Dietary intake of live microbes is inversely associated with fatigue and modified by serum folate among adults aged 40 years or more

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI:10.1016/j.maturitas.2026.108868

Galya Bigman , Amber S. Kleckner , Yuanyuan Li , Elizabeth A. Dennis , Alice S. Ryan , John D. Sorkin

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引用次数: 0

Abstract

Objectives

To investigate the independent associations between dietary live-microbe intake, as well as circulating levels of folate metabolites, and fatigue, and to examine their interaction as a potential biological pathway underlying fatigue in aging adults.

Study design

Cross-sectional analysis of adults aged ≥40 years participating in the National Health and Nutrition Examination Survey 2011–2023.

Main outcome measures

Fatigue was assessed using the Patient Health Questionnaire fatigue item and categorized as none/low versus moderate/severe. Dietary intake of live-microbe foods was derived from two 24-h recalls and classified as low, medium, or high. Total serum concentrations folate and its metabolites, including 5-methyltetrahydrofolate, were quantified. Survey-weighted logistic regression, adjusted for sociodemographic, dietary, and clinical covariates, estimated main effects and interactions between the effects of 5-methyltetrahydrofolate and of live-microbe intake; sensitivity analyses additionally adjusted for depressive symptoms and sleep disturbance.

Results

Moderate/severe fatigue was reported by 16.3% of 14,376 participants and 15.0% reported no intake of live-microbe foods. High versus low live-microbe intake was associated with lower odds of moderate/severe fatigue (odds ratio [OR] 0.60; 95% confidence interval [CI] 0.46–0.79). Higher serum 5-methyltetrahydrofolate levels were also associated with lower odds of moderate/severe fatigue (OR 0.85; 95% CI 0.73–0.98). In stratified analyses, high live-microbe intake corresponded to 38–65% lower odds of moderate/severe fatigue only among adults with higher levels of 5-methyltetrahydrofolate, with no significant associations among those with lower levels.

Conclusions

Intake of microbe-rich foods and higher levels of circulating 5-methyltetrahydrofolate are both associated with lower levels of fatigue in midlife and older adults, and folate sufficiency appears to potentiate the fatigue-reducing benefits of live-microbe foods, supporting a nutrient–microbe pathway relevant to healthy aging.

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在40岁或以上的成年人中，活微生物的饮食摄入与疲劳呈负相关，并受血清叶酸的影响。

目的：研究饮食中活微生物的摄入、叶酸代谢物的循环水平和疲劳之间的独立关系，并研究它们之间的相互作用作为老年人疲劳的潜在生物学途径。研究设计：对参加2011-2023年全国健康与营养检查调查的年龄≥40岁的成年人进行横断面分析。主要结果测量：使用患者健康问卷疲劳项目评估疲劳，并将其分为无/低与中度/严重。活微生物食物的膳食摄入量来源于两次24小时召回，并被分为低、中、高三个等级。测定血清中叶酸及其代谢物（包括5-甲基四氢叶酸）的浓度。调查加权logistic回归，调整社会人口统计学、饮食和临床协变量，估计5-甲基四氢叶酸和活微生物摄入的主要影响和相互作用；敏感性分析还对抑郁症状和睡眠障碍进行了调整。结果：14376名参与者中有16.3%的人报告了中度/重度疲劳，15.0%的人报告没有摄入活微生物食物。活微生物摄入量高与低与中度/重度疲劳的几率较低相关（优势比[OR] 0.60； 95%可信区间[CI] 0.46-0.79）。较高的血清5-甲基四氢叶酸水平也与较低的中度/重度疲劳发生率相关（OR 0.85; 95% CI 0.73-0.98）。在分层分析中，只有在5-甲基四氢叶酸水平较高的成年人中，高活微生物摄入量对应于中度/重度疲劳的几率降低38-65%，而在水平较低的成年人中没有显著相关性。结论：摄入富含微生物的食物和较高水平的循环5-甲基四氢叶酸都与中年和老年人较低的疲劳水平相关，叶酸充足似乎增强了活微生物食物的疲劳减少益处，支持与健康衰老相关的营养-微生物途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life