million 218(22.9) 88(23.2) 118(25.1) 12(11.5) ≥ 2 million 268(28.1) 144(38.0) 114(24.2) 10(9.6) Living alone or living with partner, n (%) Living alone 245(25.7) 73(19.3) 133(28.2) 39(37.5) <0.001 0.691 Living with partner 709(74.3) 306(80.7) 338(71.8) 65(62.5) BMI (kg/m 2 ), n (%) < 18.5, underweight 16(1.7) 6(1.6) 8(1.7) 2(1.9) 0.999 0.862 18.5-22.9, normal 285(29.9) 109(28.8) 145(30.8) 31(29.8) 23-24.9, overweight 251(26.3) 107(28.2) 114(24.2) 30(28.8) ≥ 25, obese 402(42.1) 157(41.4) 204(43.3) 41(39.4) Disease (Yes) Hypertension, n (%) 566(59.3) 190(50.1) 302(64.1) 74(71.2) <0.001 <0.001 Dyslipidemia, n (%) 294(30.8) 110(29.0) 153(32.5) 31(29.8) 0.502 0.6 Type 2 diabetes, n (%) 216(22.7) 77(20.4) 110(23.4) 29(28.2) 0.224 0.165 Total cholesterol (mg/dL) 171.6 ± 1.2 173 ± 1.9 170.2 ± 1.6 172.7 ± 3.1 0.481 0.107 Triglyceride (mg/dL) 122.2 ± 2.0 118.4 ± 3.1 a 121.9 ± 2.7 ab 137.4 ± 7.7 bc 0.022 0.055 HDL-cholesterol (mg/dL) 51.4 ± 0.5 52.2 ± 0.8 51 ± 0.6 50.1 ± 1.2 0.289 0.032 LDL-cholesterol (mg/dL) 107.9 ± 1.0 109 ± 1.7 106.8 ± 1.4 108.4 ± 3.0 0.606 0.289 FBS (mg/dL) 104.3 ± 21.4 104.6 ± 21.4 104.1 ± 20.9 104.4 ± 23.6 0.942 0.919 HbA1c (%) 6.0 ± 0.8 6.0 ± 0.7 6.1 ± 0.9 5.9 ± 0.7 0.235 0.202 hs-CRP (mg/dL) 1.3 ± 0.1 1.3 ± 0.1 1.3 ± 0.1 1.1 ± 0.1 0.583 0.811 Number of prescription drugs, n (%) ≥ 4 458(48.3) 150(39.6) 243(52.0) 65(63.1) <0.001 <0.001 ≤ 3 491(51.7) 229(60.4) 224(48.0) 38(36.9) Chewing status, n (%) Uncomfortable 376(39.5) 108(28.5) 209(44.4) 59(57.3) <0.001 <0.001 Comfortable(moderate) 577(60.5) 271(71.5) 262(55.6) 44(42.7) Alcohol (g/d) 29.7 ± 4.2 43.8 ± 7.8 a 23.3 ± 5.6 ab 7.1 ± 3.8 b 0.012 0.518 Smoking status, n (%) Everyday 44(4.7) 15(4) 22(4.7) 7(6.7) 0.747 0.141 Sometimes 3(0.3) 1(0.3) 2(0.4) 0(0.0) None 897(95.0) 359(95.7) 441(94.8) 97(93.3) Physical activity 458.1 ± 21.8 592.3 ± 42.5 a 414.4 ± 25.6 b 166.6 ± 34.4 c <0.001 0.003 1) Qualitative variables are presented as n (%), continuous variables are presented as means ± standard deviations or means ± standard errors. 2) p-values for differences between the frail status were obtained by a chi-square test or fisher’s exact test for qualitative variables, or by ANOVA for continuous variables, superscript letters were significantly different among the groups by Scheffѐ post hoc test 3) Values were adjusted for age and sex, p-values for differences between the frail status were obtained by the Cochran-Mantel-Haenszel test for qualitative variables, or by GLM for continuous variables Table 3 shows the macronutrient intake of the participants according to frail status and level of energy intake. In all participants, those who were frail had, on average, lower energy intake and lower carbohydrate, protein, and fat intake than those who were prefrail and robust. Regarding the percentage of energy from macronutrients, frail participants had higher energy intake from carbohydrates and lower energy intake from protein and fat than those who were prefrail or robust. The prevalence of frailty was significantly high in participants with high energy intake from carbohydrates (>65%) and low energy intake from fat (<15%). A similar relationship was observed in subjects who consumed less than the EER, but not in subjects who consumed energy adequately. Table 3 The macronutrient intake of the participants according to frail status and level of energy intake 1) All >= Calculated EER < Calculated EER All Robust Prefrail Frail p 2) All Robust Prefrail Frail p 2) All Robust Prefrail Frail p 2) (n=371) (n=479) (n=104) (n=81) (n=87) (n=13) (n=298) (n=384) (n=91) Energy (kcal/d) 1461.4 ± 16.6 1566.0 ± 26.7 a 1439.4 ± 22.6 b 1179.1 ± 43.8 c <0.001 2174.2 ± 34.6 2270.2 ± 51.5 a 2124.9 ± 50.3 ab 1906.1 ± 78.3 b 0.012 1294.4 ± 12.7 1374.6 ± 19.6 a 1284.1 ± 17.4 b 1075.2 ± 37.8c <0.001 Carbohydrate (g/d) 248.5 ± 2.8 263.0 ± 4.6 a 244.4 ± 3.9 b 213.9 ± 7.8 c <0.001 361.8 ± 6.4 375.5 ± 10.1 354.9 ± 8.7 322.4 ± 17.8 0.067 221.9 ± 2.3 232.4 ± 3.5 a 219.4 ± 3.2 b 198.4 ± 7.2c <0.001 Protein (g/d) 54.4 ± 0.8 59.0 ± 1.3 a 53.7 ± 1.1 b 41.1 ± 2.0 c <0.001 79.8 ± 2.1 84.6 ± 3.1 77.2 ± 3 67.9 ± 7.4 0.064 48.5 ± 0.7 52 ± 1.1 a 48.3 ± 0.9 b 37.2 ± 1.8c <0.001 Fat (g/d) 27.8 ± 0.6 30.9 ± 1.0 a 27.5 ± 0.9 b 17.7 ± 1.3 c <0.001 45.3 ± 1.9 47.8 ± 2.9 44.1 ± 2.8 38.3 ± 5.3 0.384 23.7 ± 0.5 26.3 ± 0.9 a 23.7 ± 0.8 a 14.8 ± 1b <0.001 Energy from carbohydrate (%) 68.8 ± 0.3 67.9 ± 0.5 a 68.5 ± 0.5 a 73.3 ± 0.9 b <0.001 67 ± 0.8 66.5 ± 1.2 67.3 ± 1.1 68 ± 3.2 0.836 69.2 ± 0.4 68.2 ± 0.6 a 68.8 ± 0.5 a 74.1 ± 0.9 b <0.001 Energy from protein (%) 14.8 ± 0.1 15.0 ± 0.2 a 14.9 ± 0.2 a 13.7 ± 0.3 b 0.006 14.6 ± 0.2 14.8 ± 0.4 14.4 ± 0.3 14.1 ± 1.2 0.652 14.9 ± 0.1 15 ± 0.2 a 15 ± 0.2 a 13.7 ± 0.3 b 0.006 Energy from fat (%) 16.4 ± 0.3 17.2 ± 0.4 a 16.6 ± 0.4 a 13.0 ± 0.7 b <0.001 18.4 ± 0.7 18.7 ± 1 18.2 ± 1 17.9 ± 2.2 0.931 15.9 ± 0.3 16.7 ± 0.5 a 16.2 ± 0.4 a 12.3 ± 0.7 b <0.001 Energy intake cut-off, n (%) < Calculated EER 773(81.0) 298(78.6) 384(81.5) 91(87.5) 0.115 - - - - AMDR for carbohydrate (%), n (%) < 55 92(9.6) 45(11.9) 42(8.9) 5(4.8) 0.001 29(16.0) 13(16.0) 13(14.9) 3(23.1) 0.922 63(8.2) 32(10.7) 29(7.6) 2(2.2) <0.001 55-65 214(22.4) 87(23.0) 117(24.8) 10(9.6) 38(21.0) 16(19.8) 20(23.0) 2(15.4) 176(22.8) 71(23.8) 97(25.3) 8(8.8) ≥ 65 648(67.9) 247(65.2) 312(66.2) 89(85.6) 114(63.0) 52(64.2) 54(62.1) 8(61.5) 534(69.1) 195(65.4) 258(67.2) 81(89.0) Protein intake cut-off, n (%) < age- and gender- specific RNI 453(47.5) 165(43.5) 212(45.0) 76(73.1) <0.001 11(6.1) 5(6.2) 3(3.4) 3(23.1) 0.035 442(57.2) 160(53.7) 209(54.4) 73(80.2) <0.001 < 0.91 g/kg 554(58.1) 203(53.6) 274(58.2) 77(74.0) 0.001 17(9.4) 7(8.6) 8(9.2) 2(15.4) 0.739 537(69.5) 196(65.8) 266(69.3) 75(82.4) 0.010 < 1.2 g/kg 783(82.1) 293(77.3) 395(83.9) 95(91.3) 0.002 68(37.6) 27(33.3) 34(39.1) 7(53.8) 0.337 715(92.5) 266(89.3) 361(94.0) 88(96.7) 0.018 AMDR for protein (%), n (%) < 7 1(0.1) 1(0.3) 0(0.0) 0(0.0) 0.571 1(0.6) 1(1.2) 0(0.0) 0(0.0) 0.433 0(0.0) 0(0.0) 0(0.0) 0(0.0) 0.401 7-20 881(92.3) 348(91.8) 434(92.1) 99(95.2) 171(94.5) 75(92.6) 84(96.6) 12(92.3) 710(91.8) 273(91.6) 350(91.1) 87(95.6) ≥ 20 72(7.5) 30(7.9) 37(7.9) 5(4.8) 9(5.0) 5(6.2) 3(3.4) 1(7.7) 63(8.2) 25(8.4) 34(8.9) 4(4.4) AMDR for fat (%), n (%) < 15 456(47.8) 170(44.9) 221(46.9) 65(62.5) 0.007 73(40.3) 33(40.7) 35(40.2) 5(38.5) 0.624 383(49.5) 137(46.0) 186(48.4) 60(65.9) 0.010 15-30 430(45.1) 176(46.4) 216(45.9) 38(36.5) 84(46.4) 36(44.4) 40(46.0) 8(61.5) 346(44.8) 140(47.0) 176(45.8) 30(33.0) ≥ 30 68(7.1) 33(8.7) 34(7.2) 1(1.0) 24(13.3) 12(14.8) 12(13.8) 0(0.0) 44(5.7) 21(7.0) 22(5.7) 1(1.1) 1) Qualitative variables are presented as n (%), continuous variables are presented as means ± standard errors. 2) p-values for differences between the frail status were obtained by a chi-square test or fisher’s exact test for qualitative variables, or by ANOVA for continuous variables, superscript letters were significantly different among the groups by Scheffѐ post hoc test 3) Values were adjusted for age and sex, p-values for differences between the frail status were obtained by the Cochran- Mantel-Haenszel test for qualitative variables, or by GLM for continuous variables Table 4 shows the adjusted multinomial logistic regression models comparing the nutrient intakes for frail and prefrail subjects with those for the robust subjects comprising the reference group. In the entire study population, energy and macronutrients were related to the risk of frailty, but after adjusting for energy intake in Model 2, most of these relationships were no longer significant. In the participants with low energy intake, relationships of macronutrients with physical frailty were still significant, even after adjusting for energy. In Model 2, the risk of frailty per 10 g increase in carbohydrates (OR =1.14, 95% CI = 1.02–1.27) and per 100 kcal increase from carbohydrates (OR = 1.38, 95% CI = 1.05–1.80) increased significantly. The risk of frailty decreased with the increase in the same amount of fat (OR = 0.67, 95% CI = 0.50–0.91) and energy from fat (OR = 0.64, 95% CI = 0.46–0.90). In the same model, the increase in protein intake and energy intake from protein did not show a significant relationship with physical frailty, but the recommended protein intake in consideration of sex and age showed a positive relationship with the prevalence of prefrailty. Notably, in both groups of subjects with low energy intake (OR = 2.94, 95% CI = 1.34–6.45) and total subjects (OR = 2.01, 95% CI = 1.03–3.93), consuming carbohydrates above the AMDR (65% of energy) was related to a higher risk of frailty, even after adjusting for energy. Table 4 The relationship between the nutrient intakes and frail status 1), 2) All < calculated EER Model 1 3) Model 2 4) Model 1 3) Model 2 4) Prefrail Frail Prefrail Frail Prefrail Frail Prefrail Frail OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Energy (100kcal/d) 0.99 0.96–1.02 0.92 0.87–0.98 – – – – 0.98 0.93–1.03 0.89 0.82–0.98 – – – – Carbohydrate (per 10 g/day) 0.99 0.97–1.01 0.97 0.94–1.00 0.98 0.95–1.02 1.07 0.98–1.16 0.99 0.96–1.02 0.97 0.93–1.02 0.99 0.94–1.04 1.14 1.02–1.27 Protein (per 10 g/day) 0.99 0.93–1.06 0.84 0.73–0.96 1.04 0.94–1.16 0.92 0.74–1.15 1.00 0.91–1.11 0.80 0.67–0.97 1.06 0.92–1.21 0.90 0.69–1.19 Fat (per 10 g/day) 1.00 0.92–1.08 0.76 0.63–0.92 1.04 0.93–1.15 0.83 0.66–1.05 0.98 0.87–1.10 0.63 0.49–0.82 1.00 0.87–1.15 0.67 0.50–0.91 Carbohydrate energy (100kcal/d) 0.98 0.94–1.02 0.92 0.85–1.00 0.96 0.88–1.06 1.17 0.95–1.45 0.97 0.91–1.04 0.93 0.83–1.05 0.98 0.86–1.11 1.38 1.05–1.80 Protein energy (100kcal/d) 0.98 0.84–1.15 0.64 0.46–0.90 1.11 0.85–1.44 0.81 0.47–1.41 1.01 0.79–1.28 0.58 0.37–0.92 1.15 0.82–1.62 0.78 0.39–1.54 Fat energy (100kcal/d) 1.00 0.92–1.09 0.74 0.60–0.91 1.04 0.93–1.17 0.81 0.63–1.06 0.98 0.86–1.11 0.60 0.45–0.81 1.00 0.86–1.17 0.64 0.46–0.90 Energy intake cut-off, n (%) ≥ Calculated EER 0.91 0.63–1.30 0.70 0.34–1.43 – – – – – – – – – – – – Energy from carbohydrate cut-off (%) < 55 (vs ≥ 55) 0.85 0.53–1.37 0.55 0.19–1.61 0.87 0.54–1.40 0.61 0.21–1.79 0.73 0.41–1.27 0.24 0.05–1.14 0.73 0.41–1.27 0.24 0.05–1.14 ≥ 65 (vs < 65) 0.88 0.64–1.20 2.18 1.12–4.22 0.86 0.62–1.18 2.01 1.03–3.93 0.97 0.68–1.37 3.16 1.45–6.86 0.94 0.66–1.35 2.94 1.34–6.45 Protein intake cut-off, n (%) ≥ age- and gender- specific RNI 1.19 0.88–1.60 0.52 0.30–0.90 1.47 1.02–2.14 0.72 0.36–1.45 1.22 0.87–1.71 0.54 0.29–1.02 1.49 0.99–2.25 0.79 0.37–1.67 ≥ 0.91 g/kg 1.04 0.77–1.40 0.77 0.44–1.35 1.18 0.82–1.69 1.38 0.68–2.80 1.09 0.77–1.55 0.88 0.45–1.75 1.20 0.81–1.78 1.45 0.66–3.17 ≥ 1.2 g/kg 0.83 0.58–1.21 0.54 0.24–1.21 0.88 0.56–1.37 0.93 0.37–2.37 0.71 0.39–1.29 0.65 0.17–2.51 0.73 0.40–1.36 0.92 0.23–3.69 Energy from fat cut-off (%) < 15 (vs ≥ 15) 0.86 0.63–1.16 1.25 0.74–2.12 0.83 0.61–1.13 1.12 0.65–1.92 0.91 0.65–1.28 1.46 0.81–2.62 0.89 0.63–1.25 1.32 0.73–2.40 ≥ 30 (vs < 30) 0.97 0.56–1.65 0.22 0.03–1.75 1.00 0.58–1.71 0.25 0.03–1.96 0.88 0.46–1.71 0.29 0.04–2.31 0.89 0.46–1.73 0.29 0.04–2.38 1) Reference category: Robust. 2) Odds ratio and 95% confidence interval were obtained by the multinomial logistic regression analysis. 3) Model 1 was adjusted for age, sex, education attainment, house income, living alone or with partner, hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, physical activity. 4) Model 2 was adjusted for Model 1 covariates and total energy. Table 5 shows the relationship between the replacement of energy from macronutrients with other macronutrients and frail status. For the group with low energy intake, replacing energy from carbohydrates with energy from fat was negatively related to the prevalence of frailty (1%, OR = 0.96, 95% CI = 0.92–1.00; 5%, OR = 0.79, 95% CI = 0.64–0.98; 10%, OR = 0.63, 95% CI = 0.41–0.97). Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05 95% CI = 1.00–1.09; 5%, OR = 1.26, 95% CI = 1.02–1.56; 10%, OR = 1.59, 95% CI = 1.03–2.43). However, substituting the energy from carbohydrates or fat with protein showed no significant relationship with risk of frailty among the low energy intake groups. Table 5 The relationship between the replacement of energy from macronutrients with other macronutrients and frail status 1), 2), 3) All < calculated EER Prefrail Frail Prefrail Frail OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Replacement of energy from carbohydrate with other macronutrients Protein for carbohydrate (1% of energy) 1.03 0.98–1.07 0.99 0.92–1.07 1.03 0.98–1.08 1.01 0.93–1.10 Protein for carbohydrate (5% of energy) 1.14 0.92–1.42 0.97 0.65–1.43 1.17 0.92–1.49 1.04 0.68–1.59 Protein for carbohydrate (10% of energy) 1.30 0.84–2.02 0.93 0.42–2.06 1.38 0.85–2.23 1.08 0.46–2.53 Fat for carbohydrate (1% of energy) 1.00 0.98–1.02 0.97 0.94–1.01 1.00 0.98–1.02 0.96* 0.92–1.00 Fat for carbohydrate (5% of energy) 1.01 0.92–1.11 0.87 0.72–1.05 0.99 0.88–1.10 0.79* 0.64–0.98 Fat for carbohydrate (10% of energy) 1.02 0.84–1.24 0.76 0.52–1.11 0.97 0.78–1.22 0.63* 0.41–0.97 Replacement of energy from fat with other macronutrients Protein for fat (1% of energy) 1.02 0.97–1.08 1.02 0.92–1.13 1.04 0.98–1.10 1.06 0.95–1.18 Protein for fat (5% of energy) 1.13 0.86–1.48 1.11 0.67–1.83 1.19 0.88–1.60 1.31 0.76–2.25 Protein for fat (10% of energy) 1.28 0.74–2.19 1.23 0.45–3.34 1.41 0.78–2.57 1.72 0.58–5.05 Carbohydrate for fat (1% of energy) 1.00 0.98–1.02 1.03 0.99–1.07 1.00 0.98–1.03 1.05* 1.00–1.09 Carbohydrate for fat (5% of energy) 0.99 0.90–1.09 1.15 0.95–1.39 1.01 0.91–1.13 1.26* 1.02–1.56 Carbohydrate for fat (10% of energy) 0.98 0.81–1.19 1.32 0.90–1.94 1.03 0.82–1.29 1.59* 1.03–2.43 Replacement of energy from protein with other macronutrients Carbohydrate for protein (1% of energy) 0.97 0.93–1.02 1.01 0.93–1.09 0.97 0.92–1.02 0.99 0.91–1.08 Carbohydrate for protein (5% of energy) 0.88 0.70–1.09 1.04 0.70–1.54 0.85 0.67–1.09 0.96 0.63–1.47 Carbohydrate for protein (10% of energy) 0.77 0.49–1.19 1.07 0.49–2.36 0.73 0.45–1.18 0.92 0.39–2.16 Fat for protein (1% of energy) 0.98 0.92–1.03 0.98 0.89–1.08 0.97 0.91–1.03 0.95 0.85–1.06 Fat for protein (5% of energy) 0.88 0.68–1.16 0.90 0.55–1.48 0.84 0.62–1.13 0.76 0.44–1.31 Fat for protein (10% of energy) 0.78 0.46–1.34 0.81 0.30–2.20 0.71 0.39–1.29 0.58 0.20–1.71 * p value < 0.005 1) Reference category: Robust. 2) Odds ratio and 95% confidence interval were obtained by the multinomial logistic regression analysis. 