Dietary Inflammatory Index, Pre-Frailty and Frailty Among Older US Adults: Evidence from the National Health and Nutrition Examination Survey, 2007–2014

Abstract

Objective: This study aimed to investigate the association between dietary inflammation, pre-frailty and frailty among older US adults. Additionally, effect modification of gender on the association between dietary inflammation and frailty was assessed. Design: Study data came from the National Health and Nutrition Examination Survey (2007-2014)–a nationally representative, cross-sectional study of adults. Participants: The analytic sample included adults ≥60 years (n=7,182). Measurements: Dietary Inflammatory Index (DII®) scores were calculated from 24-hour dietary recalls; DII was categorized into quintiles from Quintile 1 (Q1) (least inflammatory) to Q5 (most inflammatory). Frailty was assessed by four criteria: exhaustion, weakness, low body mass, and low physical activity. Individuals were then categorized into robust (0 criteria), pre-frail (1-2 criteria), or frail (3-4 criteria). Multinomial logistic regression was used to examine the odds of frailty categories (prefrail vs. robust; frail vs. robust). Results: After adjusting for potential confounders, individuals in DII quintile 5 (vs Q1) were more likely to be pre-frail (OR = 1.71; 95% CI: 1.36-2.15) and frail (OR = 1.70; 95% CI: 1.02- 2.85). Individuals in Q4 had greater odds of frailty only (OR = 1.82; 95% CI: 1.13, 2.93). No evidence of effect modification by gender on the association of DII and frailty was found. Conclusion: This study expands upon previous evidence of a relationship between dietary inflammation and frailty. When designing nutrition-based frailty interventions, inflammatory properties of diets should be considered.