Proinflammatory Diet Increases Circulating Inflammatory Biomarkers and Falls Risk in Community-Dwelling Older Men

doi:10.1093/jn/nxz256

The Journal of Nutrition

Volume 150, Issue 2, February 2020, Pages 373-381

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ABSTRACT

Background:

The relations between diet, chronic inflammation, and musculoskeletal health are unclear, especially among older men.

Objective:

This study aimed to determine associations of the Dietary Inflammatory Index (DII) with inflammatory biomarkers, musculoskeletal health, and falls risk in community-dwelling older men.

Methods:

The cross-sectional analysis included 794 community-dwelling men, mean age 81.1 ± 4.5 y, who participated in the 5-y follow-up of the Concord Health and Aging in Men Project. Of these, 616 were seen again 3 y later for the longitudinal analysis. Energy-adjusted DII (E-DII) was calculated from a validated diet history questionnaire. Bone mineral density (BMD) was measured using DXA. Twenty-four inflammatory biomarkers were analyzed. Incident falls over 3 y were determined through telephone interviews every 4 mo. Multiple regression, linear mixed effects models, negative binomial regression, and mediation analysis were utilized in this study.

Results:

A higher E-DII score (indicating a more proinflammatory diet) was associated with higher concentrations of IL-6 (β: 0.028 pg/mL; 95% CI: 0.003, 0.053), IL-7 (β: 0.020 pg/mL; 95% CI: 0.002, 0.037), and TNF-α (β: 0.027 pg/mL; 95% CI: 0.003, 0.051). A higher E-DII score was also associated with lower appendicular lean mass adjusted for BMI (ALM_BMI) (β: -0.006 kg/m²; 95% CI: -0.010, -0.001). For every unit increase in E-DII (range: -4.91 to +3.66 units), incident falls rates increased by 13% (incidence rate ratio: 1.13; 95% CI: 1.05, 1.21) over 3 y. Mediation analysis showed that the association between E-DII and 3-y incident falls was influenced by the concentrations of IL-7 by 24%. There was no association between E-DII and BMD.

Conclusions:

Consumption of a proinflammatory diet was associated with increased concentrations of IL-6, IL-7, and TNF-α; increased falls risk; and lower ALM_BMI in community-dwelling older men. The association between incident falls and E-DII was partly mediated by concentrations of IL-7.

Keywords:

dietary inflammatory index

chronic inflammation

inflammatory biomarkers

bone mineral density

falls

community-dwelling older men

Abbreviations used:

ALM

appendicular lean mass

ALM_BMI

appendicular lean mass adjusted for BMI

BMD

bone mineral density

CHAMP

Concord Health and Aging in Men Project

CRP

C-reactive protein

DII

Dietary Inflammatory Index

E-DII

energy-adjusted Dietary Inflammatory Index

GM-CSF

granulocyte/macrophage colony-stimulating factor

hs-CRP

high sensitivity C-reactive protein

IRR

incidence rate ratio

MIP

macrophage inflammatory protein

NSAID

nonsteroidal anti-inflammatory drug

PASE

Physical Activity Scale for Elderly

RANKL

receptor activator of NF-κB ligand

Cited by (0)

The CHAMP study is funded by the National Health and Medical Research Council of Australia (project grant number: 301916) and the Aging and Alzheimer's Institute. The funding body had no role in the design and conduct of the study; collection, analysis, and interpretation of the data; preparation and review of the manuscript; or the decision to publish. DS is supported by a National Health and Medical Research Council of Australia R.D. Wright Biomedical Career Development Fellowship (1123014).

Author disclosures: JRH owns a controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the Dietary Inflammatory Index from the University of South Carolina in order to develop computer and smart phone applications for patient counseling and dietary intervention in clinical settings. NS is an employee of CHI. All other authors report no conflicts of interest.