Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

Abstract

Poor diet quality and obesity, especially abdominal obesity, have been associated with systemic inflammation. The neutrophil-to-lymphocyte Ratio (NLR) is an available and inexpensive inflammation biomarker. The aim of the present study was to determine the association of dietary patterns and obesity with an inflammatory state. A group of 1747 Spanish noninstitutionalized older adults individuals were included, and a food-frequency questionnaire was applied. The Global Food Score (GFS) and Healthy Eating Index for Spanish population (SHEI) were calculated. Weight, height and waist (WC) and hip circumferences were measured, and BMI, waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) determined. In addition, body-fat percentage was measured by bioimpedance. NLR was calculated (NLR ≥ p80: 2.6; 2.8 and 2.4 as inflammatory status in the entire population, men and women, respectively). The men with inflammatory status presented significative higher values of WC, WHtR, WHR, and body-fat percentage (101.82 ± 10.34 cm, 0.61 ± 0.06, 0.98 ± 0.06, and 31.68 ± 5.94%, respectively) than those with better inflammatory status (100.18 ± 10.22 cm, 0.59 ± 0.06, 0.97 ± 0.07, and 30.31 ± 6.16%, respectively). Those males with worse inflammatory state had lower scores for protein foods (OR = 0.898 (0.812–0.993); p = 0.037). The women with NLR ≥ 2.4 had higher WHtR and WHR (0.62 ± 0.09 and 0.91 ± 0.09) than those with NLR < 2.4 (0.60 ± 0.08 and 0.90 ± 0.08). In multiple linear regression analysis, NLR was positively related with WHtR and negatively related with SHEI score (β = 0.224 ± 0.094; R2 = 0.060; p < 0.05 and β = −0.218 ± 0.101; R2 = 0.061; p < 0.05), adjusting by sex, age, marital status, education level, smoking, hours of sleeping and inflammatory diseases. In women, the higher the SHEI and GFS scores were and the better meeting the aims of cereal and vegetable servings, the less the odds of inflammatory status (OR = 0.970 (0.948–0.992); p = 0.008; OR = 0.963 (0.932–0.995); p = 0.024; OR = 0.818 (0.688–0.974); p = 0.024 and OR = 0.829 (0.730–0.942); p = 0.004, respectively). WHtR and quality of diet is related to the inflammation status in older adults regardless to the sex.

Microbiota Modulating Nutritional Approaches to Countering the Effects of Viral Respiratory Infections Including SARS-CoV-2 through Promoting Metabolic and Immune Fitness with Probiotics and Plant Bioactives

“…The neutrophil-to-lymphocyte ratio (NLR) has been reported to predict severe illness in patients with COVID-19 in the early stages of infection [13]. This agrees with another study that confirmed a strong association between elevated NLR with increased abdominal obesity-induced systemic inflammation in the older Spanish population [30]. Thus, NLR may be used as a prognostic factor for disease severity in VRIs that could facilitate an early detection of severity and the rapid implementation of interventions to aid patient responses to infection.…”

The Omega-3 Index is Inversely Associated with the Neutrophil-Lymphocyte Ratio in Adults

“…NLR values measured in this cohort (Table 1) were similar to those measured in healthy adults globally [8,24,[59][60][61][62][63]. NLR is known to increase with age [9,32,60], obesity [13,60], CRP [64,65], and to sometimes differ by sex [32,59]. These same relationships were mostly observed here as well (data not reported), suggesting that the findings from this clinical laboratory cohort are generally representative.…”

“…NLR has been used to monitor astronaut immune function during long-duration missions [10]. Elevated NLR is also a biomarker of systemic inflammation [5,[11][12][13][14], cardiovascular disease and events [6,[15][16][17][18], the severity of covid-19 [19][20][21][22], mood disorders [23], cognitive impairment [24], cancer [6,7,25], dry eye [26], periodontitis [27],…”

Factors Related to Diet Quality: A Cross-Sectional Study of 1055 University Students

“…For this reason, it cannot offer information concerning the intake of nutrients or calories. Despite these limitations, there were three main reasons that we chose this tool: it is a questionnaire specifically adapted to Spanish alimentary habits; it has repeatedly been shown to be well-equipped to assess the DQ of Spaniards [ 27 , 92 , 93 ]; finally, the original questionnaire from which it was derived has been validated with plasma biomarkers in previous studies [ 94 , 95 ]. Given the limitations listed above, further research on the present issue is needed, including a longitudinal study as well as a quantitative approach to evaluating the diet of Spanish university students.…”