The Association between Dietary Inflammatory Index and Aging Biomarkers/Conditions: A Systematic Review and Dose-response Meta-analysis

OBJECTIVES: We performed a current study to examine the association between dietary inflammatory index (DII) score and older age-related muscle conditions, including sarcopenia, low muscle mass, low muscle strength, frailty, and/or disability. DESIGN: Systematic review and dose-response meta-analysis. SETTING: A systematic literature search was performed using Scopus, PubMed/MEDLINE, and ISI Web of Science without limitation until October 04, 2022. Relative risk (RR) and 95% confidence interval (CI) were pooled by applying a random-effects model, while validated methods examined assess quality and publication bias via Newcastle-Ottawa Scale, Egger's regression asymmetry, and Begg's rank correlation tests respectively. A dose-response meta-analysis was conducted to estimate the RRs per 1-unit increment in DII scores. PARTICIPANTS: Adults (>= 18 years) MEASURES: The risk of older age-related muscle conditions (sarcopenia, low muscle mass, low muscle strength, frailty, and/or disability) RESULTS: Data were available from 19 studies with 68079 participants. Results revealed that a higher DII score was significantly related to an increased risk of sarcopenia (RR=1.50; 95% CI: 1.26, 1.79; I2=53.3%; p<0.001; n=10; sample size =43097), low muscle strength (RR=1.47; 95% CI: 1.24, 1.74; I2=6.6%; p<0.001; n=4; sample size =9339), frailty (RR=1.61; 95% CI: 1.41, 1.84; I2=0.0%; p<0.001; study=5; participant=3882) and disability (RR=1.41; 95% CI: 1.16, 1.72; I2=58.4%; p=0.001; n=5; sample size =13760), but not low muscle mass (RR=1.24; 95% CI: 0.98, 1.56; I2=49.3%; p=0.069; n=4; sample size =11222). Additionally, results of the linear dose-response indicated that an increase of one point in the DII score was related to a 14% higher risk of sarcopenia, 6% higher risk of low muscle mass, 7% higher risk of low muscle strength, and a 7% higher risk of disability in adults. Non-linear dose-response relationships also revealed a positive linear association between the DII score and the risk of sarcopenia (P-nonlinearity = 0.097, Pdose-response <0.001), frailty (P (nonlinearity) = 0.844, Pdose-response=0.010) and disability (P-nonlinearity = 0.596, Pdose-response=0.007). CONCLUSION: Adherence to a pro-inflammatory diet was significantly associated with a higher risk of sarcopenia and other age-associated adverse effects such as low muscle strength, disability, and frailty. These results indicate a necessity to prioritize the reduction of pro-inflammatory diets to help promote overall older age-related muscle conditions.

Automated summary

This study examined the association between dietary inflammatory index (DII) score and older age-related muscle conditions. The results showed that adherence to a pro-inflammatory diet was significantly associated with a higher risk of sarcopenia, low muscle strength, frailty, and disability.