Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100455
Kristin I. Folven , Eva Biringer , Roy M. Nilsen , Anne Marie Beck , Kari Sygnestveit , Eli Skeie , Øystein Hetlevik , Randi J. Tangvik
<div><h3>Objectives</h3><div>The aim of the study was to investigate associations between risk of malnutrition and risk of rehospitalisation and death in older hospital patients, and whether the possible associations were modified by age, gender, comorbidity or Ambulatory Care Sensitive Conditions (ACSCs).</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Somatic hospital in Western Norway.</div></div><div><h3>Participants</h3><div>9,768 hospital admissions for patients aged ≥65 years.</div></div><div><h3>Measurements</h3><div>Information on the risk of malnutrition was based on nutritional risk screening data from 34 point prevalence surveys conducted between 2008 and 2018. Risk of malnutrition was assessed using Nutritional Risk Screening 2002 (NRS 2002) during the initial hospital admission. Outcomes and possible effect modifiers were obtained from the hospital’s patient administration systems. The short-term outcome was the length of initial hospital stay. Long-term outcomes included total number of days in hospital, number of hospital stays and risk of death within one year following nutritional risk screening. Statistical analysis involved negative binomial and Cox regression models with adjustment for age, sex and number of diagnoses at time of nutritional risk screening.</div></div><div><h3>Results</h3><div>Overall, 34% of the patients were classified as being at risk of malnutrition. A higher proportion of the initial admissions were related to ACSCs for patients at risk of malnutrition than for those not at risk. Risk of malnutrition was associated with longer initial hospital stay (adjusted hazard ratio (95% confidence intervals) 1.31 (1.25, 1.37)), more days in hospital (adjusted risk ratio 1.25 (1.18, 1.32)) and a higher risk of having more than two hospital admissions the year following nutritional risk screening (adjusted risk ratio 1.16 (1.07, 1.26)). Patients at risk of malnutrition also had an increased risk of death within one year (adjusted hazard ratio 2.45 (2.25, 2.67)). All associations were more pronounced in the ‘65–69’ and ‘70–79’ age groups compared to the 80+ years age group, and in patients with fewer than four diagnoses compared to patients with four or more diagnoses. No significant interaction was detected between sex and risk of malnutrition with regard to patient outcomes.</div></div><div><h3>Conclusion</h3><div>Older patients at risk of malnutrition have a higher risk of rehospitalisation and death during the first year after nutritional risk screening compared with those not at risk. Among patients at risk of malnutrition, the initial hospital admissions were more often due to ACSCs. The impact of the risk of malnutrition on outcomes appears stronger in patients aged 65–79 years and in patients with less comorbidity. These findings underline the importance of nutritional risk screening and subsequent nutritional support in all groups of older patients.</div></div
{"title":"Increased risk of rehospitalisation and death in older hospital patients at risk of malnutrition: A cohort study","authors":"Kristin I. Folven , Eva Biringer , Roy M. Nilsen , Anne Marie Beck , Kari Sygnestveit , Eli Skeie , Øystein Hetlevik , Randi J. Tangvik","doi":"10.1016/j.jnha.2024.100455","DOIUrl":"10.1016/j.jnha.2024.100455","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of the study was to investigate associations between risk of malnutrition and risk of rehospitalisation and death in older hospital patients, and whether the possible associations were modified by age, gender, comorbidity or Ambulatory Care Sensitive Conditions (ACSCs).</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Somatic hospital in Western Norway.</div></div><div><h3>Participants</h3><div>9,768 hospital admissions for patients aged ≥65 years.</div></div><div><h3>Measurements</h3><div>Information on the risk of malnutrition was based on nutritional risk screening data from 34 point prevalence surveys conducted between 2008 and 2018. Risk of malnutrition was assessed using Nutritional Risk Screening 2002 (NRS 2002) during the initial hospital admission. Outcomes and possible effect modifiers were obtained from the hospital’s patient administration systems. The short-term outcome was the length of initial hospital stay. Long-term outcomes included total number of days in hospital, number of hospital stays and risk of death within one year following nutritional risk screening. Statistical analysis involved negative binomial and Cox regression models with adjustment for age, sex and number of diagnoses at time of nutritional risk screening.</div></div><div><h3>Results</h3><div>Overall, 34% of the patients were classified as being at risk of malnutrition. A higher proportion of the initial admissions were related to ACSCs for patients at risk of malnutrition than for those not at risk. Risk of malnutrition was associated with longer initial hospital stay (adjusted hazard ratio (95% confidence intervals) 1.31 (1.25, 1.37)), more days in hospital (adjusted risk ratio 1.25 (1.18, 1.32)) and a higher risk of having more than two hospital admissions the year following nutritional risk screening (adjusted risk ratio 1.16 (1.07, 1.26)). Patients at risk of malnutrition also had an increased risk of death within one year (adjusted hazard ratio 2.45 (2.25, 2.67)). All associations were more pronounced in the ‘65–69’ and ‘70–79’ age groups compared to the 80+ years age group, and in patients with fewer than four diagnoses compared to patients with four or more diagnoses. No significant interaction was detected between sex and risk of malnutrition with regard to patient outcomes.</div></div><div><h3>Conclusion</h3><div>Older patients at risk of malnutrition have a higher risk of rehospitalisation and death during the first year after nutritional risk screening compared with those not at risk. Among patients at risk of malnutrition, the initial hospital admissions were more often due to ACSCs. The impact of the risk of malnutrition on outcomes appears stronger in patients aged 65–79 years and in patients with less comorbidity. These findings underline the importance of nutritional risk screening and subsequent nutritional support in all groups of older patients.</div></div","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100455"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100422
Abeer A. Aljahdali
Background
Higher ultra-processed foods (UPF), attributed to more than half of daily intake in the US, have been associated with impaired health outcomes. Documented evidence highlights disparities in UPF consumption due to food insecurity, which is a public health challenge among older adults in the US.
