Osteosarcopenia (OS), which has become a global public health problem, is a geriatric syndrome in which sarcopenia and osteoporosis co-exist, leading to falls, fractures, and even varying degrees of disability in the elderly. The Dietary Inflammatory Index (DII) is a tool to measure the overall level of dietary inflammation in an individual, and the DII score is closely associated with the development of OS. This article reviews the basic concepts of DII and OS and their interrelationships, focusing on the associations between diet, inflammation, DII and OS, with the aim of providing a reference for dietary interventions in the prevention and control of OS patients.
Citation： TAN Yan, CHAI Fang. Research progress of Dietary Inflammatory Index and osteosarcopenia. West China Medical Journal, 2024, 39(10): 1657-1661. doi: 10.7507/1002-0179.202406210 Copy
| 1. | Kirk B, Miller S, Zanker J, et al. A clinical guide to the pathophysiology, diagnosis and treatment of osteosarcopenia. Maturitas, 2020, 140: 27-33. |
| 2. | 黄宏兴, 史晓林, 李盛华, 等. 肌少-骨质疏松症专家共识. 中国骨质疏松杂志, 2022, 28(11): 1561-1570. |
| 3. | Diao H, Yan F, He Q, et al. Association between dietary inflammatory index and sarcopenia: a meta-analysis. Nutrients, 2023, 15(1): 219. |
| 4. | 王梅, 郭曼, 吴静, 等. 膳食炎症指数与骨质疏松、骨折风险关系的 Meta 分析. 中华骨质疏松和骨矿盐疾病杂志, 2022, 15(1): 57-65. |
| 5. | Phillips CM, Chen LW, Heude B, et al. Dietary inflammatory index and non-communicable disease risk: a narrative review. Nutrients, 2019, 11(8): 1873. |
| 6. | Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr, 2004, 80(4): 1029-1035. |
| 7. | Di Giosia P, Stamerra CA, Giorgini P, et al. The role of nutrition in inflammaging. Ageing Res Rev, 2022, 77: 101596. |
| 8. | Jin Q, Hart PA, Shi N, et al. Dietary patterns of insulinemia, inflammation and glycemia, and pancreatic cancer risk: findings from the Women’s Health Initiative. Cancer Epidemiol Biomarkers Prev, 2021, 30(6): 1229-1240. |
| 9. | Barbaresko J, Koch M, Schulze MB, et al. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev, 2013, 71(8): 511-527. |
| 10. | Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr, 2005, 82(1): 163-173. |
| 11. | Sood S, Feehan J, Itsiopoulos C, et al. Higher adherence to a mediterranean diet is associated with improved insulin sensitivity and selected markers of inflammation in individuals who are overweight and obese without diabetes. Nutrients, 2022, 14(20): 4437. |
| 12. | Shivappa N, Steck SE, Hurley TG, et al. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr, 2014, 17(8): 1689-1696. |
| 13. | Cavicchia PP, Steck SE, Hurley TG, et al. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr, 2009, 139(12): 2365-2372. |
| 14. | Moludi J, Fateh HL, Pasdar Y, et al. Association of dietary inflammatory index with chronic kidney disease and kidney stones in Iranian adults: a cross-sectional study within the Ravansar non-communicable diseases cohort. Front Nutr, 2022, 9: 955562. |
| 15. | Bizzozero-Peroni B, Ortolá R, Martínez-Vizcaíno V, et al. Proinflammatory dietary pattern and depression risk in older adults: prospective analyses from the Seniors-ENRICA studies. Clin Nutr, 2022, 41(12): 2614-2620. |
| 16. | McDiarmid KP, Wood LG, Upham JW, et al. The impact of meal dietary inflammatory index on exercise-induced changes in airway inflammation in adults with asthma. Nutrients, 2022, 14(20): 4392. |
| 17. | 黄利, 杨国超, 王敏娟, 等. 膳食炎症指数的研究进展及应用. 实用医药杂志, 2019, 36(6): 572-576. |
| 18. | 袁平戈. 膳食炎症指数. 肝博士, 2023(3): 31-32. |
| 19. | Shivappa N, Hébert JR, Karamati M, et al. Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran. Eur J Nutr, 2016, 55(2): 561-568. |
| 20. | Hariharan R, Odjidja EN, Scott D, et al. The dietary inflammatory index, obesity, type 2 diabetes, and cardiovascular risk factors and diseases. Obes Rev, 2022, 23(1): e13349. |
| 21. | 陈婷婷, 赵嘉琪, 冉明奇. 膳食炎症指数与癌症关系的研究进展. 重庆医学, 2021, 50(2): 333-337. |
| 22. | 赵赛赛. 膳食炎症指数与骨质密度和骨质疏松症的关联研究. 长春: 吉林大学, 2023. |
| 23. | Cervo MMC, Scott D, Seibel MJ, et al. Proinflammatory diet increases circulating inflammatory biomarkers and falls risk in community-dwelling older men. J Nutr, 2020, 150(2): 373-381. |