3) Models were adjusted for macronutrients, age, sex, education attainment, house income, living alone or with partner, hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, physical activity, total energy. Discussion In this study comprising community-dwelling older-aged people, our findings show that the risk of frailty was positively related to the high level of energy intake from carbohydrates (>65% energy). Particularly, for the group with low energy intake, we found that a high energy intake from carbohydrates was related to an increased prevalence of frailty, whereas high energy intake from fat was related to a decreased prevalence in multivariate nutrient density models. The Fried frailty phenotype includes the components for assessing physical abilities, which are related to muscle mass and strength [ 7 ]. Muscle protein is regulated and metabolized depending on the intake of protein and amino acids [ 46 , 47 ]. Studies on the relationship between protein intake and the prevalence of frailty have been conducted considering protein intake as the main nutritional factor, but inconsistent results have been obtained [ 12 – 24 ]. In the present study, high protein intake was related to a lower prevalence of frailty, but this was not significant after adjusting for total energy. This finding is consistent with the results from the study on the relationship between protein intake and grip strength in Korean elderly women, in which total protein intake had a positive relationship with grip strength, but no significant results were found after adjusting for energy [ 33 ]. A lower protein effect after energy adjustment may partially indicate the relationship between energy intake and frailty [ 18 , 21 , 48 ]. Previous studies have suggested that low energy intake is positively related to the prevalence of frailty [ 20 , 21 ]. Several studies have shown a 5–17.9% prevalence of anorexia in the elderly [ 49 , 50 ]. Anorexia has been known to occur owing to various causes, such as reduction of PA, decrease in mastication function, increased levels of cholecystokinin and leptin hormones, decrease in digestive function, and drug intake, which leads to decreased nutritional intake [ 35 , 36 ]. Therefore, it may be important to determine the intake levels associated with the prevalence of frailty in older adults with low energy intake. In this study, the relationship between the level of macronutrient intake and the prevalence of frailty was different depending on whether the energy intake criteria were met or not. In the group with insufficient energy intake, high energy intake from carbohydrates showed a positive relationship with the prevalence of frailty, which was significant even after adjusting for total energy. In the present study, high energy intake from carbohydrates was positively associated with the prevalence of frailty. Previous studies have reported the carbohydrate intake effect on chronic disease and mortality [ 30 , 31 , 51 , 52 ]. The Atherosclerosis Risk in Communities study reported a U-shaped association between energy intake from carbohydrates and mortality as well as a significantly lower risk of death, particularly with a carbohydrate energy intake of 50–55% [ 51 ]. A meta-analysis of 432,179 people from different countries (e.g., the US, Sweden, Japan, and Greece) has also shown a U-shaped association between energy intake from carbohydrates and mortality (energy from carbohydrates of 70%, OR = 1.23, 95% CI = 1.11–1.36) [ 51 ]. The Prospective Urban Rural Epidemiology (PURE) study found that high carbohydrate energy intake was associated with an increased risk of death, but no significant association with hypertension prevalence was found [ 52 ]. High carbohydrate intake was associated with low LDL cholesterol but was also associated with low HDL cholesterol, high triglyceride levels, and an increase in the apo B/apo A1 ratio, which is known to be a strong predictor of myocardial infarction [ 53 ]. High carbohydrate intake was also associated with elevated inflammatory responses in the skeletal muscle [ 54 ], increased insulin resistance [ 55 ], mitochondrial damage in the muscle cells [ 56 ], and chronic low levels of inflammation that contribute to sarcopenia [ 57 ]. Frailty has been reported to be associated with higher oxidative stress and lower antioxidant markers in the body [ 21 , 58 , 59 ]. Low energy intake might reflect low overall nutrient intake [ 34 ]. In this study, the high prevalence of frailty in elderly subjects with low energy intake and high carbohydrate intake may be due to their poor diet quality, accompanying the low intake of antioxidant nutrients. Higher scores on the Alternate Mediterranean Diet, the Dietary Approaches to Stop Hypertension (DASH) diet, and the alternate Healthy Eating Index-2010 were reported to be associated with a lower risk of frailty in the Nurses’ Health Study (relative risk [RR] = 0.87, 95% CI = 0.85–0.90; RR = 0.93, 95% CI = 0.91–0.95; RR = 0.90, 95% CI = 0.88–0.92, respectively) [ 60 ]. Another study on men has shown that the highest quintiles of the alternative Healthy Eating Index, Mediterranean diet score, and DASH score were associated with 40%, 46%, and 43% lower rates of frailty, respectively, compared with the lowest quintile [ 61 ]. These data suggest that the quality of diet might be related to physical frailty. We found that frailty was decreased when carbohydrates were exchanged for fat in the low energy intake group. A previous meta-analysis showed the negative association between the substitution of carbohydrate with protein or fat and mortality [ 51 ]. The risk of mortality was different according to food source; substituting the carbohydrate with plant-based protein or fat was negatively associated with mortality (hazard ratio [HR] = 0.82, 95% CI = 0·78–0·87) and replacing the carbohydrates with animal-based protein or fat were positively associated with mortality (HR = 1·18, 95% CI = 1·08–1·29) [ 51 ]. These results suggest that it may be appropriate to recommend the intake of plant-based proteins or fats instead of carbohydrates. In the present study, the proportion of energy from fat in subjects with low energy intake was 13% for energy and below the lowest AMDR for fat. The PURE study represented that the highest quintile of total fat (median = 35.3%) was associated with less risk of total mortality when compared with the lowest quintile (median = 10.6%) and the highest intake of saturated fat, monounsaturated fat, and polyunsaturated fat was related to less risk of total mortality [ 52 ]. However, in a cross-sectional study of 4,724 people aged 50 years and older who participated in the US National Health and Nutrition Examination Survey, consuming more than 20% of energy from saturated fatty acids was associated with higher morbidity and mortality [ 62 ]. Therefore, the type of fat as well as the energy intake from fat within the AMDR should be considered in preventing frailty. However, our study has some limitations. First, this is a cross-sectional study, so causality between dietary intake and frailty may not be verified. Second, a single 1-day 24-h recall may not be representative of the usual intake. However, the within-person variances of the energy and macronutrients have shown to be relatively low among the elderly [ 63 , 64 ]. Future studies will be needed to clarify the relationship between macronutrient intake and frailty by using the repeated 24-h recall survey and prospective longitudinal data. Third, this study population included ambulatory older adults who lived near the center. Our results could not be fully representative of the older adults in Korea. Fourth, in this study, we were unable to gather information on the subtypes of dietary fat associated with physical frailty because no nutrient database for each subtype of fat was available. Since the health effects of intake levels according to dietary fat subtypes are different, studies suggesting the appropriate types of fats are needed. Fifth, in this study, the statistical test for subjects who consumed the recommended energy level was limited because of the small sample size. Therefore, the analysis of the relationship between energy and macronutrients and the prevalence of frailty in these subjects could not be performed. Nevertheless, our study has shown that the intake levels of carbohydrates and fats may be important factors in preventing the risk of frailty in older adults with low energy intake. Conclusions In this study, we found that the inappropriate proportion of energy from carbohydrates and fat was related to a higher prevalence of frailty in the elderly with low energy intake. It was also indicated that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor in reducing the risk of frailty, as well as protein as previously emphasized. Declarations Ethics approval and consent to participate This study was performed in accordance with the Declaration of Helsinki, and it was approved by the Institutional Review Board of Dankook University, Hanyang University and Kyung Hee University. Written informed consent was obtained from all participants. Consent for publication Not Applicable. Availability of data and materials Data are available upon reasonable request. All published articles and news articles using the KFACS database, data provision manuals and contact information are available at the KFACS website ( http://www.kfacs.kr ). The KFACS cohort database and blood samples are available to researchers, and the authors anticipate collaboration even with international researchers, although approval from the Kyung Hee University Hospital IRB is required to share the dataset or banked blood samples for all the researchers. Competing interests The authors declare that they have no competing interests. Funding This research was supported by a grant from the Korea Health Technology R&D Project through the Korean Health Industry Development Institute, which is funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI15C3153), and funded by the National Research Foundation (NRF) of Korea (grant number: R-2021-00894). Authors’ contributions KK conceived and designed the study. MKK & YL acquired data. 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OUP USA 2013. https://books.google.co.kr/books?id=UKs3VaEtNukC Coelho-Junior HJ, Marzetti E, Picca A, et al. Protein Intake and Frailty: A Matter of Quantity, Quality, and Timing. Nutrients 2020; 12 . doi:10.3390/nu12102915 Atherton PJ, Etheridge T, Watt PW, et al. Muscle full effect after oral protein: time-dependent concordance and discordance between human muscle protein synthesis and mTORC1 signaling. Am J Clin Nutr 2010; 92 :1080–8. doi:10.3945/ajcn.2010.29819 Schoufour JD, Franco OH, Kiefte-De Jong JC, et al. The association between dietary protein intake, energy intake and physical frailty: Results from the Rotterdam Study. Br J Nutr 2019; 121 :393–401. doi:10.1017/S0007114518003367 Donini LM, Poggiogalle E, Piredda M, et al. Anorexia and eating patterns in the elderly. PLoS One 2013; 8 :e63539. doi:10.1371/journal.pone.0063539 Tsutsumimoto K, Doi T, Nakakubo S, et al. Association between anorexia of ageing and sarcopenia among Japanese older adults. J Cachexia Sarcopenia Muscle 2020; 11 :1250–7. doi:10.1002/jcsm.12571 Seidelmann SB, Claggett B, Cheng S, et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Heal 2018; 3 :e419–28. doi:10.1016/S2468-2667(18)30135-X Dehghan M, Mente A, Zhang X, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017; 390 :2050–62. doi:10.1016/S0140-6736(17)32252-3 Hoogeveen RC, Gaubatz JW, Sun W, et al. Small dense low-density lipoprotein-cholesterol concentrations predict risk for coronary heart disease: the Atherosclerosis Risk In Communities (ARIC) study. Arterioscler Thromb Vasc Biol 2014; 34 :1069–77. doi:10.1161/ATVBAHA.114.303284 Antunes MM, Godoy G, de Almeida-Souza CB, et al. A high-carbohydrate diet induces greater inflammation than a high-fat diet in mouse skeletal muscle. Brazilian J Med Biol Res = Rev Bras Pesqui medicas e Biol 2020; 53 :e9039. doi:10.1590/1414-431X20199039 Barazzoni R, Zanetti M, Cappellari GG, et al. Fatty acids acutely enhance insulin-induced oxidative stress and cause insulin resistance by increasing mitochondrial reactive oxygen species (ROS) generation and nuclear factor-κB inhibitor (IκB)-nuclear factor-κB (NFκB) activation in rat muscle, in the . Diabetologia 2012; 55 :773–82. doi:10.1007/s00125-011-2396-x Elkalaf M, Anděl M, Trnka J. Low Glucose but Not Galactose Enhances Oxidative Mitochondrial Metabolism in C2C12 Myoblasts and Myotubes. PLoS One 2013; 8 :2–9. doi:10.1371/journal.pone.0070772 Beyer I, Mets T, Bautmans I. Chronic low-grade inflammation and age-related sarcopenia. Curr Opin Clin Nutr Metab Care 2012; 15 :12–22. doi:10.1097/MCO.0b013e32834dd297 Soysal P, Isik AT, Carvalho AF, et al. Oxidative stress and frailty: A systematic review and synthesis of the best evidence. Maturitas 2017; 99 :66–72. doi:10.1016/j.maturitas.2017.01.006 Das A, Cumming RG, Naganathan V, et al. Prospective Associations Between Dietary Antioxidant Intake and Frailty in Older Australian Men: The Concord Health and Ageing in Men Project. Journals Gerontol Ser A 2020; 75 :348–56. doi:10.1093/gerona/glz054 Struijk EA, Hagan KA, Fung TT, et al. Diet quality and risk of frailty among older women in the Nurses’ Health Study. Am J Clin Nutr 2020; 111 :877–83. doi:10.1093/ajcn/nqaa028 Ward RE, Orkaby AR, Chen J, et al. Association between Diet Quality and Frailty Prevalence in the Physicians’ Health Study. J Am Geriatr Soc 2020; 68 :770–6. doi:10.1111/jgs.16286 Jayanama K, Theou O, Godin J, et al. Association of fatty acid consumption with frailty and mortality among middle-aged and older adults. Nutrition 2020; 70 :110610. doi:https://doi.org/10.1016/j.nut.2019.110610 Rossato SL, Fuchs SC. Diet Data Collected Using 48-h Dietary Recall: Within—and Between-Person Variation . Front. Nutr. . 