ArticleNutrition journal2025
Association of Healthy Eating Index-2020 with muscle mass among the middle-aged individuals - a cross-sectional study based on NHANES from 2011 to 2018.
Article in Nutrition journal, 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
backgroundLow muscle mass exhibits a high prevalence in population, with its incidence increasing with age. Body mass index (BMI) has been identified as an independent predictor of poor muscle quality, and people with higher BMI have higher risk of low muscle mass. Nutrition interventions have been demonstrated efficacy in mitigating its effects. The Healthy Eating Index-2020 (HEI-2020) assesses overall diet quality but lacks studies on its association with low muscle mass. This study aims to investigate the association between the HEI-2020 and low muscle mass and to explore the mediating role of BMI among middle-aged individuals.
methodsParticipants aged 40-59 were recruited from the National Health and Nutrition Examination Survey (NHANES) 2011-2018. Muscle mass was quantified using the ratio of appendicular lean mass (ALM) to BMI, with low muscle mass criteria defined at 0.789 kg/kg/m
resultsThe sample comprised 4,355 individuals with a median age of 50 (45, 55) years, of whom 9.7% had low muscle mass. The HEI-2020 scores ranged from 22.85 to 91.33, with an average score of 52.10 ± 11.78. Participants in the highest HEI-2020 score quartile had a 65% lower risk of low muscle mass compared to those in the lowest quartile. Adequate intake of vegetables, fruits, beans, proteins and fatty acids, along with restricted intake of added sugars, was associated with lower risk of low muscle mass. BMI was identified as a mediator, accounting for 33.1% of the association between HEI-2020 and low muscle mass.
conclusionsHEI-2020 was inversely associated with low muscle mass among middle-aged individuals. The impact of a healthy diet on muscle mass is partially mediated by BMI. Adhering to the healthy eating patterns and keeping a healthy weight is conducive to the maintenance of muscle mass and the prevention of low muscle mass.
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