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Lin Y, Cao X, Zhu H, Chen X. Association of dietary inflammatory index, composite dietary antioxidant index, and frailty in elderly adults with diabetes. Eur J Med Res 2024; 29:480. [PMID: 39354551 PMCID: PMC11446060 DOI: 10.1186/s40001-024-02083-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 09/24/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND We aimed to examine the relationship of 2 dietary scores [dietary inflammatory index (DII) and composite dietary antioxidant index (CDAI)] with frailty in elderly adults with diabetes. METHODS Data were gathered from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. The frailty index was calculated using 49 deficits across various systems to define frailty. To examine the relationship of 2 dietary scores (DII and CDAI) with frailty in elderly adults with diabetes, multiple logistic regression analyses were performed. In logistic regression model, DII and CDAI were calculated as both continuous and tertiles. Subgroup analyses were performed to demonstrate stability of results. Restricted cubic splines were utilized to examine the non-linear correlations. RESULTS A total of 2,795 elderly adults with diabetes were included in this study. In the multivariate logistic regression model, the odds ratio (OR) of DII for risk of frailty was 1.08 (95% CI 1.02-1.15) and the OR of CDAI for risk of frailty was 0.96 (95% CI 0.93-0.99). The ORs of DII for risk of frailty were 1.36 (95% CI 1.09-1.70) and 1.33 (95% CI 1.04-1.70) for tertiles 2 and 3, respectively (p for trend 0.027). The ORs of CDAI for risk of frailty were 0.94 (95% CI 0.75-1.17) and 0.75 (95% CI 0.58-0.98) for tertiles 2 and 3, respectively (p for trend 0.036). The subgroup analysis demonstrated reliable and enduring connections between 2 dietary scores and frailty (all p for interaction > 0.05). In the restricted cubic spline analyses, we discovered the non-linear relationship between DII and frailty (P for nonlinearity = 0.045) and linear relationship between CDAI and frailty (P for nonlinearity = 0.769). CONCLUSION The research showed connections between 2 dietary scores (DII and CDAI) and frailty as measured by frailty index in elderly adults with diabetes.
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Affiliation(s)
- Yi Lin
- Department of Endocrinology, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou, China
| | - Xiaohua Cao
- Department of Endocrinology, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou, China
| | - Haihui Zhu
- Department of Endocrinology, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou, China
| | - Xiyi Chen
- Department of Cardiovascular and Thoracic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
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Jung S, Lee Y, Kim K, Park S. Association of the dietary inflammatory index with sarcopenic obesity and frailty in older adults. BMC Geriatr 2024; 24:654. [PMID: 39097690 PMCID: PMC11297761 DOI: 10.1186/s12877-024-05239-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 07/23/2024] [Indexed: 08/05/2024] Open
Abstract
OBJECTIVES This study examined whether a higher dietary inflammatory index (DII®) is associated with the risk of sarcopenic obesity (SO) and frailty among Korean older adults. METHODS A total of 950 participants aged 70-84 years, who completed the baseline nutrition survey of the Korean Frailty and Aging Cohort Study, were included in the analysis. The DII, quantifying the dietary inflammatory potential, was calculated using 23 foods and nutrients as assessed by a 24-h dietary recall. SO was defined as the coexistence of sarcopenia (dual-energy X-ray absorptiometry-measured appendicular skeletal muscle mass index of < 7.0 for males; <5.4 for females) and abdominal obesity (waist circumference of ≥ 90 cm for males; ≥85 cm for females). Frailty status was assessed using the Fried frailty index (range, 0-5), a simple tool for defining frailty that consists of three or more of five frailty items. Multinomial logistic regression models were used to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for confounders. RESULTS The prevalence of SO and frailty was 9.8% and 10.8%, respectively. The DII was significantly higher in the frail group (2.7) compared to the robust and SO groups (2.0 vs. 1.8) (P < 0.001). Among nutrients and foods included in the DII, the frail group exhibited lower vitamin E, niacin, vitamin B6, energy, and protein intakes than the robust and SO groups. Multivariable-adjusted OR (95% CI) for frailty versus robust (comparing DII tertile 3 to tertile 1) was 2.3 (1.1-4.8; P-trend = 0.02). However, no significant association was observed between the DII and SO (OR, 1.1; 95% CI, 0.5-2.1; P-trend = 0.6). CONCLUSIONS A higher DII score was associated with increased odds of frailty but not with SO in Korean older adults, suggesting that proinflammatory diets have a greater impact on frailty than that on SO in the older population.
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Affiliation(s)
- Sukyoung Jung
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, South Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, South Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, 31116, South Korea.
| | - Sohyun Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Gangwon, 24252, South Korea.
- The Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea.
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Çalapkorur S, Bakır B, Toklu H, Akın S. The effect of the nutritional status and dietary inflammatory index on frailty and activities of daily living in geriatric outpatients. Ir J Med Sci 2024; 193:1671-1680. [PMID: 38127190 DOI: 10.1007/s11845-023-03595-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND It has been reported that the inflammatory process plays a role in the pathophysiology of frailty in elderly individuals and that diet is effective in regulating chronic inflammation. OBJECTIVE This study aims to evaluate the effects of nutritional status and dietary inflammatory index on frailty and activities of daily living in the elderly. METHOD A cross-sectional study in a hospital in Turkey has been carried out with 187 over the age of 65 who presented to the geriatric outpatient clinic participants. Anthropometric measurements of the patients were recorded, and the dietary inflammatory index (DII) was calculated using the 24-h dietary recall method. Mini Nutritional Assessment (MNA) was used to determine the malnutrition risk, the FRAIL scale was used for frailty assessment, and Katz and Lawton & Brody scales were used for daily living activities. RESULTS The mean age of the elderly is 70.83 ± 4.98 years. The frailty rate was determined to be 28.3%. The DII score was determined as 4.41 ± 5.16 in frail patients and 1.62 ± 4.39 in non-frail patients (p < 0.05). While DII showed a negative correlation with the Lawton & Brody scale score (r = - 0.353), MNA was positively correlated to the Katz score (r = 0.386, p = 0.000) and the Lawton & Brody score (r = 0.475). In addition, one-unit increase in the MNA score was associated with a 29% decrease in the risk of frailty. CONCLUSIONS The dietary inflammatory index was found to be high in frail and malnourished individuals. It was determined that the quality of life of individuals with malnutrition decreased.