2021; 8 :361.https://www.frontiersin.org/article/10.3389/fnut.2021.667031 Tokudome Y, Imaeda N, Nagaya T, et al. Daily, Weekly, Seasonal, Within- and Between-individual Variation in Nutrient Intake According to Four Season Consecutive 7 Day Weighed Diet Records in Japanese Female Dietitians. J Epidemiol 2002; 12 :85–92. doi:10.2188/jea.12.85 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1164783","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":73770970,"identity":"39319c2d-a465-452c-a03a-62e9da460d60","order_by":0,"name":"Narae Yang","email":"","orcid":"","institution":"Dankook University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Narae","middleName":"","lastName":"Yang","suffix":""},{"id":73770971,"identity":"9c942922-6ea5-4616-a737-124473affcff","order_by":1,"name":"Yunhwan Lee","email":"","orcid":"","institution":"Ajou University School of Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yunhwan","middleName":"","lastName":"Lee","suffix":""},{"id":73770972,"identity":"7ba8c168-beac-4290-8ed0-0160b529d9c3","order_by":2,"name":"Mi Kyung Kim","email":"","orcid":"","institution":"Hanyang University College of Medicine","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mi","middleName":"Kyung","lastName":"Kim","suffix":""},{"id":73770973,"identity":"8054ce05-8ce2-407a-992a-4c9ed5e48166","order_by":3,"name":"Kirang Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYBACCWYwlcDDwN5gwMBwACgCFjhAjBaeA8RqgVAJQFYCkVok23kffi74lSajO/Pxxs8FZ2zkJBuYH35gOHMPpxZpZnZj6Zl9OTxmt9OKpWfcSDOWZmAzlmC4UYxTixwzG4M0b08FUEuOgTTPh8OJ8xgYzBgYPiTg08L8G6zl5hnj3xAt7N/wapFmZmOT5vkBdNgNHjNpnhuHE2cz8ABtuYFbi2QzG5s1b0Maj9mZtDJrnjNpxpLNPMUSCWdwa5E4f4z5Ns+fZHuz44c33+Y5ZiMncbx944cPx3BrAQPGNmQeKHIJaACCPwRVjIJRMApGwUgGAKH6Ts+v51ZyAAAAAElFTkSuQmCC","orcid":"","institution":"Dankook University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Kirang","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2021-12-13 01:59:05","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1164783/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1164783/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":20206132,"identity":"ac523ed1-f587-4b2c-920b-f4272c3969d1","added_by":"auto","created_at":"2022-04-11 17:29:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":452315,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1164783/v1/b9737a97-a047-40b9-832b-e418da5eede2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eThe Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eLife expectancy has been steadily increasing [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It is estimated to be 65.2 years for those born in 2000 and 71.9 years for those born in 2016 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, the healthy life expectancy (HALE) without disability for those born in 2016 is 64.6 years, indicating a gap between life expectancy and HALE [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The gap between life expectancy and HALE means an unhealthy survival period, and closing this gap has recently become a global goal [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Since mobility and disability are factors that affect life satisfaction and quality of life, it is necessary to manage these factors to increase HALE [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe state of reduced reserve capacity and vulnerability to stress can be defined as frailty, which has been reported to be related to a high risk of falls, hospitalization, disability, and death [\u003cspan additionalcitationids=\"CR6 CR7\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Nutritional, physical, and medical interventions could prevent or delay the deterioration of physiological function related to physical frailty [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Moreover, even in the already frail state, it is possible to recover to the prefrail stage depending on the intervention and nutritional intake level [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], so the need for intervention is emphasized at all stages of prevention, delay, and recovery of physical frailty in the elderly.\u003c/p\u003e \u003cp\u003eSince the Fried frailty index examines the physical functions, such as muscle strength [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], previous research has mainly focused on protein as a nutritional factor related to frailty [\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In a multicenter cross-sectional study conducted on 2,108 elderly people living in a community in Japan, higher protein intake was negatively related to frailty prevalence [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The relationship between relative protein intake and frailty has also been investigated in other studies, for example, 1 g/kg body weight (BW) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and 1.1 g/kg BW [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] were related to low prevalence of frailty.\u003c/p\u003e \u003cp\u003eThe Korean Nutrition Society recommends a total protein intake of 55 g for men and 45 g for women or 0.91 g/kg for individuals aged \u0026ge;65 years, which is established as the minimum amount of protein that an adult should consume to maintain nitrogen balance. However, the recommended protein intake (0.91 g/kg BW) is the minimum value for maintaining nitrogen balance in adults and does not reflect the metabolic characteristics of older adults, so consuming at least 1.0 g/kg of protein has been recommended [\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and 1.2 g/kg BW is also proposed by the Korean Geriatrics Society and the Korean Nutrition Society to prevent sarcopenia [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHowever, inconsistent results have been found regarding the relationship between protein intake and frailty and muscle strength [\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Moreover, insufficient energy intake leads to a decrease in protein synthesis even if amino acids are adequately provided. Therefore, a sufficient energy intake is an important nutritional factor in the prevention of frailty [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The study have also reported that low energy intake increased the risk of frailty, but discrepancies of the results also exist [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCarbohydrate intake is positively related to the prevalence of metabolic syndrome and diabetes [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], and since these chronic diseases are factors influencing the prevalence of frailty, not only protein but also carbohydrates and fats should be considered integrally. Studies have shown that the Korean elderly population consumed more than the acceptable macronutrient distribution range (AMDR) in carbohydrate energy consumption [\u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Therefore, understanding the high carbohydrate diet affecting frailty in the elderly is crucial.\u003c/p\u003e \u003cp\u003eTo our knowledge, only a few studies have investigated the relationship between high carbohydrate diet and frailty. Furthermore, the elderly is at risk of low energy and food intake due to anorexia of aging, chronic diseases, decreased physical activity, and decreased masticatory function [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], but these characteristics of the elderly are not considered, and simply high intake levels of quantity tend to be recommended to prevent frailty [\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. However, additional information is necessary to confirm the intake level of macronutrients related to the prevalence of frailty in subjects with low energy intake. Therefore, the aim of this study is to identify energy and macronutrient intake level that may be related to the frailty status among the older adults who tended to have a high energy intake from carbohydrates in Korea.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv class=\"Section2\" id=\"Sec3\"\u003e\n \u003ch2\u003eStudy population\u003c/h2\u003e\n \u003cp\u003eData were retrieved from the baseline surveys of the Korean Frailty and Aging Cohort Survey (KFACS), which were conducted from May to November 2016 [\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e]. KFACS enrolled 1,559 Korean community-dwelling elderly people aged 70 to 84 years. The participants were recruited according to age- and gender-specific strata, and the surveys were conducted across eight university-affiliated hospitals and two public health centers. Out of 1,559 individuals, 1,002 attended the nutrition sub-cohort. Forty-eight participants were excluded from the analysis, especially those with an energy intake under 400 kcal (n = 2), and the missing values for the components of frailty (n = 46) were also excluded. The final analytical sample included 954 subjects. This study was performed in accordance with the Declaration of Helsinki, and it was approved by the Institutional Review Board of Dankook University, Hanyang University, and Kyung Hee University. Written informed consent was obtained from all participants.\u003c/p\u003e\n\u003c/div\u003e\n\u003ch2\u003eGeneral characteristics\u003c/h2\u003e\n\u003cp\u003eInformation on age, sex, educational attainment, house income, living situation (living alone or not), physician-diagnosed chronic disease (hypertension, dyslipidemia, or type 2 diabetes), number of prescription drugs, chewing status, and smoking status was obtained after face-to-face interviews. Height and weight were measured by a trained staff. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m\u003csup\u003e2\u003c/sup\u003e). BMI was categorized as underweight (\u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e), normal weight (\u0026ge;18.5 to \u0026lt;23 kg/m\u003csup\u003e2\u003c/sup\u003e), overweight (\u0026ge;23 to \u0026lt;25 kg/m\u003csup\u003e2\u003c/sup\u003e), and obese (\u0026ge;25 kg/m\u003csup\u003e2\u003c/sup\u003e) according to the Asia-Pacific classification of BMI [\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e].\u003c/p\u003e\n\u003ch2\u003eDefinition of frailty\u003c/h2\u003e\n\u003cp\u003eWe used a modified version of the Fried frailty phenotype [\u003cspan class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e], which has the following five components: unintended weight loss, weakness (poor grip strength), self-assessed exhaustion, slow walking speed, and low physical activity. Weakness was measured using a hand dynamometer (Takei TKK 5401, Takei Scientific Instruments, Tokyo, Japan). The grip strength of each hand was measured, and the measurement was repeated after 3 min; the highest value among the averages of each measurement was used for analysis. Exhaustion was assessed using the Center for Epidemiological Studies-Depression scale. Walking speed was measured while walking 4 m at a normal rhythm. Physical activity was measured using the International Physical Activity Questionnaire\u0026ndash;Short Form (Korean version) [\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e]. Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows the information of components and criteria for adding 1 point. The frailty scores ranged from 0 to 5, and frailty status was categorized as robust (0), prefrail (1\u0026ndash;2), and frail (3\u0026ndash;5).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable border=\"1\" id=\"Tab1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eFried frailty index and criteria for adding 1 point.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eComponents\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eCriteria for adding 1 point\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnintended\u0026nbsp;weight loss [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnintended weight loss of 4.5 kg or more in the last year\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWeakness [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGrip strength lower than 26 kg for men and lower than 18 kg for women\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eExhaustion [\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u0026ldquo;I felt that everything I did was an effort\u0026rdquo; or \u0026ldquo;I could not get going\u0026rdquo; was yes for three or more days in a week\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSlow walking speed [\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWalking speed below 1 m/s after\u003c/p\u003e\n \u003cp\u003ewalking 4 m at a normal rhythm\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLow physical activity [\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMetabolic equivalent of task in minutes per week (MET-min/week) was below 494.65 kcal for men and below 283.50 kcal for women\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eDietary intake assessment\u003c/h2\u003e\n\u003cp\u003eThe interviewers were trained with the standardized protocol for the 24-h recall method. Interviews were conducted based on home visiting, and visual aids, which were developed by the Korea Disease Control and Prevention Agency, were used to estimate the quantity of the food consumed during a day. Nutrient intake was calculated using the 24-h recall dietary assessment system of the National Institute of Health and the Korea Disease Control and Prevention Agency [\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e].\u003c/p\u003e\n\u003ch2\u003eTotal energy and macronutrient intake\u003c/h2\u003e\n\u003cp\u003eTotal energy was calculated as the sum of carbohydrate (4 kcal * g/d), protein (4 kcal * g/d), and fat (9 kcal * g/d) kcal. Carbohydrates, protein, and fat were expressed as the percentage of energy to evaluate the adequacy of macronutrient intake using the AMDR (carbohydrate, 55\u0026ndash;65%; protein, 7\u0026ndash;20%; fat, 15\u0026ndash;30%) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e]. The participants were categorized by the AMDR of each macronutrient.\u003c/p\u003e\n\u003cp\u003eThe estimated energy requirement (EER) was calculated using the formula for estimating the energy requirements suggested by the Dietary Reference Intakes for Koreans {men: 662 \u0026minus; 9.53 \u0026times; age + value of physical activity level (PA) [15.91 \u0026times; weight (kg) + 539.6 \u0026times; height (m)]; women: 354 \u0026minus; 6.91 \u0026times; age + PA [9.36 \u0026times; weight+ 726 \u0026times; height (m)]}. The PA value was determined for all subjects to be 1.11 for men and 1.12 for women in consideration of the PA from the International PA Questionnaire [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e]. Energy intake was dichotomized at the cut-off point of EER.\u003c/p\u003e\n\u003cp\u003eThe relationship of protein intake with the prevalence of prefrailty and frailty was identified using four types of cutoffs: (1) AMDR (7\u0026ndash;20% of energy from protein) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e], (2) the age- and gender-specific recommended nutrient intake (RNI) (elder men, 55 g/d; elder women, 45 g/d) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e], (3) the RNI cut-off for dietary protein (0.91 g/kg BW/d) [\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e], and (4) cut-off suggested by the Korean Geriatrics Society and the Korean Nutrition Society for the prevention of sarcopenia (1.2 g/kg BW/d) [\u003cspan class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\n\u003ch2\u003eBlood tests\u003c/h2\u003e\n\u003cp\u003eBlood samples were taken after an 8-h fast and were brought to a commercial laboratory. The serum levels of triglycerides, HDL cholesterol, LDL cholesterol, FBS, HbA1c, and hs-CRP were measured.\u003c/p\u003e\n\u003cdiv class=\"Section2\" id=\"Sec9\"\u003e\n \u003ch2\u003eStatistical analysis\u003c/h2\u003e\n \u003cp\u003eEnergy intake (kcal/d, 100 kcal/d) and each macronutrient intake (g/d, 10 g/d, % from energy, kcal/d, and 100 kcal/d) were used as continuous variables, and energy and macronutrient cutoffs were used as categorical variables. Categorical variables were presented as n (%), whereas continuous variables were presented as means \u0026plusmn; standard deviations or means \u0026plusmn; standard errors. P-values for the differences in frail status were obtained using a chi-square test or Fisher\u0026rsquo;s exact test for qualitative variables or analysis of variance for continuous variables. The differences among the groups were determined using the Scheff\u0026eacute; post hoc test.\u003c/p\u003e\n \u003cp\u003eThe p-values for differences between the frail status were obtained using the Cochran\u0026ndash;Mantel\u0026ndash;Haenszel test for qualitative variables or the general linear model for continuous variables. Values were adjusted for age and sex.