Objectives
The study examined the link between food insecurity and UPF consumption. The potential of participants’ sex, age, and race and Supplemental Nutrition Assistance Program (SNAP) participation in modifying the association were explored.
Method
The analytical sample comprised 6295 US adults, aged 52 – 101 years, enrolled in the longitudinal Health and Retirement Study (HRS), a nationally representative study of aging. Food insecurity was evaluated in the 2013 HRS Health Care and Nutrition Study using the six-item Short Form Food Security Survey Module. Dietary intake was assessed using a food frequency questionnaire, and UPFs, quantified using the NOVA food classification system, were expressed as a percentage of total energy intake. The association between food insecurity and UPFs was examined using linear regression models, adjusted for sociodemographic characteristics.
Results
The prevalence of food insecurity was 15%. Mean UPFs% (95% confidence intervals) were 49.1 (47.8, 50.3), 48.5 (46.6, 50.4), and 52.3 (50.4, 54.3) among adults with food security, low food security, and very low food security, respectively (P-trend = 0.0156). Race modifies the association between food insecurity and UPFs (P-interaction = 0.0033). A positive linear trend was detected among Whites (P-trend = 0.0036), but an inverse linear trend was found among African Americans (P-trend = 0.0007). There was no evidence for heterogeneity by age, sex, or SNAP participation.
Conclusion
Food insecurity was positively correlated with UPF consumption among adults in the US. Race modifies the association with a positive linear trend among Whites and an inverse linear trend among African Americans. Further efforts are needed to promote healthy aging via improving diet quality among food-insecure older adults.
{"title":"Food insecurity and ultra-processed food consumption in the Health and Retirement Study: Cross-sectional analysis","authors":"Abeer A. Aljahdali","doi":"10.1016/j.jnha.2024.100422","DOIUrl":"10.1016/j.jnha.2024.100422","url":null,"abstract":"<div><h3>Background</h3><div>Higher ultra-processed foods (UPF), attributed to more than half of daily intake in the US, have been associated with impaired health outcomes. Documented evidence highlights disparities in UPF consumption due to food insecurity, which is a public health challenge among older adults in the US.</div></div><div><h3>Objectives</h3><div>The study examined the link between food insecurity and UPF consumption. The potential of participants’ sex, age, and race and Supplemental Nutrition Assistance Program (SNAP) participation in modifying the association were explored.</div></div><div><h3>Method</h3><div>The analytical sample comprised 6295 US adults, aged 52 – 101 years, enrolled in the longitudinal Health and Retirement Study (HRS), a nationally representative study of aging. Food insecurity was evaluated in the 2013 HRS Health Care and Nutrition Study using the six-item Short Form Food Security Survey Module. Dietary intake was assessed using a food frequency questionnaire, and UPFs, quantified using the NOVA food classification system, were expressed as a percentage of total energy intake. The association between food insecurity and UPFs was examined using linear regression models, adjusted for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>The prevalence of food insecurity was 15%. Mean UPFs% (95% confidence intervals) were 49.1 (47.8, 50.3), 48.5 (46.6, 50.4), and 52.3 (50.4, 54.3) among adults with food security, low food security, and very low food security, respectively (P-trend = 0.0156). Race modifies the association between food insecurity and UPFs (P-interaction = 0.0033). A positive linear trend was detected among Whites (P-trend = 0.0036), but an inverse linear trend was found among African Americans (P-trend = 0.0007). There was no evidence for heterogeneity by age, sex, or SNAP participation.</div></div><div><h3>Conclusion</h3><div>Food insecurity was positively correlated with UPF consumption among adults in the US. Race modifies the association with a positive linear trend among Whites and an inverse linear trend among African Americans. Further efforts are needed to promote healthy aging via improving diet quality among food-insecure older adults.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100422"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100443
Yuying Wang , Kun Zhang , Bin Wang , Bowei Yu , Ziteng Zhang , Yuetian Yu , Yuefeng Yu , Ying Sun , Yi Chen , Wen Zhang , Yan Cai , Qian Xiang , Fangzhen Xia , Ningjian Wang , Yingli Lu
Objectives
Early-famine exposure was reported to be associated with metabolic associated fatty liver disease (MAFLD); however, it has not been fully elucidated whether the gene-famine interaction exist in this association. We aimed to investigate the association between early-life famine exposure in different genetic risk stratifications and the risk of MAFLD in adulthood.