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Affiliation(s)
- Sema Çalapkorur
- Nutrition and Dietetics Department, Erciyes University Health Science Faculty, Kayseri, Turkey.
| | - Buse Bakır
- Health Science Faculty, Nutrition and Dietetics Department, İzmir Katip Celebi University, İzmir, Turkey
| | - Hilal Toklu
- Nutrition and Dietetics Department, Erciyes University Health Science Faculty, Kayseri, Turkey
| | - Sibel Akın
- Faculty of Medicine, Department of Internal Medicine/Geriatrics, Erciyes University, Kayseri, Turkey
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Xia SF, Liu Y, Chen Y, Li ZY, Cheng L, He JY, Hang L, Maitiniyazi G, Cheng XX, Sun SR, Gu DF. Association between dietary inflammatory potential and frailty is mediated by inflammation among patients with colorectal cancer: A cross-sectional study. Nutr Res 2024; 125:79-90. [PMID: 38552503 DOI: 10.1016/j.nutres.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 06/01/2024]
Abstract
Patients with colorectal cancer (CRC) are at high risk of frailty, leading to reduced quality of life and survival. Diet is associated with frailty in the elderly through regulating inflammation. Thus, we hypothesized that dietary inflammatory potential (as assessed by dietary inflammatory index [DII]) might be associated with frailty in patients with CRC through regulating inflammatory biomarkers. A total of 231 patients with CRC were included in this cross-sectional study. Dietary intake was evaluated by 3-day, 24-hour dietary recalls, and frailty status was assessed in accordance with the Fried frailty criteria. Plasma inflammatory cytokines were determined in 126 blood samples. A total of 67 patients (29.0%) were frail, with significantly higher DII scores than nonfrail patients, accompanied with significantly increased interleukin-6 (IL-6) and decreased interleukin-10 (IL-10) concentrations. Each 1-point increase of DII was related to a 25.0% increased risk of frailty. IL-6 was positively correlated with frailty and DII, whereas IL-10 was negatively correlated. After adjusting for age, sex, body mass index, education level, smoking status, and energy, mediation analysis revealed that the association between DII and frailty was significantly mediated by IL-6 (average causal mediation effect [ACME], 0.052; 95% confidence interval, 0.020-0.087; P = .002) and IL-10 (ACME, 0.025; 95% confidence interval, 0.004-0.063; P = .016). The ρ values for the sensitivity measure at which estimated ACMEs were zero were 0.3 and -0.2 for IL-6 and IL-10, respectively. Therefore, a pro-inflammatory diet was associated with frailty in patients with CRC possibly in part by affecting circulating IL-6 and IL-10 concentrations.
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Affiliation(s)
- Shu-Fang Xia
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yue Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Zi-Yuan Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Lan Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jian-Yun He
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Ling Hang
- Department of Nursing, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | | | - Xin-Xin Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Shi-Ru Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Dan-Feng Gu
- Department of Nursing, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
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Li X, Wang Q, Ma T, Chang X, Xue Y, Zhang Y, Liu W, Zhang Y, Zhao Y. Dietary inflammatory index, dietary total antioxidant capacity, and frailty among older Chinese adults. J Nutr Health Aging 2024; 28:100168. [PMID: 38341967 DOI: 10.1016/j.jnha.2024.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/18/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Frailty is an age-related syndrome associated with poor health outcomes. Studies in developed countries indicate that the dietary inflammatory index (DII) and dietary total antioxidant capacity (DTAC) are important dietary factors influencing the risk of frailty in older adults. However, few studies have explored the association between DII, DTAC, and frailty among older Chinese adults. The objective of the current study was to examine whether DII and DTAC were associated with pre-frailty or frailty among older Chinese adults. DESIGN A cross-sectional study. SETTING Community-based. PARTICIPANTS We included 6414 participants aged ≥60 years. MEASUREMENTS Dietary intake was assessed using a validated food frequency questionnaire (FFQ). The DII and energy-adjusted DII (E-DII) were calculated using food parameters. DTAC was estimated using two widely adopted antioxidant scores: DTAC based on ferric reducing antioxidant power and dietary antioxidant quality score (DAQS) obtained from vitamins (vitamins A, C, and E) and minerals (zinc and selenium) with antioxidant functions. Frailty was assessed using the frailty index (FI) calculated from 28 health-related deficits. Individuals were classified as robust (FI ≤ 0.10), pre-frailty (FI > 0.10 to <0.25), or frailty (FI ≥ 0.25). Multiple logistic regression models were used to evaluate the associations of DII and DTAC with pre-frailty and frailty. RESULTS After adjusting for confounding factors, individuals in the highest DII quintile (Q5) were more likely to have pre-frailty (odds ratio [OR] = 1.56; 95% confidence interval [CI]: 1.25-1.93; P for trend <0.001) than those in the lowest Q1. A similar positive association was detected for E-DII and pre-frailty. A significant association was found between DII and frailty. Compared with the lowest Q1, the highest Q5 of DTAC was negatively correlated with pre-frailty (OR = 0.66; 95% CI: 0.52-0.84; P for trend <0.001) and frailty (OR = 0.71; 95% CI: 0.50-0.1.03; P for trend <0.001). The DAQS yielded results similar to pre-frailty results (OR = 0.72; 95% CI: 0.58-0.89; P < 0.001). There was no evidence suggesting an association between DAQS and frailty. CONCLUSIONS More proinflammatory diets were linked to higher pre-frailty risk, whereas higher levels of dietary antioxidants were associated with lower pre-frailty and frailty risk among older Chinese adults.
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Affiliation(s)
- Xiaoxia Li
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Qingan Wang
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Tao Ma
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Xiaoyu Chang
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Yixuan Xue
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Yadi Zhang
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Wanlu Liu
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China
| | - Yuhong Zhang
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China.
| | - Yi Zhao
- School of Public Health of Ningxia Medical University, Yinchuan 750004, China; NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, School of Public Health of Ningxia Medical University, Yinchuan 750004, China.