\u003c/p\u003e\n \u003cp\u003eAdjusted multinomial logistic regression analysis was conducted to compare the energy and macronutrient intake of frail and prefrail older adults with those of the robust older adults. We tried to confirm the relationship between the prevalence of frail status and sufficient energy intake, but because of the small number of subjects with sufficient energy intake, irregularities appeared in the Hessian matrix, and the validity was uncertain, so those with sufficient energy intake were excluded from the multinomial logistic regression analysis. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were derived, after adjusting for age, sex, education attainment, house income, living situation (alone or not), hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, and PA in Model 1. Model 2 was adjusted for Model 1 covariates and total energy.\u003c/p\u003e\n \u003cp\u003eMultivariate nutrient density models were conducted to examine the relationship between macronutrients and frailty status in total subjects as well as subjects who consumed the unmet intake with the standard energy intake criteria. Detailed information on the multivariate nutrient density models is available elsewhere [\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e]. Briefly, in logistic regression analysis, total energy intake and macronutrient of interest were included as independent variables, and frail status was included as a dependent variable. With the total energy intake adjusted, the increase in the energy of the macronutrient of interest can be interpreted as a decrease in the iso-energy of other nutrients not included in the model. For example, to examine the substitution of fat with carbohydrates, the model includes carbohydrates, protein, total energy intake, and covariates but excludes fat. The OR for carbohydrates represents substituting fat with the same energy from carbohydrates. All statistical analyses were conducted using the IBM SPSS Statistics 25.0 Program (IBM SPSS INC, Armonk) and were tested at a P-value below 0.05.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 1,002 participants recruited to KFACS, 954 (95%) had complete data for all the variables of interest. Table 2 shows the relationship between the aspects of general characteristics and frailty status. The participants had an average age of 76.3 years (70\u0026ndash;84). The proportion of women was 51.7%, of which 10.9% were frail and 50.2% prefrail. After adjusting for age and sex, frail older adults were less educated, had low income, and presented with a high prevalence of physician-diagnosed hypertension. Frail older adults also had lower HDL cholesterol and marginally higher triglyceride levels. The proportion of polypharmacy and chewing discomfort according to frail status were significantly different, showing a higher proportion in frail older adults. The level of PA was lower in frail older adults than in prefrail and robust older adults.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eThe relationship between the aspects of general characteristics and frailty status\u003csup\u003e 1)\u003c/sup\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eRobust\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003ep\u003c/span\u003e\u003csup\u003e\u003cspan class=\"BoldItalic\"\u003e2)\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003ep\u003c/span\u003e\u003csup\u003e\u003cspan class=\"BoldItalic\"\u003e3)\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=371)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=479)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=104)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAge (year)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e76.3 \u0026plusmn; 3.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e75.5 \u0026plusmn; 3.7\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e76.4 \u0026plusmn; 3.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e78.7 \u0026plusmn; 3.8\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSex, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e461(48.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e232(61.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e202(42.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27(26.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eWomen\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e493(51.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e147(38.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e269(57.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e77(74.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEducational attainment, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026le; 6 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e436(45.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e121(32.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e229(48.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e86(82.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 7 years\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e517(54.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e257(68.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e242(51.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18(17.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHouse income (per a month), n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUnknown\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e80(8.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24(6.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41(8.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15(14.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;1 million won\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e388(40.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e123(32.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e198(42.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e67(64.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1-2 million\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e218(22.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e88(23.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e118(25.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12(11.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 2 million\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e268(28.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e144(38.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e114(24.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e10(9.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eLiving alone or living with partner, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving alone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e245(25.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e73(19.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e133(28.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e39(37.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.691\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLiving with partner\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e709(74.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e306(80.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e338(71.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65(62.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e), n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;18.5, underweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e16(1.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6(1.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e8(1.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2(1.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.999\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.862\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e18.5-22.9, normal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e285(29.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e109(28.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e145(30.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31(29.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23-24.9, overweight\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e251(26.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e107(28.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e114(24.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e30(28.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 25, obese\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e402(42.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e157(41.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e204(43.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41(39.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDisease (Yes)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHypertension, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e566(59.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e190(50.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e302(64.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e74(71.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDyslipidemia, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e294(30.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e110(29.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e153(32.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31(29.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.502\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eType 2 diabetes, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e216(22.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e77(20.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e110(23.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29(28.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.224\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.165\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal cholesterol (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e171.6 \u0026plusmn; 1.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e173 \u0026plusmn; 1.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e170.2 \u0026plusmn; 1.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e172.7 \u0026plusmn; 3.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.481\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.107\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTriglyceride (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e122.2 \u0026plusmn; 2.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e118.4 \u0026plusmn; 3.1\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e121.9 \u0026plusmn; 2.7\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e137.4 \u0026plusmn; 7.7\u003csup\u003ebc\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.022\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.055\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHDL-cholesterol (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51.4 \u0026plusmn; 0.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52.2 \u0026plusmn; 0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51 \u0026plusmn; 0.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50.1 \u0026plusmn; 1.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.289\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.032\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLDL-cholesterol (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e107.9 \u0026plusmn; 1.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e109 \u0026plusmn; 1.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e106.8 \u0026plusmn; 1.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e108.4 \u0026plusmn; 3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.606\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.289\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFBS (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104.3 \u0026plusmn; 21.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104.6 \u0026plusmn; 21.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104.1 \u0026plusmn; 20.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e104.4 \u0026plusmn; 23.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.942\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.919\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHbA1c (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.0 \u0026plusmn; 0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.0 \u0026plusmn; 0.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6.1 \u0026plusmn; 0.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.9 \u0026plusmn; 0.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.235\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.202\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ehs-CRP (mg/dL)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.3 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.3 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.3 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.1 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.583\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.811\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eNumber of prescription drugs, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e458(48.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e150(39.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e243(52.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e65(63.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026le; 3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e491(51.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e229(60.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e224(48.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e38(36.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChewing status, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUncomfortable\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e376(39.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e108(28.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e209(44.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e59(57.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eComfortable(moderate)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e577(60.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e271(71.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e262(55.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e44(42.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAlcohol (g/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e29.7 \u0026plusmn; 4.