{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:26:14Z","timestamp":1785767174788,"version":"3.56.0"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shinhan University Research","award":["2023"],"award-info":[{"award-number":["2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Previous studies have shown contradictory results regarding the association between vegetable and fruit consumption and the risk of sarcopenia. We aimed to evaluate this association using a meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, EMBASE, and the Cochrane Library through July 2023 using related keywords. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on the random-effects model. We included 14 observational studies with 11 cross-sectional and three cohort studies involving 6436 sarcopenias among 33,801 participants. Vegetable and fruit consumption were significantly associated with reduced sarcopenia risk (OR, 0.61; 95% CI, 0.48 to 0.79; I2 = 59.8%). The association was significant in cross-sectional studies (OR, 0.64; 95% CI, 0.49 to 0.84; I2 = 56.3%; n = 11) but not in cohort studies (OR, 0.50; 95% CI, 0.22 to 1.11; I2 = 76.4%; n = 3). Moreover, the association was significant in age \u226560 (OR, 0.64; 95% CI, 0.49 to 0.83; I2 = 58.0%; n = 10). This meta-analysis suggests that eating vegetables and fruit reduces sarcopenia risk. However, as cohort studies provide a higher level of evidence than case\u2013control studies, further prospective cohort studies should be conducted.<\/jats:p>","DOI":"10.3390\/nu16111707","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T08:15:54Z","timestamp":1717056954000},"page":"1707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Association of Dietary Vegetable and Fruit Consumption with Sarcopenia: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-2165","authenticated-orcid":false,"given":"Seung-Hee","family":"Hong","sequence":"first","affiliation":[{"name":"Department of Food and Nutritional Science, Shinhan University, Uijeongbu 11644, Gyeonggi, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1185-3095","authenticated-orcid":false,"given":"Yun-Jung","family":"Bae","sequence":"additional","affiliation":[{"name":"Major in Food and Nutrition, Division of Food Science and Biotechnology, Korea National University of Transportation, Jeungpyeong 27909, Chungcheong, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Sayer","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/jcsm.12783","article-title":"Global prevalence of sarcopenia and severe sarcopenia: A systematic review and meta-analysis","volume":"13","author":"Balntzi","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.exger.2017.06.008","article-title":"Is sarcopenia associated with an increased risk of all-cause mortality and functional disability?","volume":"96","author":"Kelley","year":"2017","journal-title":"Exp. Gerontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1002\/jcsm.12411","article-title":"Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis","volume":"10","author":"Yeung","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Bai, T., Fang, F., Li, F., Ren, Y., Hu, J., and Cao, J. (2020). Sarcopenia is associated with hypertension in older adults: A systematic review and meta-analysis. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01672-y"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s00223-020-00742-y","article-title":"Type 2 Diabetes Mellitus is Associated with Increased Risk of Sarcopenia: A Systematic Review and Meta-analysis","volume":"107","author":"Anagnostis","year":"2020","journal-title":"Calcif. Tissue Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.maturitas.2017.04.007","article-title":"Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis","volume":"103","author":"Liu","year":"2017","journal-title":"Maturitas"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s11357-012-9385-y","article-title":"Association of handgrip strength with chronic diseases and multimorbidity: A cross-sectional study","volume":"35","author":"Cheung","year":"2013","journal-title":"Age"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2042018819888824","DOI":"10.1177\/2042018819888824","article-title":"Reduced physical activity in young and older adults: Metabolic and musculoskeletal implications","volume":"10","author":"Pickles","year":"2019","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/s40520-019-01170-1","article-title":"Malnutrition and sarcopenia","volume":"31","author":"Sieber","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.clnu.2017.08.016","article-title":"Does nutrition play a role in the prevention and management of sarcopenia?","volume":"37","author":"Robinson","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Ganapathy, A., and Nieves, J.W. (2020). Nutrition and Sarcopenia-What Do We Know?. Nutrients, 12.","DOI":"10.3390\/nu12061755"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Huang, R.Y., Yang, K.C., Chang, H.H., Lee, L.T., Lu, C.W., and Huang, K.C. (2016). The Association between Total Protein and Vegetable Protein Intake and Low Muscle Mass among the Community-Dwelling Elderly Population in Northern Taiwan. Nutrients, 8.","DOI":"10.3390\/nu8060373"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9822","DOI":"10.1038\/s41598-020-66249-6","article-title":"Sex- and age-specific effects of energy intake and physical activity on sarcopenia","volume":"10","author":"Cho","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Koyanagi, A., Veronese, N., Solmi, M., Oh, H., Shin, J.I., Jacob, L., Yang, L., Haro, J.M., and Smith, L. (2020). Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries. Nutrients, 12.","DOI":"10.3390\/nu12030706"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Liu, X., Ma, Y., and Li, X. (2023). Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study. Nutrients, 15.","DOI":"10.3390\/nu15153417"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.exger.2010.08.002","article-title":"Vitamin E and C supplementation reduces oxidative stress, improves antioxidant enzymes and positive muscle work in chronically loaded muscles of aged rats","volume":"45","author":"Ryan","year":"2010","journal-title":"Exp. Gerontol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Granic, A., Jagger, C., Davies, K., Adamson, A., Kirkwood, T., Hill, T.R., Siervo, M., Mathers, J.C., and Sayer, A.A. (2016). Effect of Dietary Patterns on Muscle Strength and Physical Performance in the Very Old: Findings from the Newcastle 85+ Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0149699"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/ageing\/afu028","article-title":"Association of vegetables and fruits consumption with sarcopenia in older adults: The Fourth Korea National Health and Nutrition Examination Survey","volume":"44","author":"Kim","year":"2015","journal-title":"Age Ageing"},{"key":"ref_20","first-page":"245","article-title":"Dietary patterns and sarcopenia in a Chinese population","volume":"30","author":"Fu","year":"2021","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1007\/s00198-021-06012-3","article-title":"The role of diet quality and dietary patterns in predicting muscle mass and function in men over a 15-year period","volume":"32","author":"Davis","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Cacciatore, S., Calvani, R., Marzetti, E., Picca, A., Coelho-Junior, H.J., Martone, A.M., Massaro, C., Tosato, M., and Landi, F. (2023). Low Adherence to Mediterranean Diet Is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project. Nutrients, 15.","DOI":"10.3390\/nu15041026"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1016\/j.clnu.2022.07.035","article-title":"Antioxidant-rich foods, antioxidant supplements, and sarcopenia in old-young adults >=55 years old: A systematic review and meta-analysis of observational studies and randomized controlled trials","volume":"41","author":"Llaurado","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Park, S.J., Park, J., Won, C.W., and Lee, H.J. (2022). The Inverse Association of Sarcopenia and Protein-Source Food and Vegetable Intakes in the Korean Elderly: The Korean Frailty and Aging Cohort Study. Nutrients, 14.","DOI":"10.3390\/nu14071375"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_26","unstructured":"Wells, G.A., Shea, B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (2023, May 01). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.htm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin. Trials"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/21551197.2013.840255","article-title":"Dietary patterns and sarcopenia in an urban African American and White population in the United States","volume":"32","author":"Mason","year":"2013","journal-title":"J. Nutr. Gerontol. Geriatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.nut.2014.05.003","article-title":"Diet and its relationship to sarcopenia in community dwelling Iranian elderly: A cross sectional study","volume":"31","author":"Hashemi","year":"2015","journal-title":"Nutrition"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.jamda.2015.12.004","article-title":"A Prospective Cohort Study to Examine the Association Between Dietary Patterns and Sarcopenia in Chinese Community-Dwelling Older People in Hong Kong","volume":"17","author":"Chan","year":"2016","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s40520-016-0721-4","article-title":"Relationship between major dietary patterns and sarcopenia among menopausal women","volume":"29","author":"Mohseni","year":"2017","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Li, C., Kang, B., Zhang, T., Gu, H., Song, P., Chen, J., Wang, X., Xu, B., Zhao, W., and Zhang, J. (2020). Dietary Pattern and Dietary Energy from Fat Associated with Sarcopenia in Community-Dwelling Older Chinese People: A Cross-Sectional Study in Three Regions of China. Nutrients, 12.","DOI":"10.3390\/nu12123689"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s12603-021-1605-7","article-title":"Prospective Analysis of Fruit and Vegetable Variety on Health Outcomes in Community-Dwelling Chinese Older Adults","volume":"25","author":"Yeung","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12937-021-00665-w","article-title":"Association of nutrient-derived dietary patterns with sarcopenia and its components in community-dwelling older Japanese: A cross-sectional study","volume":"20","author":"Yokoyama","year":"2021","journal-title":"Nutr. J."