Objective: This study aimed to determine associations of Mediterranean diet adherence with circulating cytokine levels, musculoskeletal health and incident falls in community-dwelling older men.
Methods: 794 community-dwelling men with mean age 81.1+4.5 years, who participated in the 5y follow-up of the Concord Health and Ageing in Men Project(CHAMP) were included in the cross-sectional analysis, and 616 attended follow-up 3y later. Mediterranean diet adherence was assessed using MEDI-LITE (literature-derived Mediterranean diet) score. 24 evaluable circulating cytokines were analysed using Bio-Plex Pro Human Cytokine 27-plex Assay kit. Appendicular lean mass (ALM) and bone mineral density (BMD) were measured using dual-energy x-ray absorptiometry (DXA). 3y changes in gait speed and hand grip strength were assessed by walking a 6-meter course and using a dynamometer respectively. Incident falls over 3y were determined through telephone interviews every 4 months.
Results: A higher MEDI-LITE score, indicating greater adherence to Mediterranean diet, was associated with higher appendicular lean mass adjusted for body mass index (ALMBMI) (β: 0.004 kg/kg/m2; 95% CI: 0.000, 0.008), lower interleukin-7 (IL-7) (β: -0.017 pg/mL; 95% CI: -0.031, -0.003), and incident falls rates (IRR: 0.94; 95% CI: 0.89, 0.99). Higher consumption of monounsaturated fatty acids (IRR: 0.76; 95% CI: 0.59, 0.98) and monounsaturated fatty acids to saturated fatty acids ratio (IRR: 0.72; 95% CI: 0.57, 0.90) were associated with 24%, and 28% lower falls risk in older men respectively. Association between MEDI-LITE scores and 3y incident falls was mediated by IL-7 by 10%. MEDI-LITE scores were not associated with BMD or physical function parameters.
Conclusion: Mediterranean diet adherence is associated with higher ALMBMI, lower levels of IL-7, and fewer falls in older men. Monounsaturated and saturated fatty acids were the most important contributors to the association between Mediterranean diet and falls risk. Association between MEDI-LITE score and incident falls was partly mediated by IL-7.