Association between the Dietary Inflammatory Index and fracture risk in older adults: a systematic review and meta-analysis

Abstract

Objective We explored correlations between the Dietary Inflammatory Index (DII) and fracture risk in older adults. Methods We systematically searched MEDLINE, PubMed, Science Direct, Scopus, and CNKI for all relevant epidemiological studies published through October 16, 2023. Because observational studies were included in the meta-analysis, we used a random-effects model to pool the study-specific effect sizes and 95% confidence intervals (CIs). We assessed study quality using the Newcastle–Ottawa scale. This meta-analysis was registered in PROSPERO. Results Eight studies with 462,986 participants were included, with five cohort studies, two cross-sectional studies, and one case–control study. An analysis of heterogeneity among the eight included studies resulted in I2 = 87.1%, indicating significant between-study heterogeneity; hence, the random-effects model was adopted to generate the combined effect size. We found that the DII was positively associated with fracture (relative risk: 1.188, 95% CI: 1.043–1.354). This result was further confirmed in leave-one-out sensitivity analysis. Conclusions Our study provides evidence suggesting that diets high in pro-inflammatory components might increase the fracture risk among older people. Decreased consumption of pro-inflammatory foods and increased consumption of anti-inflammatory foods are suggested to prevent adverse fracture outcomes. More prospective studies involving both sexes are warranted to verify the results.