Design, setting, participants, and measurements
The study included 8213 participants from the SPECT-China study. Famine exposure subgroups was defined according to the birth year. A genetic risk score (GRS) was constructed with single nucleotide polymorphisms associated with MAFLD in East Asians. Logistic models were used to examine the association of famine exposure and GRS with MAFLD.
Results
Early-life famine exposure was positively associated with MAFLD after adjusting for multiple confounders (OR (95% CI): fetal-exposure 1.3(1.11−1.53), childhood exposure 1.12(1−1.25)). Meanwhile, with per SD increment of GRS (2.49 points), the OR(95%CI) of MAFLD was 1.1(1.04−1.16). In high GRS group, fetal-exposure was positively associated with 45% higher risk of MAFLD (1.45(1.15–1.83)). In men, neither in low or high GRS subgroups observed an association between early-life famine exposure and MAFLD. But in women with high GRS of MAFLD, fetal-exposure was positively associated with even higher risk of MAFLD (1.64(1.22–2.22)).
Conclusion
The positive association between early-life famine exposure and MAFLD is intensified by high genetic susceptibility of MAFLD in women and in general population in China; while this association does not exist in men or in those with low genetic risk scores.
{"title":"Early-life famine exposure, genetic susceptibility and risk of MAFLD in adulthood","authors":"Yuying Wang , Kun Zhang , Bin Wang , Bowei Yu , Ziteng Zhang , Yuetian Yu , Yuefeng Yu , Ying Sun , Yi Chen , Wen Zhang , Yan Cai , Qian Xiang , Fangzhen Xia , Ningjian Wang , Yingli Lu","doi":"10.1016/j.jnha.2024.100443","DOIUrl":"10.1016/j.jnha.2024.100443","url":null,"abstract":"<div><h3>Objectives</h3><div>Early-famine exposure was reported to be associated with metabolic associated fatty liver disease (MAFLD); however, it has not been fully elucidated whether the gene-famine interaction exist in this association. We aimed to investigate the association between early-life famine exposure in different genetic risk stratifications and the risk of MAFLD in adulthood.</div></div><div><h3>Design, setting, participants, and measurements</h3><div>The study included 8213 participants from the SPECT-China study. Famine exposure subgroups was defined according to the birth year. A genetic risk score (GRS) was constructed with single nucleotide polymorphisms associated with MAFLD in East Asians. Logistic models were used to examine the association of famine exposure and GRS with MAFLD.</div></div><div><h3>Results</h3><div>Early-life famine exposure was positively associated with MAFLD after adjusting for multiple confounders (OR (95% CI): fetal-exposure 1.3(1.11−1.53), childhood exposure 1.12(1−1.25)). Meanwhile, with per SD increment of GRS (2.49 points), the OR(95%CI) of MAFLD was 1.1(1.04−1.16). In high GRS group, fetal-exposure was positively associated with 45% higher risk of MAFLD (1.45(1.15–1.83)). In men, neither in low or high GRS subgroups observed an association between early-life famine exposure and MAFLD. But in women with high GRS of MAFLD, fetal-exposure was positively associated with even higher risk of MAFLD (1.64(1.22–2.22)).</div></div><div><h3>Conclusion</h3><div>The positive association between early-life famine exposure and MAFLD is intensified by high genetic susceptibility of MAFLD in women and in general population in China; while this association does not exist in men or in those with low genetic risk scores.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100443"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100454
Hongde Li , Weiya Li , Junli Li , Shiqin Peng , Yuan Feng , Yong Peng , Jiafu Wei , Zhengang Zhao , Tianyuan Xiong , Fei Chen , Mao Chen
Objectives
Nutritional status, as one of the core characteristics of frailty, the impact of its changes on clinical outcomes in older patients following transcatheter aortic valve replacement (TAVR) remains unclear.
Design
A retrospective cohort study.
Setting
This study included a total of 781 patients who underwent TAVR at West China Hospital between 2012 and 2022.
Method
The average age of the patients was 72.6 years, with a mean follow-up period of 2.2 years. All patients were followed for at least one year, and their nutritional status was assessed using the Controlling Nutritional Status (CONUT) score both before TAVR and six months post-TAVR. Based on post-TAVR changes in nutritional status, patients with normal nutritional status pre-TAVR were categorized into Non-malnutrition and New malnutrition groups, while patients with malnutrition pre-TAVR were categorized into Malnutrition regression and Malnutrition persistence groups.
