Nutrient intake and risk of multimorbidity: a prospective cohort study of 25,389 women

• Published in: BMC public health Vol. 24; no. 1; p. 696
• Main Authors: Song, Ge, Li, Weimin, Ma, Yanfen, Xian, Yao, Liao, Xia, Yang, Xueliang, Zhang, Huifeng, Cade, Janet E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.03.2024; BioMed Central; BMC
• Subjects: Aged; Aged women; Aging; Alfacalcidol; Ascorbic acid; Calcifediol; Cardiovascular disease; Care and treatment; Charlson comorbidity index; Chronic diseases; Chronic illnesses; Cohort analysis; Cohort Studies; Comorbidity; Cross-sectional studies; Diagnosis; Diet; Eating; Energy; Exercise; Female; Food; Food and nutrition; Food habits; Food intake; Health aspects; Hospital episode statistics; Humans; Iron; Life style; Linearity; Medical prognosis; Missing data; Multimorbidity; Nutrient intake; Nutrients; Nutrition research; Older people; Prospective Studies; Proteins; Public health; Questionnaires; Risk; Risk factors; Sensitivity analysis; Sociodemographics; Socioeconomic factors; Socioeconomic status; Statistical analysis; Statistical models; Vitamin B12; Vitamin D; Vitamins; Womens health; United Kingdom; United Kingdom > UK; China; Hospital episode statistics; Nutrient intake; Charlson comorbidity index; Multimorbidity
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-18191-9

Multimorbidity is becoming an increasingly serious public health challenge in the aging population. The impact of nutrients on multimorbidity remains to be determined and was explored using data from a UK cohort study. Our research analysis is mainly based on the data collected by the United Kingdom Women's Cohort Study (UKWCS), which recruited 35,372 women aged 35-69 years at baseline (1995 to 1998), aiming to explore potential associations between diet and chronic diseases. Daily intakes of energy and nutrients were estimated using a validated 217-item food frequency questionnaire at recruitment. Multimorbidity was assessed using the Charlson comorbidity index (CCI) through electronic linkages to Hospital Episode Statistics up to March 2019. Cox's proportional hazards models were used to estimate associations between daily intakes of nutrients and risk of multimorbidity. Those associations were also analyzed in multinomial logistic regression as a sensitivity analysis. In addition, a stratified analysis was conducted with age 60 as the cutoff point. Among the 25,389 participants, 7,799 subjects (30.7%) were confirmed with multimorbidity over a median follow-up of 22 years. Compared with the lowest quintile, the highest quintile of daily intakes of energy and protein were associated with 8% and 12% increased risk of multimorbidity respectively (HR 1.08 (95% CI 1.01, 1.16), p-linearity = 0.022 for energy; 1.12 (1.04, 1.21), p-linearity = 0.003 for protein). Higher quintiles of daily intakes of vitamin C and iron had a slightly lowered risk of multimorbidity, compared to the lowest quintile. A significantly higher risk of multimorbidity was found to be linearly associated with higher intake quintiles of vitamin B12 and vitamin D (p-linearity = 0.001 and 0.002, respectively) in Cox models, which became insignificant in multinomial logistic regression. There was some evidence of effect modification by age in intakes of iron and vitamin B1 associated with the risk of multimorbidity (p-interaction = 0.006 and 0.025, respectively). Our findings highlight a link between nutrient intake and multimorbidity risk. However, there is uncertainty in our results, and more research is needed before definite conclusions can be reached.