| 24. | Li R, Zhan W, Huang X, et al. Association of Dietary Inflammatory Index (DII) and depressive disorders. J Inflamm Res, 2021, 14: 6959-6973. |
| 25. | Malesza IJ, Malesza M, Walkowiak J, et al. High-fat, western-style diet, systemic inflammation, and gut microbiota: a narrative review. Cells, 2021, 10(11): 3164. |
| 26. | Shivappa N, Hébert JR, Rietzschel ER, et al. Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr, 2015, 113(4): 665-671. |
| 27. | Shivappa N, Steck SE, Hurley TG, et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutr, 2014, 17(8): 1825-1833. |
| 28. | Mazidi M, Shivappa N, Wirth MD, et al. Dietary inflammatory index and cardiometabolic risk in US adults. Atherosclerosis, 2018, 276: 23-27. |
| 29. | Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr, 1997, 127(5 Suppl): 990S-991S. |
| 30. | Bellafronte NT, Sizoto GR, Vega-Piris L, et al. Bed-side measures for diagnosis of low muscle mass, sarcopenia, obesity, and sarcopenic obesity in patients with chronic kidney disease under non-dialysis-dependent, dialysis dependent and kidney transplant therapy. PLoS One, 2020, 15(11): e0242671. |
| 31. | Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int, 1991, 1(2): 114-117. |
| 32. | Binkley N, Buehring B. Beyond FRAX: it’s time to consider “sarco-osteopenia”. J Clin Densitom, 2009, 12(4): 413-416. |
| 33. | Kobayashi K, Imagama S, Ando K, et al. Epidemiology and effect on physical function of osteosarcopenia in community-dwelling elderly people in Japan. Mod Rheumatol, 2020, 30(3): 592-597. |
| 34. | Reiss J, Iglseder B, Alzner R, et al. Sarcopenia and osteoporosis are interrelated in geriatric inpatients. Z Gerontol Geriatr, 2019, 52(7): 688-693. |
| 35. | Wang YJ, Wang Y, Zhan JK, et al. Sarco-osteoporosis: prevalence and association with frailty in Chinese community-dwelling older adults. Int J Endocrinol, 2015, 2015: 482940. |
| 36. | Fahimfar N, Zahedi Tajrishi F, Gharibzadeh S, et al. Prevalence of osteosarcopenia and its association with cardiovascular risk factors in Iranian older people: Bushehr Elderly Health (BEH) Program. Calcif Tissue Int, 2020, 106(4): 364-370. |
| 37. | Drey M, Sieber CC, Bertsch T, et al. Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res, 2016, 28(5): 895-899. |
| 38. | Huo YR, Suriyaarachchi P, Gomez F, et al. Phenotype of osteosarcopenia in older individuals with a history of falling. J Am Med Dir Assoc, 2015, 16(4): 290-295. |
| 39. | Silva TRD, Martins CC, Ferreira LL, et al. Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women. Climacteric, 2019, 22(2): 162-168. |
| 40. | Hashemi R, Motlagh AD, Heshmat R, et al. Diet and its relationship to sarcopenia in community dwelling Iranian elderly: a cross sectional study. Nutrition, 2015, 31(1): 97-104. |
| 41. | Robinson S, Granic A, Sayer AA. Nutrition and muscle strength, as the key component of sarcopenia: an overview of current evidence. Nutrients, 2019, 11(12): 2942. |
| 42. | Su Y, Yeung SSY, Chen YM, et al. The associations of dietary inflammatory potential with musculoskeletal health in Chinese community-dwelling older people: the Mr. OS and Ms. OS (Hong Kong) Cohort Study. J Bone Miner Res, 2022, 37(6): 1179-1187. |
| 43. | Visser M, Pahor M, Taaffe DR, et al. Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: the Health ABC Study. J Gerontol A Biol Sci Med Sci, 2002, 57(5): M326-M332. |
| 44. | Schaap LA, Pluijm SM, Deeg DJ, et al. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med, 2006, 119(6): 526.e9-526.e17. |
| 45. | Ganesan K, Teklehaimanot S, Tran TH, et al. Relationship of C-reactive protein and bone mineral density in community-dwelling elderly females. J Natl Med Assoc, 2005, 97(3): 329-333. |
| 46. | Al-Daghri NM, Aziz I, Yakout S, et al. Inflammation as a contributing factor among postmenopausal Saudi women with osteoporosis. Medicine (Baltimore), 2017, 96(4): e5780. |
| 47. | Schett G. Effects of inflammatory and anti-inflammatory cytokines on the bone. Eur J Clin Invest, 2011, 41(12): 1361-1366. |
| 48. | Kawao N, Kaji H. Interactions between muscle tissues and bone metabolism. J Cell Biochem, 2015, 116(5): 687-695. |
| 49. | Stefanaki C, Pervanidou P, Boschiero D, et al. Chronic stress and body composition disorders: implications for health and disease. Hormones (Athens), 2018, 17(1): 33-43. |
