{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T03:02:34Z","timestamp":1791082954853,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,3]],"date-time":"2018-12-03T00:00:00Z","timestamp":1543795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NARO Bio-oriented Technology Research Advancement Institution, Japan","award":["(advanced integration research for agriculture and interdisciplinary fields)"],"award-info":[{"award-number":["(advanced integration research for agriculture and interdisciplinary fields)"]}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R44DK103377"],"award-info":[{"award-number":["R44DK103377"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Previous studies have reported that a higher dietary inflammatory index (DII\u00ae) score is related to a higher risk of mortality and conditions that result in functional disability, such as cardiovascular disease, dementia, and fractures. Although these findings suggest that higher DII scores would affect disability-free survival, this has never been investigated directly. The present study investigated the association between the DII score and disability-free survival. Methods: We analyzed follow-up data covering a 12-year period for 793 older adults (\u226570 years) participating in a Japanese community-based cohort study. DII scores were computed on the basis of dietary intake and assessed using the Brief Self-Administered Diet History Questionnaire. Data on incident functional disability were retrieved from the public Long-Term Care Insurance database. We applied the Cox model for estimating the adjusted hazard ratios (HRs) of the composite outcome (incident functional disability or death) according to DII score tertiles (T1\u2013T3). Results: The proportion of men was 47.3%; mean (SD) age was 75.2 (4.5) years. The 12-year incidence of the composite outcome was 65.5%. A higher DII score was related to a higher risk for the composite outcome: HRs (95% confidence interval) were 1.05 (0.84, 1.32) for T2 and 1.26 (1.01, 1.57) for T3 (p-trend = 0.040) compared to the most anti-inflammatory T1 reference (HR = 1.00). Conclusions: These results suggest that a pro-inflammatory diet might be a modifiable factor affecting disability-free survival in the older population. Additional prospective studies are needed to confirm this relationship.<\/jats:p>","DOI":"10.3390\/nu10121896","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T03:01:37Z","timestamp":1543892497000},"page":"1896","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Dietary Inflammatory Index and Disability-Free Survival in Community-Dwelling Older Adults"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4189-5245","authenticated-orcid":false,"given":"Yasutake","family":"Tomata","sequence":"first","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Shivappa","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. <email>shivappa@email.sc.edu<\/email> (N.S.)"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Connecting Health Innovations, LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-3159","authenticated-orcid":false,"given":"Shu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieta","family":"Nurrika","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7661-5699","authenticated-orcid":false,"given":"Fumiya","family":"Tanji","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA. <email>shivappa@email.sc.edu<\/email> (N.S.)"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Connecting Health Innovations, LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Sendai 980-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Colombo, F., Llena-Nozal, A., Mercier, J., and Tjadens, F. (2011). Help Wanted?: Providing and Paying for Long-Term Care, OECD Publishing.","DOI":"10.1787\/9789264097759-en"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Friedman, S.M., Mulhausen, P., Cleveland, M.L., Coll, P.P., Daniel, K.M., Hayward, A.D., Shah, K., Skudlarska, B., and White, H.K. (2018). Healthy aging: American geriatrics society white paper executive summary. J. Am. Geriatr. Soc.","DOI":"10.1111\/jgs.15644"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s00011-008-7243-2","article-title":"Exploring the complex relations between inflammation and aging (inflamm-aging): Anti-inflamm-aging remodelling of inflamm-aging, from robustness to frailty","volume":"57","author":"Giunta","year":"2008","journal-title":"Inflamm. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jamda.2013.05.009","article-title":"Proinflammatory cytokines, aging, and age-related diseases","volume":"14","author":"Michaud","year":"2013","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1016\/S0140-6736(17)31544-1","article-title":"Population health and regional variations of disease burden in japan, 1990\u20132015: A systematic subnational analysis for the global burden of disease study 2015","volume":"390","author":"Nomura","year":"2017","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1017\/S0007114515002093","article-title":"Low-grade inflammation, diet composition and health: Current research evidence and its translation","volume":"114","author":"Minihane","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.pcad.2018.05.004","article-title":"Portfolio dietary pattern and cardiovascular disease: A systematic review and meta-analysis of controlled trials","volume":"61","author":"Chiavaroli","year":"2018","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1017\/S1368980013002115","article-title":"Designing and developing a literature-derived, population-based dietary inflammatory index","volume":"17","author":"Shivappa","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1017\/S1368980013002565","article-title":"A population-based dietary inflammatory index predicts levels of c-reactive protein in the seasonal variation of blood cholesterol study (seasons)","volume":"17","author":"Shivappa","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Phillips, C.M., Shivappa, N., Hebert, J.R., and Perry, I.J. (2018). Dietary inflammatory index and biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis in adults. Nutrients, 10.","DOI":"10.3390\/nu10081033"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Shivappa, N., Wirth, M.D., Murphy, E.A., Hurley, T.G., and Hebert, J.R. (2018). Association between the dietary inflammatory index (DII) and urinary enterolignans and c-reactive protein from the national health and nutrition examination survey-2003\u20132008. Eur. J. Nutr.","DOI":"10.1093\/annonc\/mdx390.056"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.nutres.2018.04.007","article-title":"Improvement in dietary inflammatory index score after 6-month dietary intervention is associated with reduction in interleukin-6 in patients with coronary heart disease: The ausmed heart trial","volume":"55","author":"Mayr","year":"2018","journal-title":"Nutr. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ruiz-Canela, M., Bes-Rastrollo, M., and Martinez-Gonzalez, M.A. (2016). The role of dietary inflammatory index in cardiovascular disease, metabolic syndrome and mortality. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17081265"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Shivappa, N., Godos, J., Hebert, J.R., Wirth, M.D., Piuri, G., Speciani, A.F., and Grosso, G. (2018). Dietary inflammatory index and cardiovascular risk and mortality\u2014A meta-analysis. Nutrients, 10.","DOI":"10.3390\/nu10020200"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4124","DOI":"10.3390\/nu7064124","article-title":"Dietary inflammatory index and incidence of cardiovascular disease in the predimed study","volume":"7","author":"Ramallal","year":"2015","journal-title":"Nutrients"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.jalz.2017.04.004","article-title":"The association between an inflammatory diet and global cognitive function and incident dementia in older women: The women\u2019s health initiative memory study","volume":"13","author":"Hayden","year":"2017","journal-title":"Alzheimers Dement."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jamda.2017.08.006","article-title":"The relationship between the dietary inflammatory index and incident frailty: A longitudinal cohort study","volume":"19","author":"Shivappa","year":"2018","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kim, D., and Park, Y. (2018). Association between the dietary inflammatory index and risk of frailty in older individuals with poor nutritional status. Nutrients, 10.","DOI":"10.3390\/nu10101363"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1002\/jbmr.3070","article-title":"Dietary inflammatory index, bone mineral density, and risk of fracture in postmenopausal women: Results from the women\u2019s health initiative","volume":"32","author":"Orchard","year":"2017","journal-title":"J. Bone Miner. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1038\/ejcn.2017.133","article-title":"The association between dietary inflammatory properties and bone mineral density and risk of fracture in US adults","volume":"71","author":"Mazidi","year":"2017","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jamda.2017.02.011","article-title":"Association between diet inflammatory index and osteoporotic hip fracture in elderly Chinese population","volume":"18","author":"Zhang","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1093\/gerona\/glr191","article-title":"Relationship between serum adiponectin levels and disability-free survival among community-dwelling elderly individuals: The Tsurugaya project","volume":"67","author":"Hozawa","year":"2012","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/gerona\/gls198","article-title":"Relationship between serum isoflavone levels and disability-free survival among community-dwelling elderly individuals: Nested case-control study of the Tsurugaya project","volume":"68","author":"Hozawa","year":"2013","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1017\/S1368980011000504","article-title":"Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults","volume":"14","author":"Kobayashi","year":"2011","journal-title":"Public Health Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2188\/jea.JE20110075","article-title":"Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults","volume":"22","author":"Kobayashi","year":"2012","journal-title":"J. Epidemiol."},{"key":"ref_26","first-page":"397","article-title":"The physical and psychological and social background factor of elderly depression in the community","volume":"7","author":"Muraoka","year":"1996","journal-title":"Ronen Seishin Igaku Zasshi"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jpsychores.2005.07.010","article-title":"Obesity and depressive symptoms in elderly Japanese: The Tsurugaya project","volume":"60","author":"Kuriyama","year":"2006","journal-title":"J. Psychosom. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1159\/000339596","article-title":"The reliability and validity of the mini-mental state examination in the elderly Croatian population","volume":"33","author":"Boban","year":"2012","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/j.1532-5415.2005.53175.x","article-title":"Care-needs certification in the long-term care insurance system of Japan","volume":"53","author":"Tsutsui","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/gps.836","article-title":"Are there inequities in the assessment of dementia under Japan\u2019s ltc insurance system?","volume":"18","author":"Arai","year":"2003","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jacc.2013.05.016","article-title":"High-sensitivity c-reactive protein and cardiovascular disease: A resolute belief or an elusive link?","volume":"62","author":"Yousuf","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1093\/eurpub\/ckx060","article-title":"Association between dietary inflammatory index, and cause-specific mortality in the MONICA\/KORA Augsburg Cohort study","volume":"28","author":"Shivappa","year":"2018","journal-title":"Eur. J. Public Health"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/12\/1896\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:30:54Z","timestamp":1760196654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/12\/1896"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,3]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["nu10121896"],"URL":"https:\/\/doi.org\/10.3390\/nu10121896","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,3]]}}}