Result
The New malnutrition group experienced higher cumulative incidences of all-cause mortality (20.5% vs. 2.4%, P = 0.002), MACE (25.5% vs. 23.7%, P = 0.001), and readmissions for heart failure (13.1% vs. 7.3%, P = 0.027) compared to the Non-malnutrition group. Conversely, the Malnutrition regression group showed a lower cumulative incidence of all-cause mortality (3.1% vs. 18.0%, P = 0.016) compared to the Malnutrition persistence group, although no statistically significant differences were observed in MACE (14.7% vs. 28.5%, P = 0.087) and readmissions for heart failure (7.0% vs. 8.3%, P = 0.551).
Conclusion
Our study indicates that deterioration in nutritional status after TAVR is associated with poorer clinical outcomes, whereas improvement is associated with better outcomes.
目的：营养状况作为衰弱的核心特征之一，其变化对经导管主动脉瓣置换术（TAVR）后老年患者临床预后的影响尚不清楚。设计：回顾性队列研究。背景：本研究共纳入2012 - 2022年间在华西医院行TAVR的781例患者。方法：患者平均年龄72.6岁，平均随访时间2.2年。所有患者随访至少一年，并在TAVR前和TAVR后6个月使用控制营养状态（CONUT）评分评估他们的营养状况。根据tavr后营养状况的变化，将tavr前营养状况正常的患者分为非营养不良组和新营养不良组，将tavr前营养不良的患者分为营养不良回归组和营养不良持续组。结果：与非营养不良组相比，新发营养不良组的全因死亡率（20.5% vs. 2.4%, P = 0.002）、MACE （25.5% vs. 23.7%, P = 0.001）和心力衰竭再入院（13.1% vs. 7.3%, P = 0.027）的累积发生率更高。相反，与营养不良持续组相比，营养不良回归组的全因死亡率累积发生率较低（3.1%比18.0%,P = 0.016），尽管MACE（14.7%比28.5%,P = 0.087）和心力衰竭再入院率（7.0%比8.3%,P = 0.551）无统计学差异。结论：我们的研究表明，TAVR术后营养状况的恶化与较差的临床结果相关，而改善与较好的临床结果相关。
{"title":"Prognostic value of nutritional changes in older patients following transcatheter aortic valve replacement","authors":"Hongde Li , Weiya Li , Junli Li , Shiqin Peng , Yuan Feng , Yong Peng , Jiafu Wei , Zhengang Zhao , Tianyuan Xiong , Fei Chen , Mao Chen","doi":"10.1016/j.jnha.2024.100454","DOIUrl":"10.1016/j.jnha.2024.100454","url":null,"abstract":"<div><h3>Objectives</h3><div>Nutritional status, as one of the core characteristics of frailty, the impact of its changes on clinical outcomes in older patients following transcatheter aortic valve replacement (TAVR) remains unclear.</div></div><div><h3>Design</h3><div>A retrospective cohort study.</div></div><div><h3>Setting</h3><div>This study included a total of 781 patients who underwent TAVR at West China Hospital between 2012 and 2022.</div></div><div><h3>Method</h3><div>The average age of the patients was 72.6 years, with a mean follow-up period of 2.2 years. All patients were followed for at least one year, and their nutritional status was assessed using the Controlling Nutritional Status (CONUT) score both before TAVR and six months post-TAVR. Based on post-TAVR changes in nutritional status, patients with normal nutritional status pre-TAVR were categorized into Non-malnutrition and New malnutrition groups, while patients with malnutrition pre-TAVR were categorized into Malnutrition regression and Malnutrition persistence groups.</div></div><div><h3>Result</h3><div>The New malnutrition group experienced higher cumulative incidences of all-cause mortality (20.5% vs. 2.4%, P = 0.002), MACE (25.5% vs. 23.7%, P = 0.001), and readmissions for heart failure (13.1% vs. 7.3%, P = 0.027) compared to the Non-malnutrition group. Conversely, the Malnutrition regression group showed a lower cumulative incidence of all-cause mortality (3.1% vs. 18.0%, P = 0.016) compared to the Malnutrition persistence group, although no statistically significant differences were observed in MACE (14.7% vs. 28.5%, P = 0.087) and readmissions for heart failure (7.0% vs. 8.3%, P = 0.551).</div></div><div><h3>Conclusion</h3><div>Our study indicates that deterioration in nutritional status after TAVR is associated with poorer clinical outcomes, whereas improvement is associated with better outcomes.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100454"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100448
Hélio José Coelho-Júnior , Alejandro Álvarez-Bustos , Leocadio Rodriguez-Mañas , Francesco Landi , Emanuele Marzetti
Sarcopenia is a prevalent neuromuscular condition among older adults, marked by significant reductions in muscle mass and strength, which result in notable impairments in physical performance. Modifications in lifestyle habits have been frequently highlighted as essential approaches to mitigate the progression of sarcopenia, with a particular focus on protein consumption. Over the past few decades, a wealth of knowledge has emerged, driven by both observational and experimental studies exploring various factors related to protein intake, such as amount, timing, and sources. This review provides a pauca verba overview of these findings, presenting a concise yet informative summary of key insights.
