Dietary inflammatory index as a modifiable risk factor for sarcopenia in adults with type 2 diabetes: A cross-sectional study

Abstract

There is growing evidence that a proinflammatory diet contributes to the increased risk of sarcopenia by exacerbating low-grade inflammation and insulin resistance, ultimately inducing muscle loss in adults with type 2 diabetes. This study aimed to analyze the association of dietary inflammatory index (DII), physical activity level, and body composition with sarcopenia in adults with type 2 diabetes. The hypothesis of this study was that higher DII increases the risk of sarcopenia. This cross-sectional study was conducted with 249 adults aged 50 years and older with type 2 diabetes who were admitted to the Internal Medicine Department of a tertiary hospital in Türkiye. Nutritional status was determined by 24-hour recall, dietary inflammatory status by energy-adjusted-DII, and physical activity by the International Physical Activity Questionnaire-Short Form. Muscle strength was measured by handgrip dynamometer, body composition analysis was measured by bioelectrical impedance method, and sarcopenia was defined according to EWGSOP-2 criteria. The mean age of the participants was 62.1 ± 6.9 years and the prevalence of sarcopenia was 15.7%. Handgrip strength and appendicular skeletal muscle mass significantly decreased with increasing DII score from tertile 1 to 3 (P < .05). A higher DII score was an independent risk factor for sarcopenia (odds ratio = 2.36, 95% confidence interval: 1.25-4.47, P = .008). This study shows that increased DII was independently associated with sarcopenia in adults with type 2 diabetes after adjustment for potential confounders. Dietary strategies aimed at reducing the potential for inflammation through dietary patterns rich in antioxidants, fiber, and omega-3 fatty acids may be useful in managing the risk of sarcopenia in adults with type 2 diabetes aged 50 years and older.