A proinflammatory diet is associated with increased odds of frailty after 12-year follow-up in a cohort of adults

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 (R)) 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 similar to 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 similar to 12 y of follow-up. Trials designed to increase consumption of anti-inflammatory foods for frailty prevention are warranted.

Automated summary

This study found that a proinflammatory diet is associated with an increased incidence of frailty, suggesting that increasing the intake of anti-inflammatory foods may help prevent frailty.