{"title":"Pauca verba on the association between protein intake and sarcopenia in older adults","authors":"Hélio José Coelho-Júnior , Alejandro Álvarez-Bustos , Leocadio Rodriguez-Mañas , Francesco Landi , Emanuele Marzetti","doi":"10.1016/j.jnha.2024.100448","DOIUrl":"10.1016/j.jnha.2024.100448","url":null,"abstract":"<div><div>Sarcopenia is a prevalent neuromuscular condition among older adults, marked by significant reductions in muscle mass and strength, which result in notable impairments in physical performance. Modifications in lifestyle habits have been frequently highlighted as essential approaches to mitigate the progression of sarcopenia, with a particular focus on protein consumption. Over the past few decades, a wealth of knowledge has emerged, driven by both observational and experimental studies exploring various factors related to protein intake, such as amount, timing, and sources. This review provides a <em>pauca verba</em> overview of these findings, presenting a concise yet informative summary of key insights.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100448"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100428
Boyu Fang, Zhipeng Wang, Guangxian Nan
Objective
Dietary inflammatory potential, measured by the dietary inflammatory index (DII) has been linked to cognitive impairment. However, evidence was mostly driven by cross-sectional studies. This meta-analysis of prospective cohort studies aims to evaluate the relationship between DII and the risk of cognitive impairment, including mild cognitive impairment (MCI) and dementia.
Methods
We conducted a systematic search of PubMed, Web of Science, and Embase for studies published up to July 25, 2024. Prospective cohort studies with adults aged 18 years or older, without dementia at baseline, and reporting the incidence of cognitive impairment by DII category were included. Data were analyzed using a random-effects model to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs).
Results
Nine prospective cohort studies with 266,169 participants were included. A high DII at baseline was associated with an increased risk of cognitive impairment during follow-up (RR: 1.34, 95% CI: 1.15–1.55, p < 0.001) with moderate heterogeneity (I² = 56%). Subgroup analyses revealed consistent associations across types of cognitive impairment (MCI, overall dementia, Alzheimer’s disease) and study characteristics (p for subgroup difference all >0.05). Sensitivity analyses confirmed the robustness of the results.
Conclusions
This meta-analysis suggests that a higher dietary inflammatory potential is independently associated with an increased risk of cognitive impairment. These findings underscore the potential impact of dietary inflammation on cognitive health and highlight the need for dietary strategies to mitigate cognitive decline risk.
目的：通过饮食炎症指数（DII）测量的饮食炎症潜力与认知障碍有关。然而，证据主要来自横断面研究。这项前瞻性队列研究的荟萃分析旨在评估DII与认知障碍风险之间的关系，包括轻度认知障碍（MCI）和痴呆。方法：我们对PubMed、Web of Science和Embase进行了系统检索，检索截止到2024年7月25日发表的研究。前瞻性队列研究纳入了18岁或以上的成年人，基线时无痴呆，并报告了DII类别的认知障碍发生率。采用随机效应模型对数据进行分析，以95%置信区间（ci）计算合并风险比（rr）。结果：9项前瞻性队列研究纳入266169名参与者。基线时高DII与随访期间认知障碍风险增加相关（RR: 1.34, 95% CI: 1.15-1.55, p 0.05）。敏感性分析证实了结果的稳健性。结论：这项荟萃分析表明，较高的饮食炎症潜力与认知障碍风险增加独立相关。这些发现强调了饮食炎症对认知健康的潜在影响，并强调了饮食策略减轻认知衰退风险的必要性。
{"title":"Dietary inflammatory potential and the risk of cognitive impairment: A meta-analysis of prospective cohort studies","authors":"Boyu Fang, Zhipeng Wang, Guangxian Nan","doi":"10.1016/j.jnha.2024.100428","DOIUrl":"10.1016/j.jnha.2024.100428","url":null,"abstract":"<div><h3>Objective</h3><div>Dietary inflammatory potential, measured by the dietary inflammatory index (DII) has been linked to cognitive impairment. However, evidence was mostly driven by cross-sectional studies. This meta-analysis of prospective cohort studies aims to evaluate the relationship between DII and the risk of cognitive impairment, including mild cognitive impairment (MCI) and dementia.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of PubMed, Web of Science, and Embase for studies published up to July 25, 2024. Prospective cohort studies with adults aged 18 years or older, without dementia at baseline, and reporting the incidence of cognitive impairment by DII category were included. Data were analyzed using a random-effects model to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Nine prospective cohort studies with 266,169 participants were included. A high DII at baseline was associated with an increased risk of cognitive impairment during follow-up (RR: 1.34, 95% CI: 1.15–1.55, p < 0.001) with moderate heterogeneity (I² = 56%). Subgroup analyses revealed consistent associations across types of cognitive impairment (MCI, overall dementia, Alzheimer’s disease) and study characteristics (p for subgroup difference all >0.05). Sensitivity analyses confirmed the robustness of the results.