Household solid fuel use and the risk of sarcopenia among middle-aged and older adults in China: the first nationwide cross-sectional and longitudinal study

Abstract

Background: Little is known about the association between household solid fuel use and sarcopenia risk. Using a nationally representative survey, we investigated the association between solid fuel used for heating and cooking and sarcopenia risk among middle-aged and older Chinese adults. Methods: We leveraged two waves of data from the China Health and Retirement Longitudinal Study (CHARLS); 12,723 participants aged ≥ 45 years from 28 provinces across China were enrolled in 2011. Sarcopenia status was classified according to the Asian Working Group for Sarcopenia 2019 criteria. A total of 3,110 participants without sarcopenia were recruited at baseline and were followed up until 2013. Primary fuel types and durations used for heating and cooking were assessed using a validated questionnaire. Multinomial logistic regression explored the cross-sectional and longitudinal associations between solid fuel use and different stages of sarcopenia. Findings: The prevalence of possible sarcopenia and sarcopenia were 34∙8% and 5∙7%, respectively. Compared with clean fuel users, those using solid fuel for both heating and cooking had significantly higher risks of possible sarcopenia (odds ratio, [OR] 1∙72, 95%CI: 1∙54-1∙91) and sarcopenia (OR 1∙74, 1∙31-2∙31). During the two-year follow-up, 569 participants (18∙3%) developed with possible sarcopenia and 86 (2∙8%) had sarcopenia. In the longitudinal analyses, solid fuel use was positively associated with the risk of possible sarcopenia (OR 1∙75, 1∙32-2∙31), and the association was higher in individuals with a longer duration of solid fuel use. However, no significant association was observed with the incidence of sarcopenia. Older adults, with less physical activity might have a higher risk of sarcopenia when exposed to solid fuel. Interpretation: Household solid fuel is associated with a higher risk of sarcopenia among middle-aged and older Chinese adults. These findings provide novel evidence for prioritizing public health policies to promote healthy aging by reducing solid fuel use.