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Joo SH, Song JW, Shin K, Kim MJ, Lee J, Song YW. Knee osteoarthritis with a high grade of Kellgren-Lawrence score is associated with a worse frailty status, KNHANES 2010-2013. Sci Rep 2023; 13:19714. [PMID: 37953320 PMCID: PMC10641064 DOI: 10.1038/s41598-023-46558-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023] Open
Abstract
Frailty as a syndrome of physical decline in late life is associated with adverse health outcomes. Knee osteoarthritis (KOA) could contribute to frailty conditions. The objective of this study was to evaluate the impact of KOA on frailty risk in a Korean National Health and Nutrition Examination Survey (KNHANES) cohort. In this study (N, total = 11,910, age; 64.10 years old [63.94-64.27; mean 95% CI], sex (female, %); 6,752 (56.69)), KOA patients were defined as those with knee joint pain and grade 2 Kellgren-Lawrence (K-L) or more on plain radiographic images who were 40 years old or older in Korean population data of KNHANES. The frailty index was calculated using 46 items related to co-morbidities and laboratory parameters. The impact of KOA on frailty risk was evaluated with logistic regression analyses. The prevalence of KOA patients was 35.6% [95% CI 34.7-36.46]. In polytomous logistic regression, the relative risk ratio (RRR) of KOA was significantly increased in the pre-frail group (2.76, 95% CI 2.30-3.31) and the frail group (7.28, 95% CI 5.90-8.98). RRR of frailty was significantly increased in patients with K-L grade 3 (1.36, 95% CI 1.13-1.63) and K-L grade 4 (2.19, 95% CI 1.72-2.79). Older age, higher BMI, smoking status, alcohol intake, low-income status, higher WBC count, higher platelet count, higher serum creatinine level and low estimated GFR were significantly associated with increased frailty risk. High hemoglobin and regular walking habits were associated with decreased frailty risk in KOA patients. In this large observation population- based survey cohort, KOA is linked to an increased risk of frailty syndrome. We found a significant connection between KOA and frailty syndrome. These results show that we need to think about the overall health of people with KOA and give them special care to prevent frailty syndrome.
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Affiliation(s)
- Sang Hyun Joo
- Department of Internal Medicine, Daewoo General Hospital, Daewoo Medical Foundation, Geoje, Korea
- Department of Microbiology and Immunology, College of Medicine, Pusan National University, Yangsan, Korea
| | - Jin Woo Song
- Departement of Athletic Training, Gannon University, Erie, PA, USA
| | - Kichul Shin
- Division of Rheumatology, Biomedical Research Institute SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Min Jung Kim
- Division of Rheumatology, Biomedical Research Institute SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Joongyub Lee
- Department of Preventive Medicine, Seoul National University, Seoul, Korea
| | - Yeong Wook Song
- Medical Research Center, Institute of Human-Environment Interface Biology, Seoul National University, 103 Daehak-Ro, Iwha-Dong, Jongno-Gu, Seoul, Republic of Korea.
- Song Rheumatology Clinic, 2F, HiBro BLDG, 503, Teheran-Ro, Gangnam-Gu, Seoul, Republic of Korea.
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Kuczmarski MF, Beydoun MA, Georgescu MF, Noren Hooten N, Mode NA, Evans MK, Zonderman AB. Pro-Inflammatory Diets Are Associated with Frailty in an Urban Middle-Aged African American and White Cohort. Nutrients 2023; 15:4598. [PMID: 37960250 PMCID: PMC10648548 DOI: 10.3390/nu15214598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Diet quality is a modifiable risk factor for frailty, but research on the association of frailty with dietary inflammatory potential is limited. The objective was to determine associations between diet quality assessed by the dietary inflammatory index (DII) with frailty status over time. Participants with both dietary and frailty data from the longitudinal Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used (n = 2901, 43.5% male, 43.8% African American, 48.5 y mean baseline age, with a mean 8.7 y of follow-up). Group-based trajectory modeling identified two frailty (remaining non-frail or being pre-frail/frail over time) and three diet quality trajectory groups (high or medium pro-inflammatory and anti-inflammatory potentials). Multiple logistic regression found both medium pro-inflammatory and anti-inflammatory DII trajectory groups, compared to the high pro-inflammatory group, were positively associated with being non-frail over time for the overall sample, both sexes and races. Kaplan-Meier curves and log-rank test revealed anti-inflammatory DII scores were associated with lower risk for being pre-frail or frail. No longitudinal relationship existed between frailty status at baseline and annualized DII change, a check on reverse causality. This study contributes to our current knowledge providing longitudinal evidence of the link between anti-inflammatory DII score with lower frailty risk.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA; (M.A.B.); (M.F.G.); (N.N.H.); (N.A.M.); (M.K.E.); (A.B.Z.)
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Wong THT, George ES, Abbott G, Daly RM, Georgousopoulou EN, Tan SY. Nut and seed consumption is inversely associated with metabolic syndrome in females but not males: findings from the 2005-2018 NHANES data. Eur J Nutr 2023; 62:2415-2427. [PMID: 37115204 PMCID: PMC10421777 DOI: 10.1007/s00394-023-03157-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE To assess the association between nut and seed consumption, both combined and separately, and metabolic syndrome and its components, including fasting glucose, triglycerides, high-density lipoprotein (HDL) cholesterol, central obesity, and blood pressure. METHODS This cross-sectional analysis used data from 22,687 adults (aged ≥ 18 years) involved in seven cycles (2005-2018) of the National Health and Nutrition Examination Survey (NHANES). Habitual nut and seed intakes were estimated by the Multiple Source Method using data from two 24-h dietary recalls. Metabolic syndrome was ascertained using biochemical data and self-reported medication use. Sex-specific effect estimates were obtained using logistic and linear regressions adjusting for lifestyle and socioeconomic confounders. RESULTS Compared to non-consumers, female, but not male, habitual consumers of either nuts or seeds had lower odds of having metabolic syndrome (OR: 0.83, 95% CI 0.71, 0.97). Both nut intake alone and seed intake alone were inversely associated with high fasting glucose and low HDL-cholesterol in females compared to non-consumers. When restricted to habitual consumers only, the combined intake of nuts and seeds at 6 g/day was associated with the lowest triglycerides and highest HDL-cholesterol in females. Combined consumption of nuts and seeds up to one ounce-equivalent (15 g) per day, but not in higher intake levels, was inversely associated with metabolic syndrome, high fasting glucose, central obesity, and low HDL-cholesterol in females. CONCLUSIONS Nut and seed consumption, both separately or combined, below 15 g/day was inversely associated with metabolic syndrome and its component conditions in females but not males.