</div></div><div><h3>Conclusions</h3><div>This meta-analysis suggests that a higher dietary inflammatory potential is independently associated with an increased risk of cognitive impairment. These findings underscore the potential impact of dietary inflammation on cognitive health and highlight the need for dietary strategies to mitigate cognitive decline risk.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100428"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100429
Lauren Struszczak , Mary Hickson , Irene McClelland , Brad Metcalf , Manuela Barreto , Luciana Torquati , Jon Fulford , Rachael Allen , Claire Hulme , Mary F. O’Leary , Joanna L. Bowtell
<div><h3>Objectives</h3><div>To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes.</div></div><div><h3>Design</h3><div>A randomised crossover trial.</div></div><div><h3>Setting</h3><div>Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub.</div></div><div><h3>Participants</h3><div>Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, <em>n</em> = 28), or, 12-weeks without intervention followed by 12-weeks of meal provision intervention (meals second group, <em>n</em> = 28).</div></div><div><h3>Intervention</h3><div>A daily high protein and high energy home-delivered meal for 12-weeks. Each meal contained >50% daily protein requirements (0.6 g kg<sup>−1</sup> of the recommended 1.2 g kg<sup>−1</sup>.day<sup>−1</sup>, ∼42 g protein per meal) and >40% daily energy requirements (∼715 kcal).</div></div><div><h3>Measurements</h3><div>Physical, physiological and psychological health (including MNA score, body composition, hand grip strength, self-esteem, and depression) were evaluated in participants’ homes before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by <em>t</em>-test then effects were combined using meta-analysis. Retention of any meal provision effect after cessation of meal delivery was quantified as change from the end of the meal intervention versus 12-weeks follow-up via paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>The meal intervention significantly increased MNA score with a medium effect size (MNA: pooled Cohen’s D = 0.74, <em>p</em> < 0.001). Energy and protein intake increased significantly during the control period where participants were asked to maintain their habitual diet in the meals second group (energy intake: increase = 252 kcal [95% CI 36–487 kcal], t(22) = 2.408, <em>p</em> = 0.025, protein intake: increase = 0.20 g kg<sup>−1</sup> [95% CI 0.04–0.357 g kg<sup>−1</sup>], t(22) = 2.629, <em>p</em> = 0.015), which confounded the principle of a randomised crossover design analysis. When the control effect in those in the meals second group was removed from the analysis, the effect of the meal provision was much greater (meal provision significantly improved energy and protein intakes (311 kcal <em>D</em> = 0.52 (95% CI 0.22 to 0.82), <em>p</em> < 0.001; 0.24 g kg<sup>−1</sup> <em>D</em> = 0.52 (0.19–0.81), <em>p</em> < 0.001, respectively), MNA score (2.6 points <em>D</em> = 1.14 (0.78–1.50), <em>p</em> < 0.001), and handgrip strength (1.5 kg <em>D</em> = 0.36 (0.06–0.66), <em>p</em> = 0.02), but did not change
目的：确定是否每天提供高蛋白，高能量餐12周营养不良的老年人独立生活在社区可以改善身体，生理和心理的结果。设计：随机交叉试验。环境：参与者家庭距离膳食供应商15英里范围内；达特穆尔社区厨房中心。参与者：56名居住在社区的老年人（82±7岁，70%为女性）被随机分配（根据基线最小营养评估（MNA）评分和同居或独居进行分层），接受12周的膳食供应，然后12周不干预（第一组，n = 28），或者12周不干预，然后12周膳食供应干预（第二组，n = 28）。干预措施：每天吃一份高蛋白高能量的家庭送餐，持续12周。每餐含有每日所需蛋白质的50%（推荐的1.2 g kg-1中的0.6 g kg-1）。第1天，每餐42克蛋白质)和每日能量需求的40%（约715千卡）。测量方法：在每12周（基线、12周和24周）之前和之后，在参与者家中评估身体、生理和心理健康（包括MNA评分、身体成分、握力、自尊和抑郁）。采用t检验评估膳食供应的效果，然后采用meta分析对效果进行综合分析。通过配对t检验，将停止送餐后保留的任何膳食供应效应量化为从膳食干预结束到12周随访的变化。结果：膳食干预显著提高了MNA评分，效果中等（MNA: pooled Cohen’s D = 0.74, p < 0.001）。在对照组期间，参与者被要求在第二餐组保持他们的习惯饮食，能量和蛋白质摄入量显著增加(能量摄入量：增加= 252 kcal [95% CI 36-487 kcal], t(22) = 2.408, p = 0.025，蛋白质摄入量：增加= 0.20 g kg-1 [95% CI 0.04-0.357 g kg-1], t(22) = 2.629, p = 0.015)，这混淆了随机交叉设计分析的原则。当从分析中剔除第二组膳食的控制效应时，膳食供应的影响要大得多(膳食供应显著提高了能量和蛋白质摄入量(311千卡D = 0.52 (95% CI 0.22至0.82),p < 0.001；0.24 g kg- 1d = 0.52 (0.19-0.81), p < 0.001)， MNA评分（2.6分D = 1.14 （0.78-1.50), p < 0.001），和握力（1.5 kg D = 0.36 (0.06-0.66), p = 0.02），但没有改变抑郁或自尊水平）。12周后，膳食效应的以下百分比被保留：68%的MNA评分，27%的负情绪评分，15%的每日能量摄入量，6%的每日蛋白质摄入量和0%的握力。结论：为社区居住的老年人提供高蛋白、高能量膳食12周，改善了他们的营养状况和握力，表明衰弱风险降低。在退出干预后，益处并未保留，这表明需要在该队列中进行持续的干预以满足营养需求。家庭送餐为居住在社区的老年人提供了一种受欢迎的可扩展干预措施，以预防营养不良，促进健康并维持高质量的独立生活，从而减轻老龄化和脆弱对卫生和社会保健系统的负担。
