Association of the dietary inflammatory index with sarcopenic obesity and frailty in older adults

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.

Keywords: Aging; Dietary inflammatory index; Frailty; Korean older adults; Sarcopenic obesity.

Fig. 1

Odds ratios (95% confidence intervals) for sarcopenic obesity and frailty by tertiles of the dietary inflammatory index score Abbreviations: T, tertile; DII, dietary inflammatory index; OR, odds ratio; CI, confidence interval Data source: Korean Frailty and Aging Cohort Survey (KFACS) Note: Multinomial logistic regression models are used to estimate odds ratios and their corresponding 95% confidence intervals for the presence of SO and frailty versus robust by comparing tertile 2 and 3 with tertile 1 of the DII as the exposure variables. The number of each SO and frailty cases and their percentages are presented as No. cases (%) according to the DII tertile. P for trends is determined by treating the median value of the DII score as a continuous variable using multinomial logistic regression models. The multivariable-adjusted model is adjusted for age, sex, education level, monthly household income level, family structure, number of chronic diseases, number of prescribed drugs, chewing status, smoking status, alcohol consumption, physical activity level, and total energy intake