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43.8 \u0026plusmn; 7.8\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e23.3 \u0026plusmn; 5.6\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7.1 \u0026plusmn; 3.8\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.012\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.518\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSmoking status, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEveryday\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e44(4.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e15(4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22(4.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7(6.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.747\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.141\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSometimes\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3(0.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1(0.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2(0.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e897(95.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e359(95.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e441(94.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97(93.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePhysical activity\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e458.1 \u0026plusmn; 21.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e592.3 \u0026plusmn; 42.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e414.4 \u0026plusmn; 25.6\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e166.6 \u0026plusmn; 34.4\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.003\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"7\" align=\"left\"\u003e\n\u003cp\u003e1) Qualitative variables are presented as n (%), continuous variables are presented as means \u0026plusmn; standard deviations or means \u0026plusmn; standard errors.\u0026nbsp;2)\u0026nbsp;p-values for differences between the frail status were obtained by a chi-square test or fisher\u0026rsquo;s exact test for qualitative variables, or by ANOVA for continuous variables, superscript letters were significantly different among the groups by\u0026nbsp;Scheffѐ post hoc test\u0026nbsp;3) Values were adjusted for age and sex, p-values for differences between the frail status were obtained by the\u0026nbsp;Cochran-Mantel-Haenszel\u0026nbsp;test for qualitative variables, or by GLM for continuous variables\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e shows the macronutrient intake of the participants according to frail status and level of energy intake. In all participants, those who were frail had, on average, lower energy intake and lower carbohydrate, protein, and fat intake than those who were prefrail and robust. Regarding the percentage of energy from macronutrients, frail participants had higher energy intake from carbohydrates and lower energy intake from protein and fat than those who were prefrail or robust. The prevalence of frailty was significantly high in participants with high energy intake from carbohydrates (\u0026gt;65%) and low energy intake from fat (\u0026lt;15%). A similar relationship was observed in subjects who consumed less than the EER, but not in subjects who consumed energy adequately.\u003c/p\u003e\n\u003ctable border=\"1\"\u003e\u003ccaption\u003e\n\u003cp\u003eTable 3\u003c/p\u003e\n\u003cp\u003eThe macronutrient intake of the participants according to frail status and level of energy intake\u003csup\u003e1)\u003c/sup\u003e\u003c/p\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"3\" width=\"11%\"\u003e\n\u003cp\u003e \u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"5\" width=\"27%\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"5\" width=\"32%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026gt;= Calculated EER\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"6\" width=\"29%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lt; Calculated EER\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"2\" width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eRobust\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" width=\"4%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003csup\u003e2)\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e\u003cstrong\u003eRobust\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003csup\u003e2)\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" rowspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eRobust\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd rowspan=\"2\" width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003csup\u003e2)\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=371)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=479)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=104)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=81)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=87)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=13)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=298)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=384)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e(n=91)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eEnergy (kcal/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1461.4 \u0026plusmn; 16.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1566.0 \u0026plusmn; 26.7\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1439.4 \u0026plusmn; 22.6\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1179.1 \u0026plusmn; 43.8\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e2174.2 \u0026plusmn; 34.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e2270.2 \u0026plusmn; 51.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e2124.9 \u0026plusmn; 50.3\u003csup\u003eab\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1906.1 \u0026plusmn; 78.3\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.012\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e1294.4 \u0026plusmn; 12.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1374.6 \u0026plusmn; 19.6\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1284.1 \u0026plusmn; 17.4\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1075.2 \u0026plusmn; 37.8c\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eCarbohydrate (g/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e248.5 \u0026plusmn; 2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e263.0 \u0026plusmn; 4.6\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e244.4 \u0026plusmn; 3.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e213.9 \u0026plusmn; 7.8\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e361.8 \u0026plusmn; 6.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e375.5 \u0026plusmn; 10.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e354.9 \u0026plusmn; 8.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e322.4 \u0026plusmn; 17.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.067\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e221.9 \u0026plusmn; 2.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e232.4 \u0026plusmn; 3.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e219.4 \u0026plusmn; 3.2\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e198.4 \u0026plusmn; 7.2c\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eProtein (g/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e54.4 \u0026plusmn; 0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e59.0 \u0026plusmn; 1.3\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e53.7 \u0026plusmn; 1.1\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e41.1 \u0026plusmn; 2.0\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e79.8 \u0026plusmn; 2.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e84.6 \u0026plusmn; 3.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e77.2 \u0026plusmn; 3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e67.9 \u0026plusmn; 7.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.064\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e48.5 \u0026plusmn; 0.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e52 \u0026plusmn; 1.1\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e48.3 \u0026plusmn; 0.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e37.2 \u0026plusmn; 1.8c\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eFat (g/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e27.8 \u0026plusmn; 0.6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e30.9 \u0026plusmn; 1.0\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e27.5 \u0026plusmn; 0.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e17.7 \u0026plusmn; 1.3\u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e45.3 \u0026plusmn; 1.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e47.8 \u0026plusmn; 2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e44.1 \u0026plusmn; 2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e38.3 \u0026plusmn; 5.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.384\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e23.7 \u0026plusmn; 0.5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e26.3 \u0026plusmn; 0.9\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e23.7 \u0026plusmn; 0.8\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.8 \u0026plusmn; 1b\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eEnergy from carbohydrate (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68.8 \u0026plusmn; 0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e67.9 \u0026plusmn; 0.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68.5 \u0026plusmn; 0.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e73.3 \u0026plusmn; 0.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e67 \u0026plusmn; 0.8\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e66.5 \u0026plusmn; 1.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e67.3 \u0026plusmn; 1.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68 \u0026plusmn; 3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.836\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e69.2 \u0026plusmn; 0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68.2 \u0026plusmn; 0.6\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68.8 \u0026plusmn; 0.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e74.1 \u0026plusmn; 0.9\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eEnergy from protein (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.8 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e15.0 \u0026plusmn; 0.2\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.9 \u0026plusmn; 0.2\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e13.7 \u0026plusmn; 0.3\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.6 \u0026plusmn; 0.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e14.8 \u0026plusmn; 0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.4 \u0026plusmn; 0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e14.1 \u0026plusmn; 1.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.652\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e14.9 \u0026plusmn; 0.1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e15 \u0026plusmn; 0.2\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e15 \u0026plusmn; 0.2\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e13.7 \u0026plusmn; 0.3\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.006\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eEnergy from fat (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e16.4 \u0026plusmn; 0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e17.2 \u0026plusmn; 0.4\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e16.6 \u0026plusmn; 0.4\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e13.0 \u0026plusmn; 0.7\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e18.4 \u0026plusmn; 0.7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e18.7 \u0026plusmn; 1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e18.2 \u0026plusmn; 1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e17.9 \u0026plusmn; 2.2\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.931\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e15.9 \u0026plusmn; 0.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e16.7 \u0026plusmn; 0.5\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e16.2 \u0026plusmn; 0.4\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e12.3 \u0026plusmn; 0.7\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eEnergy intake cut-off, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;Calculated EER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e773(81.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e298(78.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e384(81.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e91(87.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.115\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e-\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" width=\"16%\"\u003e\n\u003cp\u003eAMDR for carbohydrate (%), n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;55\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e92(9.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e45(11.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e42(8.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e5(4.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e29(16.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e13(16.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e13(14.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e3(23.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.922\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e63(8.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e32(10.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e29(7.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e2(2.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;55-65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e214(22.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e87(23.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e117(24.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e10(9.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e38(21.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e16(19.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e20(23.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e2(15.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e176(22.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e71(23.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e97(25.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e8(8.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge; 65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e648(67.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e247(65.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e312(66.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e89(85.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e114(63.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e52(64.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e54(62.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e8(61.