{"title":"Provision of a daily high protein and high energy meal: Effects on the physical and psychological wellbeing of community-dwelling, malnourished older adults; a randomised crossover trial","authors":"Lauren Struszczak , Mary Hickson , Irene McClelland , Brad Metcalf , Manuela Barreto , Luciana Torquati , Jon Fulford , Rachael Allen , Claire Hulme , Mary F. O’Leary , Joanna L. Bowtell","doi":"10.1016/j.jnha.2024.100429","DOIUrl":"10.1016/j.jnha.2024.100429","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes.</div></div><div><h3>Design</h3><div>A randomised crossover trial.</div></div><div><h3>Setting</h3><div>Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub.</div></div><div><h3>Participants</h3><div>Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, <em>n</em> = 28), or, 12-weeks without intervention followed by 12-weeks of meal provision intervention (meals second group, <em>n</em> = 28).</div></div><div><h3>Intervention</h3><div>A daily high protein and high energy home-delivered meal for 12-weeks. Each meal contained >50% daily protein requirements (0.6 g kg<sup>−1</sup> of the recommended 1.2 g kg<sup>−1</sup>.day<sup>−1</sup>, ∼42 g protein per meal) and >40% daily energy requirements (∼715 kcal).</div></div><div><h3>Measurements</h3><div>Physical, physiological and psychological health (including MNA score, body composition, hand grip strength, self-esteem, and depression) were evaluated in participants’ homes before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by <em>t</em>-test then effects were combined using meta-analysis. Retention of any meal provision effect after cessation of meal delivery was quantified as change from the end of the meal intervention versus 12-weeks follow-up via paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>The meal intervention significantly increased MNA score with a medium effect size (MNA: pooled Cohen’s D = 0.74, <em>p</em> < 0.001). Energy and protein intake increased significantly during the control period where participants were asked to maintain their habitual diet in the meals second group (energy intake: increase = 252 kcal [95% CI 36–487 kcal], t(22) = 2.408, <em>p</em> = 0.025, protein intake: increase = 0.20 g kg<sup>−1</sup> [95% CI 0.04–0.357 g kg<sup>−1</sup>], t(22) = 2.629, <em>p</em> = 0.015), which confounded the principle of a randomised crossover design analysis. When the control effect in those in the meals second group was removed from the analysis, the effect of the meal provision was much greater (meal provision significantly improved energy and protein intakes (311 kcal <em>D</em> = 0.52 (95% CI 0.22 to 0.82), <em>p</em> < 0.001; 0.24 g kg<sup>−1</sup> <em>D</em> = 0.52 (0.19–0.81), <em>p</em> < 0.001, respectively), MNA score (2.6 points <em>D</em> = 1.14 (0.78–1.50), <em>p</em> < 0.001), and handgrip strength (1.5 kg <em>D</em> = 0.36 (0.06–0.66), <em>p</em> = 0.02), but did not change ","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100429"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100445
Xiaoming Zhang , Dongmei Ye , Rui Zeng, Fayi Xie, Wan Zhu, Jiang Wang , Ke Zhu, Tenghui Fan, Lihuan Chen, Aizhang Zhu , Mengxia Shi, Qingli Dou
{"title":"Association between cardiometabolic multimorbidity, body roundness index, and frailty index in Chinese middle-aged and older adults","authors":"Xiaoming Zhang , Dongmei Ye , Rui Zeng, Fayi Xie, Wan Zhu, Jiang Wang , Ke Zhu, Tenghui Fan, Lihuan Chen, Aizhang Zhu , Mengxia Shi, Qingli Dou","doi":"10.1016/j.jnha.2024.100445","DOIUrl":"10.1016/j.jnha.2024.100445","url":null,"abstract":"","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100445"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100449
Shaojie Li , Longbing Ren , Yang Hu , Yifei Wu , Yuling Jiang , Mingzhi Yu , Haiyan Kou , Dudu Wu , Wenjian Zhou , Zhouwei Liu , Faqin Lv , Yao Yao
Objectives
Housing is an important social determinant of health. However, limited studies have focused on the relationship between housing quality and sarcopenia, especially in low- and middle-income countries. This study aims to examine the association between housing quality and sarcopenia in older adults in China and India.
