Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study

Qiaoqiao Du; Yanhui Lu; Fan Hu; Xinglin Feng; Yunquan Zhang; Shaojie Li; Chi Zhang; Hua Zhang; Yi Zeng; Yao Yao; Zhaohui Lu; Wenya Zhang; Xiangyang Gao

doi:10.3389/fnut.2023.1218453

Dietary diversity and possible sarcopenia among older people in China: a nationwide population-based study

Front Nutr. 2023 Jun 30:10:1218453. doi: 10.3389/fnut.2023.1218453. eCollection 2023.

Authors

Qiaoqiao Du¹, Yanhui Lu², Fan Hu², Xinglin Feng³, Yunquan Zhang⁴, Shaojie Li⁵, Chi Zhang⁶, Hua Zhang⁷, Yi Zeng⁸, Yao Yao⁵, Zhaohui Lu¹, Wenya Zhang¹, Xiangyang Gao⁹

Affiliations

¹ Health Management Center, The Second Affiliated Hospital of Soochow University, Suzhou, China.
² Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, China.
³ Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
⁴ Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China.
⁵ China Center for Health Development Studies, Peking University, Beijing, China.
⁶ The Key Laboratory of Geriatrics, Institute of Geriatric Medicine, Chinese, Academy of Medical Sciences, National Center of Gerontology of National Health Commission, Beijing, China.
⁷ Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
⁸ Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
⁹ Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.

Abstract

Background: Sarcopenia is a common geriatric disease. Many dietary factors may contribute to the development of sarcopenia. Few studies have been conducted on dietary diversity and sarcopenia in Chinese older adults. Among a nationwide sample, the objective of this study is to assess the association between the dietary diversity score (DDS) and the prevalence of possible sarcopenia. We considered the different patterns of dietary diversity in relation to possible sarcopenia.

Methods: We conducted this analysis utilizing the cross-sectional data from the 2012, 2014, and 2018 waves of the Chinese longitudinal healthy longevity survey (CLHLS). A standard developed by the Asian Working Group for Sarcopenia 2019 (AWGS2019) was used to assess the possibility of sarcopenia. On the basis of the DDS generated by previous studies, we have constructed four new indicators as follows: total diet, animal-based diet, plant-based diet, and plant-based diet without the consumption of legume products and nuts. We used the generalized estimation equation (GEE) model to evaluate the associations between the DDS of the total diet, animal-based diet, plant-based diet, and plant-based diet without the intake of legume products and nuts and possible sarcopenia. These associations were statistically adjusted for a variety of potential confounders. Sensitivity analysis was performed by excluding some participants who were long-term bedridden, had Alzheimer's disease, or were terminally ill.

Results: The analysis included 6,624 participants (mean age 83.4 years at baseline). In our study, we found that participants with a higher DDS of the total diet (OR = 0.62; 95% CI: 0.51-0.77), animal-based diet (OR = 0.62; 95% CI: 0.49-0.79), and plant-based diet (OR = 0.64;95% CI: 0.51-0.80) were at a lower risk of developing sarcopenia. In sensitivity analyses, the associations remained unchanged.

Conclusion: Taking a diversified diet, including animal foods, may reduce the risk of developing sarcopenia. According to the findings of this study, adopting a diversified diet might reduce the risk of sarcopenia for older adults.

Keywords: China; dietary diversity; older adults; plant-based diet; possible sarcopenia.

Grants and funding

We received funding from the National Key R&D Program of China (2020YFC2008905), the National High Level Hospital Clinical Research Funding (BJ-2022-133), Suzhou Kejiaoxingwei Youth Science and Technology Project (KJXW2021014), the National Natural Sciences Foundation of China (72061137004), and the U.S. National Institute of Aging/National Institute of Health (P01AG031719).