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Borges, K., Artacho, R., Jodar-Graus, R., Molina-Montes, E., and Ruiz-Lopez, M.D. (2022). Calf Circumference, a Valuable Tool to Predict Sarcopenia in Older People Hospitalized with Hip Fracture. Nutrients, 14.","DOI":"10.3390\/nu14204255"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1017\/S0007114521003901","article-title":"A posteriori dietary patterns in 71-year-old Swedish men and the prevalence of sarcopenia 16 years later","volume":"128","author":"Karlsson","year":"2021","journal-title":"Br. J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1017\/S0007114521003871","article-title":"Dietary patterns and sarcopenia in elderly adults: The Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) study","volume":"128","author":"Wang","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1239945","DOI":"10.3389\/fragi.2023.1239945","article-title":"Association of dietary patterns and sarcopenia in the elderly population: A cross-sectional study","volume":"4","author":"Wang","year":"2023","journal-title":"Front. Aging"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1007\/s00198-012-2203-7","article-title":"A higher alkaline dietary load is associated with greater indexes of skeletal muscle mass in women","volume":"24","author":"Welch","year":"2013","journal-title":"Osteoporos. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1128S","DOI":"10.3945\/ajcn.2010.28608B","article-title":"Review of muscle wasting associated with chronic kidney disease","volume":"91","author":"Workeneh","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.3389\/fphys.2017.01045","article-title":"The Role of Inflammation in Age-Related Sarcopenia","volume":"8","author":"Dalle","year":"2017","journal-title":"Front. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"316943","DOI":"10.1155\/2012\/316943","article-title":"Rationale for antioxidant supplementation in sarcopenia","volume":"2012","author":"Cerullo","year":"2012","journal-title":"J. Aging Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1093\/jn\/nxaa221","article-title":"Lower Dietary and Circulating Vitamin C in Middle- and Older-Aged Men and Women Are Associated with Lower Estimated Skeletal Muscle Mass","volume":"150","author":"Lewis","year":"2020","journal-title":"J. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/978-3-319-70178-3_9","article-title":"Sex Differences in Muscle Wasting","volume":"1043","author":"Anderson","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1146\/annurev-nutr-071715-050901","article-title":"Understanding Age-Related Changes in Skeletal Muscle Metabolism: Differences Between Females and Males","volume":"36","author":"Gheller","year":"2016","journal-title":"Annu. Rev. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2333721416667879","DOI":"10.1177\/2333721416667879","article-title":"Physical Activity Protects Men but Not Women for Sarcopenia Development","volume":"2","author":"Rivera","year":"2016","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0195-6663(03)00014-X","article-title":"Sex differences in fruit and vegetable intake in older adults","volume":"40","author":"Baker","year":"2003","journal-title":"Appetite"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia","volume":"15","author":"Chen","year":"2014","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/ageing\/afq034","article-title":"Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People","volume":"39","author":"Baeyens","year":"2010","journal-title":"Age Ageing"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"111269","DOI":"10.1016\/j.mad.2020.111269","article-title":"Associations between diet and handgrip strength: A cross-sectional study from UK Biobank","volume":"189","author":"Gedmantaite","year":"2020","journal-title":"Mech. Ageing Dev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1002\/jcsm.12413","article-title":"Dietary nitrate intake is associated with muscle function in older women","volume":"10","author":"Sim","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/11\/1707\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:51:06Z","timestamp":1760107866000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/11\/1707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,30]]},"references-count":54,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["nu16111707"],"URL":"https:\/\/doi.org\/10.3390\/nu16111707","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,30]]}}}