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Affiliation(s)
- Tommy H T Wong
- School of Public Health, Li Ka Shing, Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Elena S George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | | | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
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Martínez CF, Esposito S, Di Castelnuovo A, Costanzo S, Ruggiero E, De Curtis A, Persichillo M, Hébert JR, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Gialluisi A, Bonaccio M. Association between the Inflammatory Potential of the Diet and Biological Aging: A Cross-Sectional Analysis of 4510 Adults from the Moli-Sani Study Cohort. Nutrients 2023; 15:nu15061503. [PMID: 36986232 PMCID: PMC10056325 DOI: 10.3390/nu15061503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Chronological age (CA) may not accurately reflect the health status of an individual. Rather, biological age (BA) or hypothetical underlying "functional" age has been proposed as a relevant indicator of healthy aging. Observational studies have found that decelerated biological aging or Δage (BA-CA) is associated with a lower risk of disease and mortality. In general, CA is associated with low-grade inflammation, a condition linked to the risk of the incidence of disease and overall cause-specific mortality, and is modulated by diet. To address the hypothesis that diet-related inflammation is associated with Δage, a cross-sectional analysis of data from a sub-cohort from the Moli-sani Study (2005-2010, Italy) was performed. The inflammatory potential of the diet was measured using the Energy-adjusted Dietary Inflammatory Index (E-DIITM) and a novel literature-based dietary inflammation score (DIS). A deep neural network approach based on circulating biomarkers was used to compute BA, and the resulting Δage was fit as the dependent variable. In 4510 participants (men 52.0%), the mean of CA (SD) was 55.6 y (±11.6), BA 54.8 y (±8.6), and Δage -0.77 (±7.7). In a multivariable-adjusted analysis, an increase in E-DIITM and DIS scores led to an increase in Δage (β = 0.22; 95%CI 0.05, 0.38; β = 0.27; 95%CI 0.10, 0.44, respectively). We found interaction for DIS by sex and for E-DIITM by BMI. In conclusion, a pro-inflammatory diet is associated with accelerated biological aging, which likely leads to an increased long-term risk of inflammation-related diseases and mortality.
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Affiliation(s)
- Claudia F Martínez
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
- Population Health Research Center, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Simona Esposito
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | | | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Mariarosaria Persichillo
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
- Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, 21100 Varese-Como, Italy
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy
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10
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Sun M, Wang L, Wang X, Tong L, Fang J, Wang Y, Yang Y, Li B. Interaction between sleep quality and dietary inflammation on frailty: NHANES 2005-2008. Food Funct 2023; 14:1003-1010. [PMID: 36546877 DOI: 10.1039/d2fo01832b] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims: The underlying mechanism of both sleep disorders and frailty is chronic inflammation, which can be reflected by the dietary inflammatory index (DII). Therefore, we aimed to explore the association between sleep quality, frailty, and dietary inflammation. Methods: 9007 participants aged over 20 years from the National Health and Nutrition Examination Survey (NHANES) in 2005-2008 were involved in the study. Dietary inflammation was assessed by DII, sleep quality was assessed by the Pittsburgh sleep quality index (PSQI), and frailty was assessed by the 36-item frailty index (FI). Logistic regression, stratified analysis of sub-groups, and forest plots were used in this study. Results: Both pro-inflammatory diet and poor sleep quality were risk factors for frailty. There was an interaction between dietary inflammation and sleep quality (P-interaction = 0.003). Pro-inflammatory diet was associated with increased risk of frailty among the population with poor sleep quality. Compared with the anti-inflammatory diet and good sleep quality group, the OR of frailty was 1.44 (1.21, 1.73) and 2.16 (1.64, 2.80) for the anti-inflammatory diet and poor sleep quality and pro-inflammatory diet and poor sleep quality groups, respectively. Conclusion: There was an interaction between dietary inflammation and sleep quality on frailty. Anti-inflammatory diet may attenuate the detrimental impacts of poor sleep quality on frailty.
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Affiliation(s)
- Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Li Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Jiaxin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
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11
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Cao Y, Li P, Zhang Y, Qiu M, Li J, Ma S, Yan Y, Li Y, Han Y. Dietary Inflammatory Index and All-Cause Mortality in Older Adults with Hypertension: Results from NHANES. J Clin Med 2023; 12:jcm12020506. [PMID: 36675436 PMCID: PMC9864621 DOI: 10.3390/jcm12020506] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Both diet and inflammation are strongly associated with hypertension. However, the relationship between the dietary inflammatory index (DII) and the prognosis of hypertensive patients over 65 years of age is unclear. The objective of this study is to investigate the correlation between DII and all-cause mortality in older adults with hypertension. Data were obtained from the 2011−2018 National Health and Nutrition Examination Survey (NHANES) and followed for survival through December 31, 2019. DII was calculated by the 24 h dietary history interview. Cox proportional hazards models were used to investigate the associations. A total of 2531 participants were finally included. During a median follow-up of 4.33 years, 471 participants were determined as all-cause mortality. After adjusting for confounding factors, DII was positively correlated with the risk of all-cause mortality (HR = 1.08, 95% CI = 1.01−1.16). Compared with the anti-inflammatory diet group (DII < 0), the pro-inflammatory diet group (DII > 0) had a 54% increased risk of all-cause death (HR = 1.54, 95% CI = 1.13−2.10). The results were robust in subgroup and sensitivity analyses. DII was positively correlated with the all-cause mortality of elderly hypertensive patients. The results provided an aid to dietary evaluation in the nonpharmacologic management of hypertension.
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Affiliation(s)
- Yang Cao
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Pengxiao Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Yan Zhang
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Miaohan Qiu
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Jing Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Sicong Ma
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Yudong Yan
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Yi Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- Correspondence: (Y.L.); (Y.H.)
| | - Yaling Han
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- Correspondence: (Y.L.); (Y.H.)
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12
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Resciniti NV, Farina MP, Merchant AT, Lohman MC. Depressive Symptoms Partially Mediate the Association of Frailty Phenotype Symptoms and Cognition for Females but Not Males. J Aging Health 2023; 35:42-49. [PMID: 35527693 PMCID: PMC9640765 DOI: 10.1177/08982643221100688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We aimed to evaluate whether depressive symptoms mediated the relationship between frailty phenotype and cognitive function by sex. METHODS Data came from the Health and Retirement Study from 2012-2016. The outcome was measured by Fried's frailty criteria, our outcome was continuous global cognition, and mediator was depressive symptoms. We used mediation analysis, stratified by sex, to estimate the direct and indirect effects of frailty symptoms on cognition mediated by depressive symptoms. RESULTS Males had a larger total effect (β= -0.43; 95% CI: -0.66, -0.02) for lower cognitive score for each increase in frailty symptom compared to females (β= -0.28; 95% CI: -0.47, -0.08). A significant indirect effect from frailty phenotype to cognition was found through depressive symptoms for females but not males. CONCLUSION These results highlight the importance of identifying individuals with frailty and depressive symptoms to monitor and provide interventions to preserve cognitive function.
