ArticleBMC medicine2021
Relationship between diet quality scores and the risk of frailty and mortality in adults across a wide age spectrum.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 2 of them syntheses that pooled it.
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Who cites it
99 citing papers in PubMed, 2 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- The Healthy Eating Index-2015 and All-Cause/Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2024Pooled it
- Dose-Response Association of Dietary Inflammatory Potential with All-Cause and Cause-Specific Mortality.Advances in nutrition (Bethesda, Md.) · 2022Pooled it
- Adherence to Mediterranean Diet and Response to an Exercise Program to Prevent Hospitalization-Associated Disability in Older Adults: A Secondary Analysis from a Randomized Controlled Trial.The journal of nutrition, health & aging · 2023Trial
- Dynamic frailty trajectories and risk of age-related macular degeneration: a prospective cohort study in UK Biobank.GeroScience · 2026Article
- Factors associated with sustained robustness in older adults: an 8-year multinational longitudinal study using SHARE data.BMC geriatrics · 2026Observational
- Dietary Food-Group Diversity Is Associated with Lower Frailty Severity in Older Adults Undergoing Geriatric Outpatient Assessment.Foods (Basel, Switzerland) · 2026Article
- Article
- Association between oral health and frailty among older cancer patients: a cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Association of Healthy Eating Index-2020 scores and its components with epilepsy in US adults: a cross-sectional study of NHANES 2005-2020.BMC neurology · 2026Article
- The impact of frailty scores on latent tuberculosis infection and all-cause mortality in this population.Medicine · 2026Article
- Lifestyle and psychosocial determinants of quality of life in Turkish community-dwelling older adults: a multivariate and hierarchical regression approach.BMC geriatrics · 2026Article
- Longitudinal study on the relationship between DASH-style dietary pattern and allostatic load in Chinese pregnant women.Nutrition research and practice · 2026Article
- Association between the novel dietary index for gut microbiota and diabetic kidney disease among patients with diabetes: evidence from the NHANES.BMC public health · 2026Article
- Reproducibility and validity of healthy dietary indices derived from 24-hour dietary recalls.Frontiers in nutrition · 2026Article
- Dietary Patterns Influence Chronic Disease Risk and Health Outcomes in Older Adults: A Narrative Review.Nutrients · 2025Review
- Association between a dietary index for gut microbiota and frailty in U.S. adults aged 40 and older: evidence from NHANES 1999-2018.Journal of health, population, and nutrition · 2025Article
- The association of ultra-processed foods and risk of sarcopenia among community-dwelling older adults.BMC geriatrics · 2025Article
- Association of healthy lifestyle patterns with changes in physical frailty and subjective cognitive function among community-dwelling older adults: a 3-year longitudinal study.BMC geriatrics · 2025Article
- Chronic pain and mortality risk among middle-age and older Japanese: the Shika town cohort study.Pain reports · 2025Article
- Association of estimated glucose disposal rate with all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome: Two prospective cohorts.American journal of preventive cardiology · 2025Article
39 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBeyond intakes of total energy and individual nutrient, eating patterns may influence health, and thereby the risk of adverse outcomes. How different diet measures relate to frailty-a general measure of increased vulnerability to unfavorable health outcomes-and mortality risk, and how this might vary across the life course, is not known. We investigated the associations of five dietary indices (Nutrition Index (NI), the energy-density Dietary Inflammatory Index (E-DII™), Healthy Eating Index-2015 (HEI-2015), Mediterranean Diet Score (MDS), and Dietary Approaches to Stop Hypertension (DASH)) with frailty and mortality.
methodsWe included 15,249 participants aged ≥ 20 years from the 2007-2012 cohorts of the National Health and Nutrition Examination Survey (NHANES). The NI combined 31 nutrition-related deficits. The E-DII is a literature-derived dietary index associated with inflammation. The HEI-2015 assesses adherence to the Dietary Guidelines of Americans. The MDS represents adherence to the traditional Mediterranean diet. DASH combines macronutrients and micronutrients to prevent hypertension. Frailty was evaluated using a 36-item frailty index. Mortality status was ascertained up to December 31, 2015.
resultsParticipants' mean age was 47.2 ± 16.7 years and 51.7% were women. After adjusting for age, sex, race, educational level, marital and employment status, smoking, BMI, and study cohort, higher NI and E-DII scores and lower HEI-2015, MDS, and DASH scores were individually significantly associated with frailty. All dietary scores were significantly associated with 8-year mortality risk after adjusting for basic covariates and frailty: NI (hazard ratio per 0.1 point, 1.15, 95%CI 1.10-1.21), E-DII (per 1 point, 1.05, 1.01-1.08), HEI-2015 (per 10 points, 0.93, 0.89-0.97), MDS (per 1 point, 0.94, 0.90-0.97), and DASH (per 1 point, 0.96, 0.93-0.99). The associations of E-DII, HEI-2015, and MDS scores with 8-year mortality risk persisted after additionally adjusting for NI.
conclusionsNI, E-DII, HEI-2015, MDS, and DASH scores are associated with frailty and 8-year mortality risk in adults across all ages. Nevertheless, their mechanisms and sensitivity to predict health outcomes may differ. Nutrition scores have the potential to include measures of both consumption and laboratory and physical measures of exposure.
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