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Diet-induced inflammation is associated with sarcopenia and muscle strength in older adults who visit a frailty clinic

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Diet-induced inflammation may be associated with sarcopenia; however, few reports have examined this relationship.


To examine the association between the dietary inflammatory index (DII) and sarcopenia in older adults who visited a frailty clinic in Japan.


This cross-sectional study used outpatient data from the Frailty Registry Study. The DII is an index of diet-induced inflammation, and a dietary assessment was performed using a brief self-administered diet history questionnaire to calculate the DII score. We classified DII scores by quartiles (Q1–Q4), and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression analyses for sarcopenia were performed. Age, sex, comorbidities, and physical activity were entered as confounding factors (Model 1) and Models 2, 3, and 4 with BMI, protein intake, and energy intake added to Model 1.


We included 304 patients in the analysis (mean age, 77.6 ± 6.3 years; female, 67.4%). The prevalence of sarcopenia was 14.5%. Logistic regression analyses showed that DII scores were significantly associated with sarcopenia in Model 1 and 2 (Model 1, reference: Q1, Q4: OR 3.10, P = 0.020; Model 2, Q4: OR 3.40, P = 0,022) but not in Model 3 and 4.


Diet-induced inflammation is associated with a higher likelihood of sarcopenia; however, this association disappeared after confounding for protein and energy intake.


The results demonstrated that dietary protein and energy parameters were the main drivers for muscle health in medical patients.

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Availability of data and materials

The data sets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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We thank all the collaborators of data collection and management of the Frailty Registry Study and the Center for Frailty and Locomotive Syndrome at the National Center for Geriatrics and Gerontology for their dedicated clinical research.


This study was supported by the Japan Society for the Promotion of Science (Grant number: 21H03390) and the Research Funding of Longevity Sciences from the Ministry of Health, Labour and Welfare of Japan (Grant numbers: 20–57).

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Authors and Affiliations



All authors have read the manuscript and approved its submission. Tatsuro Inoue, Keisuke Maeda, Akio Shimizu contributed to the study conceptualization and design. All authors contributed to the acquisition, analysis, and interpretation of data and drafted the manuscript. All authors contributed to the critical revisions of the manuscript for important intellectual content. Tatsuro Inoue and Keisuke Maeda were responsible for the statistical analyses. Keisuke Maeda supervised the study.

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Correspondence to Keisuke Maeda.

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Conflict of interests

The authors have no conflicts of interest to declare.

Ethical approval

This study was conducted in accordance with the 1964 Declaration of Helsinki and with the approval of the Ethics Committees of the National Center for Geriatrics and Gerontology (No. 1459) and Niigata University of Health and Welfare (No. 18521−201124).

Informed consent

We obtained written informed consent from the patients for registration in the Frail Registry Study.

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Inoue, T., Shimizu, A., Ueshima, J. et al. Diet-induced inflammation is associated with sarcopenia and muscle strength in older adults who visit a frailty clinic. Aging Clin Exp Res 34, 2525–2532 (2022).

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