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Affiliation(s)
- Nicholas V. Resciniti
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Mateo P. Farina
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Anwar T. Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Matthew C. Lohman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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13
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The possible role of increased consumption of ultra-processed food products in the development of frailty: a threat for healthy ageing? Br J Nutr 2022; 128:461-466. [PMID: 34503590 DOI: 10.1017/s0007114521003470] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Frailty, a multifactorial ageing-related syndrome characterised by reduced resistance to stressors and possibly associated with low-grade systemic inflammation, results in negative health outcomes and compromises healthy ageing. There is a growing body of evidence on the relationship between dietary habits, low-grade systemic inflammation and the risk of frailty. Consumption of dietary ultra-processed products (UPP) could negatively contribute to these conditions. In this article, we intend to (i) discuss the role that UPP might have on the development of frailty considering the inflammatory potential of this type of food and (ii) to raise awareness on deleterious effects of excess UPP intake in the development of adverse health outcomes, in particular, frailty and compromised healthy ageing. UPP are industrial formulations whose nutrient profile has been associated with inflammation and altered gut microbiota. Besides, diets with a greater presence of unprocessed foods and antioxidants have been linked to the reduction of oxidative stress and the expression of inflammatory biomarkers. Because inflammation is believed to be a contributing factor in the development of frailty, it is possible that UPP would contribute to the onset or increase of this condition. Importantly, the increasing consumption of UPP in younger populations might pose a greater risk to the development of compromised healthy ageing in the long term.
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14
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Millar CL, Dufour AB, Hebert JR, Shivappa N, Okereke OI, Kiel DP, Hannan MT, Sahni S. Association of Proinflammatory Diet With Frailty Onset Among Adults With and Without Depressive Symptoms: Results From the Framingham Offspring Study. J Gerontol A Biol Sci Med Sci 2022; 78:250-257. [PMID: 35830506 PMCID: PMC9951064 DOI: 10.1093/gerona/glac140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset because they typically have higher levels of inflammation. The study objective was to determine the association between a proinflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. METHODS This prospective study included 1 701 nonfrail individuals with self-reported baseline (1998-2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM; calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria (i.e., slow gait, weak grip strength, unintentional weightloss, low physical activity, and self-reported exhaustion). Results are presented by baseline CES-D scores <16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders. RESULTS In all study participants, mean (SD) age was 58(8) years and E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more proinflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, 1-unit higher E-DII score was associated with 14% increased odds (95% CI: 1.05-1.24) of frailty. In those with depressive symptoms, 1-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13-2.13). CONCLUSIONS The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.
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Affiliation(s)
- Courtney L Millar
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Alyssa B Dufour
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, South Carolina, USA
| | - Olivia I Okereke
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Shivani Sahni
- Address correspondence to: Shivani Sahni, PhD, Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, USA. E-mail:
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15
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Liao X, Bian H, Zheng X, Ai J, Yang L, Liu L, Qiu S, Wei Q. Association of the inflammatory potential of diet and lower urinary tract symptoms among men in the United States. Aging Male 2021; 24:72-79. [PMID: 34233582 DOI: 10.1080/13685538.2021.1920911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Inflammation is crucial in the pathogenesis of lower urinary tract symptoms (LUTS) in men. Diet modulates inflammation. Therefore, diet could be a modifiable factor in male LUTS prevention and treatment. We aimed to investigate the association between dietary inflammatory potential and male LUTS. METHODS We used two cycles of National Health and Nutrition Examination Survey (NHANES) with self-report LUTS data. We calculated the dietary inflammatory index (DII) based on a 24 h diet recall and evaluated male LUTS. Clinical LUTS was defined as two or more coexisting symptoms. We used univariate and multivariate logistic regression models, the smooth curve fitting to analyze the relationship between clinical LUTS and the DII score. Subgroup analyses were conducted. RESULTS We observed a positive non-linear relationship between clinical LUTS and DII. We found that when DII was higher than the inflection point 2.39, a 1-unit increase in DII was associated with 26.1% higher adjusted odds of clinical LUTS. Subgroup analyses showed that the DII score was only positively correlated with clinical LUTS risk in non-drinkers, smokers, and non-obese people (DII >2.39). CONCLUSIONS Inflammation might be the key mechanism bridging dietary consumption to male LUTS. Excessive pro-inflammatory food intake (DII >2.39) warrants special vigilance, especially for non-drinkers, smokers, and non-obese men.
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Affiliation(s)
- Xinyang Liao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Haiyang Bian
- Department of Epidemiology and Biostatistics, Institute of Reproductive and Child Health, Peking University School of Public Health, Beijing, PR China
| | - Xiaonan Zheng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Jianzhong Ai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Lu Yang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Liangren Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Shi Qiu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
- Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, PR China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, PR China
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16
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Fan Y, Zhang Y, Li J, Liu Y, Zhou L, Yu Y. Association between Healthy Eating Index-2015 and physical frailty among the United States elderly adults: the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Aging Clin Exp Res 2021; 33:3245-3255. [PMID: 33978925 DOI: 10.1007/s40520-021-01874-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/28/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Diet plays an important role in the development of age-related chronic diseases. However, the association between diet quality assessed by Healthy Eating Index (HEI)-2015, the latest version of HEI, and physical frailty among the general United States (US) elderly adults remains unclear. AIMS The present study aims to explore the association between HEI-2015 and physical frailty in elderly adults using data from National Health and Nutrition Examination Survey (NHANES) 2011-2014. METHODS HEI-2015 scores were calculated from 2 days 24-h recall interviews. Physical frailty status was assessed by four criteria developed by Fried et al.: exhaustion, weakness, low body mass, and low physical activity, and then categorized into robust (0 criteria), pre-frail (1-2 criteria), or frail (3-4 criteria). The binary and multinomial logistic regressions were used to examine the odds of frailty status. RESULTS A total of 2345 participants aged 60 years or older were included. According to the 4-items frailty criteria, 51.1% participants were robust, 42.1% were pre-frail, and 6.8% were frail. Compared to the lowest HEI-2015 quartile, the elderly adults in the higher quartile had a lower odds of physical frailty (P < 0.05). Regarding the frailty criterion separately, higher HEI-2015 was associated with lower odds of exhaustion, weakness, low physical activity and unintentional weight loss, respectively (P < 0.05). Among 13 HEI-2015 components, adherence to the recommended intake of whole fruits and total vegetables components were less likely to be physically frail (P < 0.05). CONCLUSION Higher HEI-2015 was inversely associated with lower odds of physical frailty in the US elderly adults.
