Résumé
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.
| Langue d'origine | English |
|---|---|
| Numéro d'article | 64 |
| Journal | BMC Medicine |
| Volume | 19 |
| Numéro de publication | 1 |
| DOI | |
| Statut de publication | Published - déc. 2021 |
Note bibliographique
Funding Information:We are grateful to the Faculty of Medicine Ramathibodi Hospital, Mahidol University, for supporting KJ with a research fellowship to conduct this research; our colleagues at Geriatric Medicine Research, Dalhousie University/Nova Scotia Health for their support; all NHANES participants; and the NHANES researchers for making this data publicly available.
Funding Information:
Dr. Kenneth Rockwood is Chief Science Officer of DGI Clinical, which in the last 5 years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck and in 2019 another with Nutricia. Otherwise, any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities.
Publisher Copyright:
© 2021, The Author(s).
ASJC Scopus Subject Areas
- General Medicine
PubMed: MeSH publication types
- Journal Article