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e534(69.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e195(65.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e258(67.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e81(89.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eProtein intake cut-off, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;age- and gender- specific RNI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e453(47.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e165(43.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e212(45.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e76(73.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e11(6.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e5(6.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e3(3.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e3(23.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.035\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e442(57.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e160(53.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e209(54.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e73(80.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt; 0.91 g/kg\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e554(58.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e203(53.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e274(58.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e77(74.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e17(9.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e7(8.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e8(9.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e2(15.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.739\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e537(69.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e196(65.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e266(69.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e75(82.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.010\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;1.2 g/kg\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e783(82.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e293(77.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e395(83.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e95(91.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68(37.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e27(33.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e34(39.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e7(53.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.337\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e715(92.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e266(89.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e361(94.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e88(96.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.018\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eAMDR for protein (%), n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;7\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(0.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(0.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.571\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(0.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e1(1.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.433\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.401\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;7-20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e881(92.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e348(91.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e434(92.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e99(95.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e171(94.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e75(92.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e84(96.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e12(92.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e710(91.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e273(91.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e350(91.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e87(95.6)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge; 20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e72(7.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e30(7.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e37(7.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e5(4.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e9(5.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e5(6.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e3(3.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(7.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e63(8.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e25(8.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e34(8.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e4(4.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003eAMDR for fat (%), n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026lt;\u0026nbsp;15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e456(47.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e170(44.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e221(46.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e65(62.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e0.007\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e73(40.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e33(40.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e35(40.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e5(38.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.624\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e383(49.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e137(46.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e186(48.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e60(65.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0.010\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;15-30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e430(45.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e176(46.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e216(45.9)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e38(36.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e84(46.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e36(44.4)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e40(46.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e8(61.5)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e346(44.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e140(47.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e176(45.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e30(33.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd width=\"11%\"\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026ge; 30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e68(7.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e33(8.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e34(7.2)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(1.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"4%\"\u003e\n\u003cp\u003e\u003cem\u003e \u003c/em\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e24(13.3)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"6%\"\u003e\n\u003cp\u003e12(14.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e12(13.8)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e0(0.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e \u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" width=\"8%\"\u003e\n\u003cp\u003e44(5.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e21(7.0)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e22(5.7)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e1(1.1)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd width=\"5%\"\u003e\n\u003cp\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"17\" width=\"100%\"\u003e\n\u003cp\u003e1) Qualitative variables are presented as n (%), continuous variables are presented as means \u0026plusmn; standard errors. 2) p-values for differences between the frail status were obtained by a chi-square test or fisher\u0026rsquo;s exact test for qualitative variables, or by ANOVA for continuous variables, superscript letters were significantly different among the groups by\u0026nbsp;Scheffѐ post hoc test\u0026nbsp;3) Values were adjusted for age and sex, p-values for differences between the frail status were obtained by the\u0026nbsp;Cochran- Mantel-Haenszel\u0026nbsp;test for qualitative variables, or by GLM for continuous variables\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 4 shows the adjusted multinomial logistic regression models comparing the nutrient intakes for frail and prefrail subjects with those for the robust subjects comprising the reference group. In the entire study population, energy and macronutrients were related to the risk of frailty, but after adjusting for energy intake in Model 2, most of these relationships were no longer significant. In the participants with low energy intake, relationships of macronutrients with physical frailty were still significant, even after adjusting for energy. In Model 2, the risk of frailty per 10 g increase in carbohydrates (OR =1.14, 95% CI = 1.02\u0026ndash;1.27) and per 100 kcal increase from carbohydrates (OR = 1.38, 95% CI = 1.05\u0026ndash;1.80) increased significantly. The risk of frailty decreased with the increase in the same amount of fat (OR = 0.67, 95% CI = 0.50\u0026ndash;0.91) and energy from fat (OR = 0.64, 95% CI = 0.46\u0026ndash;0.90). In the same model, the increase in protein intake and energy intake from protein did not show a significant relationship with physical frailty, but the recommended protein intake in consideration of sex and age showed a positive relationship with the prevalence of prefrailty. Notably, in both groups of subjects with low energy intake (OR = 2.94, 95% CI = 1.34\u0026ndash;6.45) and total subjects (OR = 2.01, 95% CI = 1.03\u0026ndash;3.93), consuming carbohydrates above the AMDR (65% of energy) was related to a higher risk of frailty, even after adjusting for energy.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eThe relationship between the nutrient intakes and frail status\u003csup\u003e1), 2)\u003c/sup\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd rowspan=\"4\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"8\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eAll\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"8\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lt; calculated EER\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eModel 1\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e3)\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eModel 2\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e4)\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eModel 1\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e3)\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eModel 2\u003c/strong\u003e\u003csup\u003e\u003cstrong\u003e4)\u003c/strong\u003e\u003c/sup\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003eOR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"BoldItalic\"\u003e(95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnergy (100kcal/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.96\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u0026ndash;0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.82\u0026ndash;0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate (per 10 g/day)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u0026ndash;1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u0026ndash;1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.95\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.96\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u0026ndash;1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u0026ndash;1.27\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein (per 10 g/day)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u0026ndash;0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u0026ndash;1.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.74\u0026ndash;1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u0026ndash;1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.67\u0026ndash;0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.69\u0026ndash;1.19\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat (per 10 g/day)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.66\u0026ndash;1.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u0026ndash;1.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.49\u0026ndash;0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u0026ndash;1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.67\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.50\u0026ndash;0.91\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate energy (100kcal/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u0026ndash;1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u0026ndash;1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.95\u0026ndash;1.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u0026ndash;1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.83\u0026ndash;1.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u0026ndash;1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.05\u0026ndash;1.80\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein energy (100kcal/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.84\u0026ndash;1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u0026ndash;1.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.47\u0026ndash;1.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.79\u0026ndash;1.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.37\u0026ndash;0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.82\u0026ndash;1.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.78\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.39\u0026ndash;1.54\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat energy (100kcal/d)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.74\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.60\u0026ndash;0.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u0026ndash;1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.45\u0026ndash;0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u0026ndash;1.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnergy intake cut-off, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; Calculated EER\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;1.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.70\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.34\u0026ndash;1.