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Affiliation(s)
- Yameng Fan
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China
| | - Yinyin Zhang
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China
| | - Jiaqiao Li
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China
| | - Yamei Liu
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China
| | - Long Zhou
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China.
- Department of Cardiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yan Yu
- School of Public Health, Xi'an Jiaotong University, 76 West Yanta Road, Xi'an, 710061, China.
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17
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Cardoso BR, Tan SY, Daly RM, Via JD, Georgousopoulou EN, George ES. Intake of Nuts and Seeds Is Associated with a Lower Prevalence of Nonalcoholic Fatty Liver Disease in US Adults: Findings from 2005-2018 NHANES. J Nutr 2021; 151:3507-3515. [PMID: 34522969 DOI: 10.1093/jn/nxab253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/20/2020] [Accepted: 07/08/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease globally. Nuts and seeds, due to their unique nutrient composition, may provide health benefits for the prevention of NAFLD. To date, no research has investigated the association between nut and seed intake and NAFLD prevalence in a non-Mediterranean Western population. OBJECTIVES This study aimed to explore the association between nut and seed intake with NAFLD and metabolic biomarkers in a US representative sample. METHODS This cross-sectional study used data from 25,360 adults involved in the 2005-2018 NHANES, including adults (aged ≥18 y) with negative serology for hepatitis B and C and nonexcessive alcohol consumption. NAFLD was assessed using the fatty liver index (FLI); metabolic biomarkers were also assessed; nut and seed intake was evaluated from two 24-h dietary recalls. ANOVA and Poisson regression were used to establish the relation between nut and seed intake categories and NAFLD prevalence. RESULTS Nut and seed consumption was associated with a reduced prevalence of NAFLD. In females, in the fully adjusted model, this was significant across all nut and seed consumption categories but was most prominent in the moderate consumption group (7%, 15%, and 14% risk reduction in low, moderate, and adequate consumption categories, respectively, compared with nonconsumers). In males, moderate intake of nuts and seeds demonstrated a significantly lower prevalence of NAFLD (9%) compared with nonconsumers. CONCLUSIONS Daily consumption for nuts and seeds was associated with a lower prevalence of NAFLD in non-Mediterranean, US adults, although the benefits seem to be greater in females across all categories of nut and seed consumption groups compared with nonconsumers. Both males and females presented with lower prevalence of NAFLD with intakes of 15-30 g/d.
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Affiliation(s)
- Barbara R Cardoso
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.,Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Sze-Yen Tan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.,Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Ekavi N Georgousopoulou
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | - Elena S George
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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18
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Millar CL, Dufour AB, Shivappa N, Habtemariam D, Murabito JM, Benjamin EJ, Hebert JR, Kiel DP, Hannan MT, Sahni S. A proinflammatory diet is associated with increased odds of frailty after 12-year follow-up in a cohort of adults. Am J Clin Nutr 2021; 115:334-343. [PMID: 34558613 PMCID: PMC8827080 DOI: 10.1093/ajcn/nqab317] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/17/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Frailty occurs in 10-15% of community-living older adults and inflammation is a key determinant of frailty. Though diet is a modulator of inflammation, there are few prospective studies elucidating the role of diet-associated inflammation on frailty onset. OBJECTIVES We sought to determine whether a proinflammatory diet was associated with increased odds of frailty in adults from the Framingham Heart Study (FHS). DESIGN AND METHODS This study was nested in a prospective cohort that included individuals without frailty. Diet was assessed in 1998-2001 using a valid FFQ, and frailty was measured in 2011-2014. FFQ-derived energy-adjusted dietary inflammatory index (E-DII®) scores were computed, with higher E-DII scores indicating a more proinflammatory diet. Frailty was defined as fulfilling ≥3 of 5 Fried Phenotype criteria. Information on potential mediators, serum IL-6 and C-reactive protein was obtained in 1998-2001. Logistic regression estimated ORs and 95% CIs for E-DII (as continuous and in quartiles) and frailty onset adjusting for relevant confounders. RESULTS Of 1701 individuals without frailty at baseline (mean ± SD age: 58 ± 8 y; range: 33-81 y; 55% female), 224 developed frailty (13% incidence) over ∼12 y. The mean ± SD E-DII score was -1.95 ± 2.20; range: -6.71 to +5.40. After adjusting for relevant confounders, a 1-unit higher E-DII score was associated with 16% increased odds of developing frailty (95% CI: 1.07, 1.25). In categorical analyses, participants in the highest (proinflammatory) compared with lowest quartile of E-DII had >2-fold increased odds of frailty (ORquartile4vs.1: 2.22; 95% CI: 1.37, 3.60; P-trend < 0.01). IL-6 and C-reactive protein were not major contributors in the pathway. CONCLUSIONS In this cohort of middle-aged and older adults, a proinflammatory diet was associated with increased odds of frailty over ∼12 y of follow-up. Trials designed to increase consumption of anti-inflammatory foods for frailty prevention are warranted.
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Affiliation(s)
- Courtney L Millar
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alyssa B Dufour
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Daniel Habtemariam
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Joanne M Murabito
- Boston University School of Medicine and Public Health, Boston, MA, USA,NHLBI's Framingham Heart Study, Framingham, MA, USA
| | - Emelia J Benjamin
- Boston University School of Medicine and Public Health, Boston, MA, USA,NHLBI's Framingham Heart Study, Framingham, MA, USA,Cardiovascular Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - James R Hebert
- Department of Epidemiology and Biostatistics and the Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA,Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, USA
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA,Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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19
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Zhang S, Bian H, Qiu S, Cai B, Jin K, Zheng X, Li J, Tu X, Ai J, Yang L, Wei Q. Associations between the dietary inflammatory index and urinary incontinence among women younger than 65 years. Sci Rep 2021; 11:9340. [PMID: 33927304 PMCID: PMC8084978 DOI: 10.1038/s41598-021-88833-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/12/2021] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to evaluate the association between dietary inflammatory index (DII) and urinary incontinence (UI) among a representative sample of the US women. We performed a cross-sectional analysis of women younger than 65 years using the 1999 to 2016 NHANES (National Health and Nutrition Examination Survey) populations. DII were calculated based on baseline dietary intake using 24-h dietary recalls. UI was determined and categorized by self-reported questions. Multivariable logistic regression models were used to assess the association between DII and UI. Stratified linear regression models were applied to test for interaction in prespecified subgroup of interest. A total of 13,441 women age between 20 and 65 years were included in the final analysis. Of these participants 3230 (24.03%) complained of urgency UI, 5276 (39.25%) complained of stress UI and 2028 (15.09%) complained of mixed UI. On multivariate analysis, analysis with DII categorized as quartiles revealed significantly increase odds of urgency UI in the most pro-inflammatory quartile compared to the most anti-inflammatory quartile (OR 1.24, 95% CI 1.07–1.44, P = 0.004 for trend) in full adjustment model. Similar results were observed in SUI (OR 1.14, 95% CI 1.00–1.30, P = 0.021 for trend) and MUI (OR 1.20, 95% CI 1.02−1.43, P = 0.022 for trend). More pro-inflammatory diets, as presented by higher DII scores are associated with an increased likelihood of UI in American women younger than 65 years. Further studies are needed to explore the possible physiological mechanism and evaluate the potential therapeutic implications.