Methods
The study was based on the China Health and Retirement Longitudinal Study and Longitudinal Aging Study in India. Housing quality was evaluated by five indicators, including housing materials, water sources, sanitation facilities, main fuel for cooking, and availability of electricity. Housing quality is divided into three types: good (0–1 poor housing indicators), medium (2–3 poor housing indicators), and poor (4–5 poor housing indicators). Sarcopenia was evaluated according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus. The logistic regression model was performed to examine the association between housing quality and sarcopenia.
Results
The medium (OR = 1.69, 95%CI = 1.49−1.90) and poor housing quality (OR = 2.19, 95%CI = 1.89−2.54) were associated with sarcopenia in CHARLS. Similar results were also observed in the LASI with significantly higher prevalence of sarcopenia in medium (OR = 1.22, 95%CI = 1.11–1.33), and poor housing quality (OR = 1.60, 95%CI = 1.43−1.79). Moreover, we observed a linear relationship between housing quality and the prevalence of sarcopenia both in CHARLS and LASI (all P for trend <0.001).
Conclusions
Poorer housing quality was associated with a higher prevalence of sarcopenia in older adults in China and India. Housing quality improvement plans such as access to tap water, promotion of clean energy may have a positive effect on reducing the prevalence of sarcopenia.
{"title":"Associations between housing quality and sarcopenia among older adults: evidence from China and India","authors":"Shaojie Li , Longbing Ren , Yang Hu , Yifei Wu , Yuling Jiang , Mingzhi Yu , Haiyan Kou , Dudu Wu , Wenjian Zhou , Zhouwei Liu , Faqin Lv , Yao Yao","doi":"10.1016/j.jnha.2024.100449","DOIUrl":"10.1016/j.jnha.2024.100449","url":null,"abstract":"<div><h3>Objectives</h3><div>Housing is an important social determinant of health. However, limited studies have focused on the relationship between housing quality and sarcopenia, especially in low- and middle-income countries. This study aims to examine the association between housing quality and sarcopenia in older adults in China and India.</div></div><div><h3>Methods</h3><div>The study was based on the China Health and Retirement Longitudinal Study and Longitudinal Aging Study in India. Housing quality was evaluated by five indicators, including housing materials, water sources, sanitation facilities, main fuel for cooking, and availability of electricity. Housing quality is divided into three types: good (0–1 poor housing indicators), medium (2–3 poor housing indicators), and poor (4–5 poor housing indicators). Sarcopenia was evaluated according to the Asian Working Group for Sarcopenia (AWGS) 2019 Consensus. The logistic regression model was performed to examine the association between housing quality and sarcopenia.</div></div><div><h3>Results</h3><div>The medium (OR = 1.69, 95%CI = 1.49−1.90) and poor housing quality (OR = 2.19, 95%CI = 1.89−2.54) were associated with sarcopenia in CHARLS. Similar results were also observed in the LASI with significantly higher prevalence of sarcopenia in medium (OR = 1.22, 95%CI = 1.11–1.33), and poor housing quality (OR = 1.60, 95%CI = 1.43−1.79). Moreover, we observed a linear relationship between housing quality and the prevalence of sarcopenia both in CHARLS and LASI (all <em>P</em> for trend <0.001).</div></div><div><h3>Conclusions</h3><div>Poorer housing quality was associated with a higher prevalence of sarcopenia in older adults in China and India. Housing quality improvement plans such as access to tap water, promotion of clean energy may have a positive effect on reducing the prevalence of sarcopenia.</div></div>","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100449"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jnha.2024.100442
Chen-Ying Lin , Hao-Hua An, Fan Wu , Jing-Na Lin
{"title":"Reply to the letter to the editor regarding: The impact of dietary acid load on superagers with exceptional cognitive abilities: A propensity score analysis of national health and nutrition examination survey (NHANES) 2011–2014","authors":"Chen-Ying Lin , Hao-Hua An, Fan Wu , Jing-Na Lin","doi":"10.1016/j.jnha.2024.100442","DOIUrl":"10.1016/j.jnha.2024.100442","url":null,"abstract":"","PeriodicalId":54778,"journal":{"name":"Journal of Nutrition Health & Aging","volume":"29 2","pages":"Article 100442"},"PeriodicalIF":4.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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