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ndash;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnergy from carbohydrate cut-off (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;55 (vs \u0026ge; 55)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.53\u0026ndash;1.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.19\u0026ndash;1.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.54\u0026ndash;1.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.61\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.21\u0026ndash;1.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.41\u0026ndash;1.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.05\u0026ndash;1.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.41\u0026ndash;1.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.05\u0026ndash;1.14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 65 (vs \u0026lt; 65)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.64\u0026ndash;1.20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.12\u0026ndash;4.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.62\u0026ndash;1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u0026ndash;3.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.68\u0026ndash;1.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.45\u0026ndash;6.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.66\u0026ndash;1.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.34\u0026ndash;6.45\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein intake cut-off, n (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; age- and gender- specific RNI\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u0026ndash;1.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.30\u0026ndash;0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.47\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u0026ndash;2.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.36\u0026ndash;1.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u0026ndash;1.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.29\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u0026ndash;2.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.37\u0026ndash;1.67\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 0.91 g/kg\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.77\u0026ndash;1.40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.77\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.44\u0026ndash;1.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.82\u0026ndash;1.69\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.68\u0026ndash;2.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.77\u0026ndash;1.55\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.45\u0026ndash;1.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u0026ndash;1.78\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.45\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.66\u0026ndash;3.17\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 1.2 g/kg\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.58\u0026ndash;1.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.24\u0026ndash;1.21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.56\u0026ndash;1.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.37\u0026ndash;2.37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.39\u0026ndash;1.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.17\u0026ndash;2.51\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.40\u0026ndash;1.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.23\u0026ndash;3.69\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEnergy from fat cut-off (%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026nbsp;15 (vs \u0026ge; 15)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;1.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.74\u0026ndash;2.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.61\u0026ndash;1.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.65\u0026ndash;1.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.65\u0026ndash;1.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u0026ndash;2.62\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;1.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u0026ndash;2.40\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026ge; 30 (vs \u0026lt; 30)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.56\u0026ndash;1.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.03\u0026ndash;1.75\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.58\u0026ndash;1.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.03\u0026ndash;1.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;1.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.04\u0026ndash;2.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.89\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;1.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.04\u0026ndash;2.38\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"17\" align=\"left\"\u003e\n\u003cp\u003e1) Reference category: Robust. 2) Odds ratio and 95% confidence interval were obtained by the multinomial logistic regression analysis. 3) Model 1 was adjusted for age, sex, education attainment, house income, living alone or with partner, hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, physical activity. 4) Model 2 was adjusted for Model 1 covariates and total energy.\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e shows the relationship between the replacement of energy from macronutrients with other macronutrients and frail status. For the group with low energy intake, replacing energy from carbohydrates with energy from fat was negatively related to the prevalence of frailty (1%, OR = 0.96, 95% CI = 0.92\u0026ndash;1.00; 5%, OR = 0.79, 95% CI = 0.64\u0026ndash;0.98; 10%, OR = 0.63, 95% CI = 0.41\u0026ndash;0.97). Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05 95% CI = 1.00\u0026ndash;1.09; 5%, OR = 1.26, 95% CI = 1.02\u0026ndash;1.56; 10%, OR = 1.59, 95% CI = 1.03\u0026ndash;2.43). However, substituting the energy from carbohydrates or fat with protein showed no significant relationship with risk of frailty among the low energy intake groups.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tabb\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cp\u003eTable 5\u003c/p\u003e\n\u003cp\u003eThe relationship between the replacement of energy from macronutrients with other macronutrients and frail status\u003csup\u003e 1), 2), 3)\u003c/sup\u003e\u003c/p\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003eAll\u003c/p\u003e\n\u003c/th\u003e\n\u003cth colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt; calculated EER\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003ePrefrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eFrail\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"5\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReplacement of energy from carbohydrate with other macronutrients\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for carbohydrate (1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.10\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for carbohydrate (5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.42\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.65\u0026ndash;1.43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.68\u0026ndash;1.59\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for carbohydrate (10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.84\u0026ndash;2.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.42\u0026ndash;2.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u0026ndash;2.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;2.53\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for carbohydrate (1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.94\u0026ndash;1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.96*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for carbohydrate (5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.87\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.72\u0026ndash;1.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u0026ndash;1.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.79*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.64\u0026ndash;0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for carbohydrate (10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.84\u0026ndash;1.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.52\u0026ndash;1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.78\u0026ndash;1.22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.41\u0026ndash;0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReplacement of energy from fat with other macronutrients\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for fat\u0026nbsp;(1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u0026ndash;1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.10\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.95\u0026ndash;1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for fat\u0026nbsp;(5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.86\u0026ndash;1.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.67\u0026ndash;1.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u0026ndash;1.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.76\u0026ndash;2.25\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eProtein for fat\u0026nbsp;(10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.74\u0026ndash;2.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.23\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.45\u0026ndash;3.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.78\u0026ndash;2.57\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.72\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.58\u0026ndash;5.05\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for fat (1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u0026ndash;1.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u0026ndash;1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.05*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.00\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for fat (5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.90\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.15\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.95\u0026ndash;1.39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u0026ndash;1.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.26*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.02\u0026ndash;1.56\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for fat (10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u0026ndash;1.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.90\u0026ndash;1.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.82\u0026ndash;1.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.59*\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.03\u0026ndash;2.43\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"4\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eReplacement of energy from protein with other macronutrients\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for protein (1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.01\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.93\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.02\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.99\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u0026ndash;1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for protein (5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.70\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.04\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.70\u0026ndash;1.54\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.67\u0026ndash;1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.96\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.63\u0026ndash;1.47\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCarbohydrate for protein (10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.77\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.49\u0026ndash;1.19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.07\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.49\u0026ndash;2.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.73\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.45\u0026ndash;1.18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.39\u0026ndash;2.16\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for protein\u0026nbsp;(1% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.92\u0026ndash;1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.89\u0026ndash;1.08\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.97\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.91\u0026ndash;1.03\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.95\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.85\u0026ndash;1.06\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for protein\u0026nbsp;(5% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.88\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.68\u0026ndash;1.16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.90\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.55\u0026ndash;1.48\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.84\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.62\u0026ndash;1.13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.76\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.44\u0026ndash;1.31\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eFat for protein\u0026nbsp;(10% of energy)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.78\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.46\u0026ndash;1.34\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.81\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.30\u0026ndash;2.20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.71\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.39\u0026ndash;1.29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.20\u0026ndash;1.71\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"9\" align=\"left\"\u003e\n\u003cp\u003e* p value \u0026lt; 0.005 1) Reference category: Robust. 2) Odds ratio and 95% confidence interval were obtained by the multinomial logistic regression analysis. 3) Models were adjusted for macronutrients, age, sex, education attainment, house income, living alone or with partner, hypertension, triglyceride, number of prescription drugs, chewing status, alcohol, physical activity, total energy.\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study comprising community-dwelling older-aged people, our findings show that the risk of frailty was positively related to the high level of energy intake from carbohydrates (\u0026gt;65% energy). Particularly, for the group with low energy intake, we found that a high energy intake from carbohydrates was related to an increased prevalence of frailty, whereas high energy intake from fat was related to a decreased prevalence in multivariate nutrient density models.