Dietary inflammation index and osteoarthritis in the elderly: is there a mediating role of physical activity?

Abstract

Objective: This study examined whether physical activity (PA) explains the association between dietary inflammatory potential and OA in the elderly. Methods: A total of 1249 elderly people (≥65 years) were eligible for this study from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. The semi-quantitative Food Frequency Questionnaire (FFQ) and Global PA Questionnaire (GPAQ) were used to evaluate the diet and PA of the elderly, respectively. The multivariable logistic regression model estimated the odds ratio (OR) and 95% confidence interval (CI) between Energy-adjusted Dietary Inflammatory Index (E-DII) and OA. The interaction of E-DII and PA on depressive events was tested, and the mediation analysis of PA was performed. Results: The average E-DII in this study was +0.68 (SE 0.08), and the score ranges from -5.32 (most anti-inflammatory) to +4.26 (most pro-inflammatory). In comparison with the first quartile, the elderly from the second quartile (OR: 1.16 [95% CI: 1.06, 1.68]) to the fourth quartile (OR: 1.64 [ 95% CI: 1.13, 2.37]) had a higher risk of OA before adjustment for PA. An interaction was observed between E-DII and PA in terms of the risk of OA (PInteraction <0.001). The whole related part was mediated by PA (20.08%). Conclusion: Our findings indicate that the higher pro-inflammatory potential of diet is associated with a higher risk of OA, and low PA is an important part of the mediating factor in the relationship between systemic low-grade dietary inflammation and the risk of OA.

Dietary Inflammatory Index and Magnetic Resonance Imaging–Detected Knee Structural Change and Pain: A 10.7‐Year Follow‐up Study

“…The present study failed to detect significant associations between E-DII scores and CV loss and BML size increase, except for medial tibial BML increase over 10.7 years. These findings appear to be contrary to two cross-sectional studies that found the DII scores to be associated with prevalent and symptomatic KOA 15,24 and a 48-month follow-up study showing DII scores to be related to incident ROA. 25 Veronese et al found that participants with higher DII scores had a higher prevalence of radiographic symptomatic KOA compared to those consuming a more anti-inflammatory diet, indicated by a lower DII score.…”

“…15 A cross-sectional association between E-DII scores and selfreported OA was reported using data from 1,249 older adults in the National Health and Nutrition Examination Survey (NHANES), and this association was partially mediated by physical activity. 24 Liu et al found that the highest E-DII score quartile was associated with a higher incidence of radiographic and symptomatic KOA over 48-month follow-up period, and these associations were mediated by BMI. 25 The discrepancies between our study and the crosssectional studies may be due to differences in participants' characteristics, knee structure assessment, and study design and/or variations in the follow-up period.…”

“…17,18 There is evidence that the supplementation of vitamin D, as a DII component, can improve pain and function in patients with KOA 19,20 ; however, vitamin D supplementation may not confer cardiovascular and cancer protection. 21,22 There is also evidence to suggest that higher DII scores were associated with more severe pain in patients with KOA, 23 higher risk of prevalent radiographic and self-reported OA, 15,24 incident KOA, 25 and elevated levels of IL-10 and IL-17 in patients with KOA. 26 However, to date, no study has investigated the relationship of DII scores with alternations of knee structure on magnetic resonance imaging (MRI) or pain course.…”

The association between dietary inflammation index and depression

“…Dietary intake was assessed from a single 24-h dietary recall in NHANES. It contains 27 dietary ingredient or nutrient parameters used to calculate the E-DII or DII score, including carbohydrates, protein, fat, cholesterol, (saturated, monounsaturated and polyunsaturated) fatty acids, omega-3 and omega-6 polyunsaturated fatty acids, vitamins (A, B1, B2, B6, B12, C, D, E), niacin, iron, magnesium, zinc, selenium, folic acid, beta carotene, alcohol, fiber and caffeine ( 21 ).…”

The association between dietary inflammation index and bone mineral density: results from the United States National Health and nutrition examination surveys

“…The higher the absolute value of DII, the stronger the effect of diet on inflammation. DII has been reported to strongly correlate with many chronic diseases, such as coronary heart disease [ 18 ], metabolic syndrome [ 19 ], cancer [ 20 ], and osteoarthritis [ 21 ]. Studies demonstrated that a low DII diet was related to improved BMD in postmenopausal women of different races [ 22–24 ].…”