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Affiliation(s)
- Shiyu Zhang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Haiyang Bian
- Institute of Reproductive and Child Health and Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.,Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Boyu Cai
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Kun Jin
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xiaonan Zheng
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Jiakun Li
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Xiang Tu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Jianzhong Ai
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
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20
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Matsumoto Y, Shivappa N, Sugioka Y, Tada M, Okano T, Mamoto K, Inui K, Habu D, Hebert JR, Koike T. Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study. Arthritis Res Ther 2021; 23:105. [PMID: 33832530 PMCID: PMC8028141 DOI: 10.1186/s13075-021-02478-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/12/2021] [Indexed: 02/04/2023] Open
Abstract
Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA. Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011). Conclusions The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA. Trial registration UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.
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Affiliation(s)
- Yoshinari Matsumoto
- Shirahama Foundation for Health and Welfare, Search Institute for Bone and Arthritis Disease (SINBAD), Nishimuro-gun, Shirahama-cho 1447, Wakayama, 649-2211, Japan.,Department of Medical Nutrition, Osaka City University Graduate School of Human Life Science, Sumiyoshi-ku, Sugimoto-cho 3-3-138, Osaka, 558-8585, Japan
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC, 29201, USA
| | - Yuko Sugioka
- Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan
| | - Masahiro Tada
- Departments of Orthopaedic Surgery, Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan
| | - Tadashi Okano
- Departments of Orthopaedic Surgery, Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan
| | - Kenji Mamoto
- Departments of Orthopaedic Surgery, Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan
| | - Kentaro Inui
- Departments of Orthopaedic Surgery, Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan
| | - Daiki Habu
- Department of Medical Nutrition, Osaka City University Graduate School of Human Life Science, Sumiyoshi-ku, Sugimoto-cho 3-3-138, Osaka, 558-8585, Japan
| | - James R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Department of Nutrition, Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC, 29201, USA
| | - Tatsuya Koike
- Shirahama Foundation for Health and Welfare, Search Institute for Bone and Arthritis Disease (SINBAD), Nishimuro-gun, Shirahama-cho 1447, Wakayama, 649-2211, Japan. .,Center for Senile Degenerative Disorders (CSDD), Osaka City University Medical School, Abeno-ku, Asahimachi 1-4-3, Osaka, 545-8585, Japan.
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21
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Gojanovic M, Holloway-Kew KL, Hyde NK, Mohebbi M, Shivappa N, Hebert JR, O’Neil A, Pasco JA. The Dietary Inflammatory Index Is Associated with Low Muscle Mass and Low Muscle Function in Older Australians. Nutrients 2021; 13:nu13041166. [PMID: 33916033 PMCID: PMC8065722 DOI: 10.3390/nu13041166] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 01/02/2023] Open
Abstract
Age-associated chronic, low grade systemic inflammation has been recognised as an important contributing factor in the development of sarcopenia; importantly, diet may regulate this process. This cross-sectional study examined the association of diet-related inflammation with components of sarcopenia. Participants (n = 809) aged 60–95 years from the Geelong Osteoporosis Study were studied. Body composition was measured by dual energy X-ray absorptiometry. In this study, low appendicular lean mass (ALM/height2, kg/m2) was defined as T-score < −1 and low muscle function as Timed-Up-and-Go >10 s over 3 m (TUG > 10). Dietary inflammatory index (DII®) scores, based on specific foods and nutrients, were computed using dietary data collected from a food frequency questionnaire. Associations between DII scores and low muscle mass and low muscle function, alone and combined, were determined using linear and logistic regression. After adjusting for covariates, higher DII score was associated with lower ALM/height2 (β −0.05, standard error (SE) 0.02, p = 0.028), and higher natural log-transformed (ln) (TUG) (β 0.02, standard error 0.01, p = 0.035) and higher likelihood for these components combined (odds ratio 1.33, 95% confidence interval 1.05 to 1.69, p = 0.015). A pro-inflammatory diet, as indicated by higher DII score, is associated with lower muscle mass, poorer muscle function and increased likelihood for the combination of low muscle mass and low muscle function. Further studies investigating whether anti-inflammatory dietary interventions could reduce the risk of sarcopenia are needed.
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Affiliation(s)
- Marlene Gojanovic
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
- Correspondence:
| | - Kara L. Holloway-Kew
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Natalie K. Hyde
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria 3220, Australia;
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Adrienne O’Neil
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
| | - Julie A. Pasco
- IMPACT Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Victoria 3220, Australia; (K.L.H.-K.); (N.K.H.); (A.O.); (J.A.P.)
