ArticleJournal of health, population, and nutrition2025
Association between a dietary index for gut microbiota and frailty in U.S. adults aged 40 and older: evidence from NHANES 1999-2018.
Article in Journal of health, population, and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty is an increasing public health concern, and diet is a key modifiable factor in its management. However, it remains unclear whether the dietary index for gut microbiota (DI-GM), which reflects gut-supporting dietary patterns, is associated with frailty. We therefore examined this association in U.S. adults.
methodsIn this population-based cross-sectional study, we used data from the National Health and Nutrition Examination Survey 1999–2018, including adults aged ≥ 40 years. Frailty was measured using a 49-item frailty index. We conducted weighted multivariable logistic regression to estimate the association between DI-GM and frailty. Restricted cubic spline (RCS) models were fitted to explore potential non-linear relationships. Threshold effect analyses were performed to identify cut-off points in this association.
resultsA total of 16,646 participants were included, of whom 5,862 were classified as frail. After multivariable adjustment, each point increase in DI-GM was associated with an 8% lower odds of frailty (OR = 0.92, 95% CI = 0.89–0.96). RCS analysis showed a nonlinear association between DI-GM and frailty (p for nonlinearity = 0.003), with an inflection point at a DI-GM score of 5. Segmental logistic regression indicated that when DI-GM ≥ 5, frailty risk decreased as DI-GM increased (OR = 0.84, 95% CI = 0.79–0.90). Further sex-stratified analysis revealed that higher DI-GM scores were linked to lower frailty risk in females (OR = 0.89, 95% CI = 0.86–0.93), while no such association was observed in males (OR = 0.97, 95% CI = 0.91–1.03; p for interaction = 0.005).
conclusionDI-GM was nonlinearly associated with frailty in middle-aged and older adults, with a negative association observed after reaching a specific threshold. Additionally, this association was observed in females but not in males. This is the first study to demonstrate a nonlinear, sex-specific relationship between DI-GM and frailty.
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