\u003c/p\u003e \u003cp\u003eThe Fried frailty phenotype includes the components for assessing physical abilities, which are related to muscle mass and strength [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Muscle protein is regulated and metabolized depending on the intake of protein and amino acids [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Studies on the relationship between protein intake and the prevalence of frailty have been conducted considering protein intake as the main nutritional factor, but inconsistent results have been obtained [\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In the present study, high protein intake was related to a lower prevalence of frailty, but this was not significant after adjusting for total energy. This finding is consistent with the results from the study on the relationship between protein intake and grip strength in Korean elderly women, in which total protein intake had a positive relationship with grip strength, but no significant results were found after adjusting for energy [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. A lower protein effect after energy adjustment may partially indicate the relationship between energy intake and frailty [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Previous studies have suggested that low energy intake is positively related to the prevalence of frailty [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies have shown a 5\u0026ndash;17.9% prevalence of anorexia in the elderly [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Anorexia has been known to occur owing to various causes, such as reduction of PA, decrease in mastication function, increased levels of cholecystokinin and leptin hormones, decrease in digestive function, and drug intake, which leads to decreased nutritional intake [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Therefore, it may be important to determine the intake levels associated with the prevalence of frailty in older adults with low energy intake. In this study, the relationship between the level of macronutrient intake and the prevalence of frailty was different depending on whether the energy intake criteria were met or not. In the group with insufficient energy intake, high energy intake from carbohydrates showed a positive relationship with the prevalence of frailty, which was significant even after adjusting for total energy.\u003c/p\u003e \u003cp\u003eIn the present study, high energy intake from carbohydrates was positively associated with the prevalence of frailty. Previous studies have reported the carbohydrate intake effect on chronic disease and mortality [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. The Atherosclerosis Risk in Communities study reported a U-shaped association between energy intake from carbohydrates and mortality as well as a significantly lower risk of death, particularly with a carbohydrate energy intake of 50\u0026ndash;55% [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. A meta-analysis of 432,179 people from different countries (e.g., the US, Sweden, Japan, and Greece) has also shown a U-shaped association between energy intake from carbohydrates and mortality (energy from carbohydrates of \u0026lt;40%, OR = 1.20, 95% CI = 1.09\u0026ndash;1.32; energy from carbohydrates \u0026gt;70%, OR = 1.23, 95% CI = 1.11\u0026ndash;1.36) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. The Prospective Urban Rural Epidemiology (PURE) study found that high carbohydrate energy intake was associated with an increased risk of death, but no significant association with hypertension prevalence was found [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. High carbohydrate intake was associated with low LDL cholesterol but was also associated with low HDL cholesterol, high triglyceride levels, and an increase in the apo B/apo A1 ratio, which is known to be a strong predictor of myocardial infarction [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. High carbohydrate intake was also associated with elevated inflammatory responses in the skeletal muscle [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e], increased insulin resistance [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e], mitochondrial damage in the muscle cells [\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], and chronic low levels of inflammation that contribute to sarcopenia [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFrailty has been reported to be associated with higher oxidative stress and lower antioxidant markers in the body [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Low energy intake might reflect low overall nutrient intake [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. In this study, the high prevalence of frailty in elderly subjects with low energy intake and high carbohydrate intake may be due to their poor diet quality, accompanying the low intake of antioxidant nutrients. Higher scores on the Alternate Mediterranean Diet, the Dietary Approaches to Stop Hypertension (DASH) diet, and the alternate Healthy Eating Index-2010 were reported to be associated with a lower risk of frailty in the Nurses\u0026rsquo; Health Study (relative risk [RR] = 0.87, 95% CI = 0.85\u0026ndash;0.90; RR = 0.93, 95% CI = 0.91\u0026ndash;0.95; RR = 0.90, 95% CI = 0.88\u0026ndash;0.92, respectively) [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. Another study on men has shown that the highest quintiles of the alternative Healthy Eating Index, Mediterranean diet score, and DASH score were associated with 40%, 46%, and 43% lower rates of frailty, respectively, compared with the lowest quintile [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. These data suggest that the quality of diet might be related to physical frailty.\u003c/p\u003e \u003cp\u003eWe found that frailty was decreased when carbohydrates were exchanged for fat in the low energy intake group. A previous meta-analysis showed the negative association between the substitution of carbohydrate with protein or fat and mortality [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. The risk of mortality was different according to food source; substituting the carbohydrate with plant-based protein or fat was negatively associated with mortality (hazard ratio [HR] = 0.82, 95% CI = 0\u0026middot;78\u0026ndash;0\u0026middot;87) and replacing the carbohydrates with animal-based protein or fat were positively associated with mortality (HR = 1\u0026middot;18, 95% CI = 1\u0026middot;08\u0026ndash;1\u0026middot;29) [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. These results suggest that it may be appropriate to recommend the intake of plant-based proteins or fats instead of carbohydrates. In the present study, the proportion of energy from fat in subjects with low energy intake was 13% for energy and below the lowest AMDR for fat. The PURE study represented that the highest quintile of total fat (median = 35.3%) was associated with less risk of total mortality when compared with the lowest quintile (median = 10.6%) and the highest intake of saturated fat, monounsaturated fat, and polyunsaturated fat was related to less risk of total mortality [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. However, in a cross-sectional study of 4,724 people aged 50 years and older who participated in the US National Health and Nutrition Examination Survey, consuming more than 20% of energy from saturated fatty acids was associated with higher morbidity and mortality [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]. Therefore, the type of fat as well as the energy intake from fat within the AMDR should be considered in preventing frailty.\u003c/p\u003e \u003cp\u003eHowever, our study has some limitations. First, this is a cross-sectional study, so causality between dietary intake and frailty may not be verified. Second, a single 1-day 24-h recall may not be representative of the usual intake. However, the within-person variances of the energy and macronutrients have shown to be relatively low among the elderly [\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. Future studies will be needed to clarify the relationship between macronutrient intake and frailty by using the repeated 24-h recall survey and prospective longitudinal data. Third, this study population included ambulatory older adults who lived near the center. Our results could not be fully representative of the older adults in Korea. Fourth, in this study, we were unable to gather information on the subtypes of dietary fat associated with physical frailty because no nutrient database for each subtype of fat was available. Since the health effects of intake levels according to dietary fat subtypes are different, studies suggesting the appropriate types of fats are needed. Fifth, in this study, the statistical test for subjects who consumed the recommended energy level was limited because of the small sample size. Therefore, the analysis of the relationship between energy and macronutrients and the prevalence of frailty in these subjects could not be performed. Nevertheless, our study has shown that the intake levels of carbohydrates and fats may be important factors in preventing the risk of frailty in older adults with low energy intake.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn this study, we found that the inappropriate proportion of energy from carbohydrates and fat was related to a higher prevalence of frailty in the elderly with low energy intake. It was also indicated that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor in reducing the risk of frailty, as well as protein as previously emphasized.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the Declaration of Helsinki, and it was approved by the Institutional Review Board of Dankook University, Hanyang University and Kyung Hee University. Written informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData are available upon reasonable request. All published articles and news articles using the KFACS database, data provision manuals and contact information are available at the KFACS website (\u003ca href=\"http://www.kfacs.kr/\"\u003ehttp://www.kfacs.kr\u003c/a\u003e). The KFACS cohort database and blood samples are available to researchers, and the authors anticipate collaboration even with international researchers, although approval from the Kyung Hee University Hospital IRB is required to share the dataset or banked blood samples for all the researchers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by a grant from the Korea Health Technology R\u0026amp;D Project through the Korean Health Industry Development Institute, which is funded by the Ministry of Health \u0026amp; Welfare, Republic of Korea (grant number: HI15C3153), and funded by the National Research Foundation (NRF) of Korea (grant number: R-2021-00894).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKK conceived and designed the study. MKK \u0026amp; YL acquired data. NY \u0026amp; KK analyzed and interpreted the data. NY wrote the first draft of the manuscript. MKK \u0026amp; YL provided critical comments for important intellectual content and approved the final submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to the study participants and the staff of the Korean Frailty and Aging Cohort Study for their cooperation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWorld Health Organization. Healthy life expectancy (HALE) Data by country. https://apps.who.int/gho/data/view.main.HALEXv?lang=en (accessed 21 Apr 2021)\u003c/li\u003e\n \u003cli\u003eUnited Nations. 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Nutr. . 2021;\u003cstrong\u003e8\u003c/strong\u003e:361.https://www.frontiersin.org/article/10.3389/fnut.2021.667031\u003c/li\u003e\n \u003cli\u003eTokudome Y, Imaeda N, Nagaya T, \u003cem\u003eet al.\u003c/em\u003e Daily, Weekly, Seasonal, Within- and Between-individual Variation in Nutrient Intake According to Four Season Consecutive 7 Day Weighed Diet Records in Japanese Female Dietitians. \u003cem\u003eJ Epidemiol\u003c/em\u003e 2002;\u003cstrong\u003e12\u003c/strong\u003e:85\u0026ndash;92. doi:10.2188/jea.12.85\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"frailty, macronutrients, carbohydrates, protein, fat, older adults","lastPublishedDoi":"10.21203/rs.3.rs-1164783/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1164783/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: The relationship between macronutrients and frailty is unclear. Previous studies have confirmed the relationships between energy and protein intake and physical frailty, while few studies have examined the role of carbohydrate or fat intake in the prevalence of frailty. The aim of this study is to investigate the relationship of energy and macronutrients with physical frailty in the Korean elderly population who had a high proportion of energy intake from carbohydrates.\u003c/p\u003e\u003cp\u003eMethods: This study included 954 adults aged 70 to 84 years who have completed the assessment of frailty and 24-h recall upon enrolment in the Korean Frailty and Aging Cohort Study and have no extreme intake under 400 kcal (n = 2). The relationship between energy or macronutrients and frailty was evaluated using multivariate logistic regression models and multivariate nutrient density models.\u003c/p\u003e\u003cp\u003eResults: In the subjects with low energy intake (odds ratio [OR] = 2.94, 95% confidence interval [CI] = 1.34–6.45) and total subjects (OR = 2.01, 95% CI = 1.03–3.93), consuming carbohydrates above the acceptable macronutrient distribution range (65% of energy) was related to a higher risk of frailty. Substituting the energy from fat with carbohydrates was related to a higher risk of frailty (1%, OR = 1.05, 95% CI = 1.00–1.09; 5%, OR = 1.26, 95% CI = 1.02–1.56; 10%, OR = 1.59, 95% CI = 1.03–2.43).\u003c/p\u003e\u003cp\u003eConclusions: This study showed that the proportion of energy intake from carbohydrates and fats may be an important nutritional intervention factor for reducing the risk of frailty.\u003c/p\u003e","manuscriptTitle":"The Impact of High Carbohydrate Intake on Physical Frailty in Older Korean Adults: a Cohort-based Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-01-05 22:30:35","doi":"10.21203/rs.3.rs-1164783/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"01bc2a32-652a-4b4c-97ec-370b0bcf6735","owner":[],"postedDate":"January 5th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":9528809,"name":"Geriatrics \u0026 Gerontology"}],"tags":[],"updatedAt":"2022-04-11T17:29:19+00:00","versionOfRecord":[],"versionCreatedAt":"2022-01-05 22:30:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1164783","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1164783","identity":"rs-1164783","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}