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

• Published in: The American journal of clinical nutrition 2022-02, Vol.115 (2), p.334-343
• Main Authors: Millar, Courtney L, Dufour, Alyssa B, Shivappa, Nitin, Habtemariam, Daniel, Murabito, Joanne M, Benjamin, Emelia J, Hebert, James R, Kiel, Douglas P, Hannan, Marian T, Sahni, Shivani
• Format: Article
• Language: English
• Subjects: Adult; Adults; Aged; Aged, 80 and over; aging; C-reactive protein; C-Reactive Protein - analysis; community-based; Diet; Diet - adverse effects; Diet - statistics & numerical data; Diet Surveys; epidemiology; Female; Follow-Up Studies; Food consumption; food frequency questionnaire; Frailty; Frailty - epidemiology; Frailty - etiology; Humans; Independent Living - statistics & numerical data; Inflammation; Interleukin 6; Interleukin-6 - blood; Logistic Models; Longitudinal Studies; Male; Middle Aged; Odds Ratio; Older people; Original Research Communications; Phenotypes; prospective cohort study; Prospective Studies; Proteins; Quartiles; Risk Factors
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/nqab317

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. We sought to determine whether a proinflammatory diet was associated with increased odds of frailty in adults from the Framingham Heart Study (FHS). 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®) 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. 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 ∼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. In this cohort of middle-aged and older adults, a proinflammatory diet was associated with increased odds of frailty over ∼12 y of follow-up. Trials designed to increase consumption of anti-inflammatory foods for frailty prevention are warranted.