# Evaluation of Dietary Guideline Adherence and Risk of Sarcopenia in Elder Taiwanese

## TL;DR

This study finds that following dietary guidelines, especially eating more vegetables and dairy, is linked to a lower risk of muscle loss in older Taiwanese adults.

## Contribution

The study introduces a new dietary index (HEI-TW) adapted for Taiwan and shows its link to reduced sarcopenia risk.

## Key findings

- Higher HEI-TW scores were associated with lower odds of sarcopenia.
- Greater vegetable and dairy intake was linked to reduced sarcopenia risk.
- The association was stronger in men and those aged 75 or older.

## Abstract

Dietary strategies play an important role in determining longevity and healthy aging. There is an increasing awareness of dietary factors and sarcopenia, which presents as a decline in muscle mass and function, mainly in the senior population. The aim of this study is to explore the association of adherence to the Dietary Guideline (DG) on muscle health in the elder Taiwanese. We included 410 adults aged 65 or older, of whom 189 (46.1%) were women, in the Nutrition and Health Survey in Taiwan (NAHSIT) during 2014–2016 with comprehensive records of food frequency questionnaires and 24‐h dietary recalls, as well as measurements of dual‐energy X‐ray absorptiometry (DXA) for muscle mass and 8‐m gait speed for physical performance. A novel indicator, named Healthy Eating Index for Taiwanese (HEI‐TW), was developed as an amended version of HEI‐2015 to assess how dietary patterns adhere to the DG of Taiwan. Participants who fulfilled “low muscle mass” and “poor physical performance” defined by the Asian Working Group for Sarcopenia (AWGS) criteria were recognized as having sarcopenia; others, in contrast, were recognized as healthy controls. Seventy‐one (17.3%) participants categorized into the sarcopenia group had significantly lower mean scores of overall HEI‐TW, total vegetables, unrefined grains, and dairy products. The adjusted odds ratios (95% confidence intervals) for sarcopenia were 0.98 (0.95–1.00) for overall HEI‐TW, 0.78 (0.66–0.94) for total vegetables, and 0.85 (0.76–0.95) for dairy, respectively, for one unit increase in these components. In subgroup analysis stratified by sex and age, the overall HEI‐TW was inversely associated with the odds of sarcopenia among men and individuals aged 75 or older. This study showed that a higher HEI‐TW score adhering to Taiwan DG and abundant consumption of total vegetables and dairy products is associated with lower prevalence of muscle loss and sarcopenia in elder Taiwanese.

We utilized a nationwide nutrition survey in Taiwan and developed a novel index to explore the association between dietary adherence and sarcopenia. Better adherence to the dietary guideline, especially meeting the recommendations of vegetable and dairy intake, has an association with a lower risk of sarcopenia. By adapting a dietary index, this study provides a modified tool for assessing diet quality and its impact on sarcopenia in Taiwanese older adults.