Publication: Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum
Issued Date
2021-12-01
Resource Type
ISSN
17417015
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2-s2.0-85102563669
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Medicine. Vol.19, No.1 (2021)
Suggested Citation
Kulapong Jayanama, Olga Theou, Judith Godin, Leah Cahill, Nitin Shivappa, James R. Hébert, Michael D. Wirth, Yong Moon Park, Teresa T. Fung, Kenneth Rockwood Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum. BMC Medicine. Vol.19, No.1 (2021). doi:10.1186/s12916-021-01918-5 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77619
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Title
Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum
Other Contributor(s)
Harvard T.H. Chan School of Public Health
University of South Carolina College of Nursing
Dalhousie University, Faculty of Medicine
University of South Carolina
Dalhousie University
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Fay W. Boozman College of Public Health
Simmons University
Connecting Health Innovations LLC
University of South Carolina College of Nursing
Dalhousie University, Faculty of Medicine
University of South Carolina
Dalhousie University
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Fay W. Boozman College of Public Health
Simmons University
Connecting Health Innovations LLC
Abstract
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.