Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, South Korea.
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, South Korea.
BMC Geriatr. 2024 Aug 3;24(1):654. doi: 10.1186/s12877-024-05239-z.
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.
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.
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 B, 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).
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.
本研究旨在探讨较高的饮食炎症指数（DII）是否与韩国老年人发生肌少症性肥胖（SO）和衰弱的风险相关。
本研究共纳入了 950 名年龄在 70-84 岁之间、完成了韩国衰弱和老龄化队列研究基线营养调查的参与者。DII 是通过 24 小时膳食回忆评估的 23 种食物和营养素来计算的，用于量化饮食的炎症潜能。SO 定义为肌少症（双能 X 射线吸收法测量的四肢骨骼肌质量指数男性<7.0；女性<5.4）和腹型肥胖（男性腰围≥90cm；女性腰围≥85cm）同时存在。采用 Fried 衰弱指数（范围 0-5）评估衰弱状态，这是一种简单的定义衰弱的工具，由五个衰弱项目中的三个或更多组成。采用多变量逻辑回归模型来估计比值比（OR）及其 95%置信区间（CI），并调整混杂因素。
SO 和衰弱的患病率分别为 9.8%和 10.8%。与强壮和 SO 组相比，衰弱组的 DII 显著较高（2.7 比 2.0 和 1.8）（P<0.001）。在 DII 中包含的营养素和食物中，衰弱组的维生素 E、烟酸、维生素 B、能量和蛋白质摄入量低于强壮和 SO 组。与强壮组相比，衰弱组与强壮组相比（比较 DII 三分位 3 与三分位 1）的 frailty 的多变量调整 OR（95%CI）为 2.3（1.1-4.8；P-trend=0.02）。然而，DII 与 SO 之间没有显著关联（OR，1.1；95%CI，0.5-2.1；P-trend=0.6）。
较高的 DII 评分与韩国老年人衰弱的几率增加相关，但与 SO 无关，这表明促炎饮食对老年人衰弱的影响大于 SO。