- Department of Medicine-Western Health, University of Melbourne, St Albans, Victoria 3021, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria 3220, Australia
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22
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Jayanama K, Theou O, Godin J, Cahill L, Shivappa N, Hébert JR, Wirth MD, Park YM, Fung TT, Rockwood K. Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum. BMC Med 2021; 19:64. [PMID: 33722232 PMCID: PMC7962372 DOI: 10.1186/s12916-021-01918-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/19/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Beyond intakes of total energy and individual nutrient, eating patterns may influence health, and thereby the risk of adverse outcomes. How different diet measures relate to frailty-a general measure of increased vulnerability to unfavorable health outcomes-and mortality risk, and how this might vary across the life course, is not known. We investigated the associations of five dietary indices (Nutrition Index (NI), the energy-density Dietary Inflammatory Index (E-DII™), Healthy Eating Index-2015 (HEI-2015), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH)) with frailty and mortality. METHODS We included 15,249 participants aged ≥ 20 years from the 2007-2012 cohorts of the National Health and Nutrition Examination Survey (NHANES). The NI combined 31 nutrition-related deficits. The E-DII is a literature-derived dietary index associated with inflammation. The HEI-2015 assesses adherence to the Dietary Guidelines of Americans. The MDS represents adherence to the traditional Mediterranean diet. DASH combines macronutrients and micronutrients to prevent hypertension. Frailty was evaluated using a 36-item frailty index. Mortality status was ascertained up to December 31, 2015. RESULTS Participants' mean age was 47.2 ± 16.7 years and 51.7% were women. After adjusting for age, sex, race, educational level, marital and employment status, smoking, BMI, and study cohort, higher NI and E-DII scores and lower HEI-2015, MDS, and DASH scores were individually significantly associated with frailty. All dietary scores were significantly associated with 8-year mortality risk after adjusting for basic covariates and frailty: NI (hazard ratio per 0.1 point, 1.15, 95%CI 1.10-1.21), E-DII (per 1 point, 1.05, 1.01-1.08), HEI-2015 (per 10 points, 0.93, 0.89-0.97), MDS (per 1 point, 0.94, 0.90-0.97), and DASH (per 1 point, 0.96, 0.93-0.99). The associations of E-DII, HEI-2015, and MDS scores with 8-year mortality risk persisted after additionally adjusting for NI. CONCLUSIONS NI, E-DII, HEI-2015, MDS, and DASH scores are associated with frailty and 8-year mortality risk in adults across all ages. Nevertheless, their mechanisms and sensitivity to predict health outcomes may differ. Nutrition scores have the potential to include measures of both consumption and laboratory and physical measures of exposure.
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Affiliation(s)
- Kulapong Jayanama
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia Canada
| | - Olga Theou
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia Canada
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada
| | - Judith Godin
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia Canada
| | - Leah Cahill
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC USA
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC USA
| | - Michael D. Wirth
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC USA
- College of Nursing, University of South Carolina, Columbia, SC USA
| | - Yong-Moon Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR USA
| | - Teresa T. Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Department of Nutrition, Simmons University, Boston, MA USA
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Dalhousie University & Nova Scotia Health, Halifax, Nova Scotia Canada
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia Canada
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23
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Lohman MC, Sonnega AJ, Resciniti NV, Leggett AN. Frailty Phenotype and Cause-Specific Mortality in the United States. J Gerontol A Biol Sci Med Sci 2021; 75:1935-1942. [PMID: 31956891 DOI: 10.1093/gerona/glaa025] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Frailty is a common condition among older adults increasing risk of adverse outcomes including mortality; however, little is known about the incidence or risk of specific causes of death among frail individuals. METHODS Data came from the Health and Retirement Study (HRS; 2004-2012), linked to underlying cause-of-death information from the National Death Index (NDI). Community-dwelling HRS participants aged 65 and older who completed a general health interview and physical measurements (n = 10,490) were included in analysis. Frailty was measured using phenotypic model criteria-exhaustion, low weight, low energy expenditure, slow gait, and weakness. Underlying causes of death were determined using International Classification of Diseases, Version 10 codes. We used Cox proportional hazards and competing risks regression models to calculate and compare incidence of cause-specific mortality by frailty status. RESULTS During follow-up, prefrail and frail older adults had significantly greater hazard of all-cause mortality compared to individuals without symptoms (adjusted hazard ratio [HR] prefrail: 1.85, 95% CI: 1.51, 2.25; HR frail: 2.75, 95% CI: 2.14, 3.53). Frailty was associated with 2.96 (95% CI: 2.17, 4.03), 2.82 (95% CI: 2.02, 3.94), 3.48 (95% CI: 2.17, 5.59), and 2.87 (95% CI: 1.47, 5.59) times greater hazard of death from heart disease, cancer, respiratory illness, and dementia, respectively. CONCLUSIONS Significantly greater risk of mortality from several different causes should be considered alongside the potential costs of screening and intervention for frailty in subspecialty and general geriatric clinical practice. Findings may help investigators estimate the potential impact of frailty reduction approaches on mortality.
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Affiliation(s)
- Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia
| | - Amanda J Sonnega
- Institute for Social Research, University of Michigan, Ann Arbor
| | - Nicholas V Resciniti
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia
| | - Amanda N Leggett
- Department of Psychiatry, University of Michigan, Ann Arbor.,Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
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24
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Vicente BM, Lucio Dos Santos Quaresma MV, Maria de Melo C, Lima Ribeiro SM. The dietary inflammatory index (DII®) and its association with cognition, frailty, and risk of disabilities in older adults: A systematic review. Clin Nutr ESPEN 2020; 40:7-16. [PMID: 33183575 DOI: 10.1016/j.clnesp.2020.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Systemic inflammation is considered an important issue in older adults and is associated with adverse health outcomes, such as frailty and cognitive impairment. Diet is a critical associated factor, and the dietary inflammatory index (DII®) is proposed as a promising tool to identify the association between diet and health outcomes. Our aims were: (i) to investigate the association between the DII® and frailty, cognition, and the consequent risk of disability in older adults; (ii) to discuss particularities of the use of DII® with older adults. METHODS The research question was based on the PICOS strategy: Population = older adults; Intervention or Exposure = DII; Comparison = any comparator; Outcomes = frailty, cognition, and risk of disability; Type of study = cohort, cross-sectional or case-control studies. We searched publications in two electronic databases (PUBMED and Web of Science) up to May 20th, 2020. RESULTS Seven studies met our criteria. Three investigated cognition (one cohort and two cross-sectional), and four investigated frailty or risk of disability (one cohort and three cross-sectional); none of the studies investigated both outcomes (frailty and cognition) simultaneously. The studies presented some issues, mainly concerning: (i) the collection of dietary data and calculation of the DII; (ii) the study design; (iii) calculation of the sample size; (iv) eligibility criteria; (v) time for follow-up; (vi) and choice of covariates. CONCLUSION despite the issues, the use of DII resulted in a significant association, or predictive value, with variables related to frailty and cognitive decline. Further studies, with sensitivity analysis of the different components of this index, are needed. DII showed to be a promising tool in the investigation of geriatric syndromes. This systematic review was registered in PROSPERO (CRD42020155672).
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Affiliation(s)
| | | | | | - Sandra Maria Lima Ribeiro
- Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, SP, Brazil.
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