| 50. | Kim HS, Sohn C, Kwon M, et al. Positive association between dietary inflammatory index and the risk of osteoporosis: results from the KoGES_Health Examinee (HEXA) cohort study. Nutrients, 2018, 10(12): 1999. |
| 51. | Wang L, Ye C, Zhao F, et al. Association between the dietary inflammatory index and the risk of fracture in chinese adults: longitudinal study. JMIR Public Health Surveill, 2023, 9: e43501. |
| 52. | Linton C, Wright HH, Wadsworth DP, et al. Dietary Inflammatory Index and associations with sarcopenia symptomology in community-dwelling older adults. Nutrients, 2022, 14(24): 5319. |
| 53. | Esmaeily Z, Daei S, Rezaei M, et al. Association between dietary inflammatory potential and the probable sarcopenia among community-dwelling older adults: a cross-sectional study. BMC Geriatr, 2022, 22(1): 834. |
| 54. | Su Y, Elshorbagy A, Turner C, et al. The association of circulating amino acids and dietary inflammatory potential with muscle health in Chinese community-dwelling older people. Nutrients, 2022, 14(12): 2471. |
| 55. | 樊海源. 膳食炎症指数与肌肉衰减症关系研究及风险预测模型的应用. 乌鲁木齐: 新疆医科大学, 2023. |
| 56. | Bian D, Liu X, Wang C, et al. Association between Dietary Inflammatory Index and sarcopenia in Crohn’s disease patients. Nutrients, 2022, 14(4): 901. |
| 57. | Orchard T, Yildiz V, Steck SE, et al. Dietary inflammatory index, bone mineral density, and risk of fracture in postmenopausal women: results from the Women’s Health Initiative. J Bone Miner Res, 2017, 32(5): 1136-1146. |
| 58. | 杨国超. 老年人膳食炎症指数与骨量关系的研究. 西安: 西安医学院, 2019. |
| 59. | Fang Y, Zhu J, Fan J, et al. Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis. Osteoporos Int, 2021, 32(4): 633-643. |
- 1. Kirk B, Miller S, Zanker J, et al. A clinical guide to the pathophysiology, diagnosis and treatment of osteosarcopenia. Maturitas, 2020, 140: 27-33.
- 2. 黄宏兴, 史晓林, 李盛华, 等. 肌少-骨质疏松症专家共识. 中国骨质疏松杂志, 2022, 28(11): 1561-1570.
- 3. Diao H, Yan F, He Q, et al. Association between dietary inflammatory index and sarcopenia: a meta-analysis. Nutrients, 2023, 15(1): 219.
- 4. 王梅, 郭曼, 吴静, 等. 膳食炎症指数与骨质疏松、骨折风险关系的 Meta 分析. 中华骨质疏松和骨矿盐疾病杂志, 2022, 15(1): 57-65.
- 5. Phillips CM, Chen LW, Heude B, et al. Dietary inflammatory index and non-communicable disease risk: a narrative review. Nutrients, 2019, 11(8): 1873.
- 6. Lopez-Garcia E, Schulze MB, Fung TT, et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr, 2004, 80(4): 1029-1035.
- 7. Di Giosia P, Stamerra CA, Giorgini P, et al. The role of nutrition in inflammaging. Ageing Res Rev, 2022, 77: 101596.
- 8. Jin Q, Hart PA, Shi N, et al. Dietary patterns of insulinemia, inflammation and glycemia, and pancreatic cancer risk: findings from the Women’s Health Initiative. Cancer Epidemiol Biomarkers Prev, 2021, 30(6): 1229-1240.
- 9. Barbaresko J, Koch M, Schulze MB, et al. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev, 2013, 71(8): 511-527.
- 10. Fung TT, McCullough ML, Newby PK, et al. Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr, 2005, 82(1): 163-173.
- 11. Sood S, Feehan J, Itsiopoulos C, et al. Higher adherence to a mediterranean diet is associated with improved insulin sensitivity and selected markers of inflammation in individuals who are overweight and obese without diabetes. Nutrients, 2022, 14(20): 4437.
- 12. Shivappa N, Steck SE, Hurley TG, et al. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr, 2014, 17(8): 1689-1696.
- 13. Cavicchia PP, Steck SE, Hurley TG, et al. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C-reactive protein. J Nutr, 2009, 139(12): 2365-2372.
- 14. Moludi J, Fateh HL, Pasdar Y, et al. Association of dietary inflammatory index with chronic kidney disease and kidney stones in Iranian adults: a cross-sectional study within the Ravansar non-communicable diseases cohort. Front Nutr, 2022, 9: 955562.
- 15. Bizzozero-Peroni B, Ortolá R, Martínez-Vizcaíno V, et al. Proinflammatory dietary pattern and depression risk in older adults: prospective analyses from the Seniors-ENRICA studies. Clin Nutr, 2022, 41(12): 2614-2620.
- 16. McDiarmid KP, Wood LG, Upham JW, et al. The impact of meal dietary inflammatory index on exercise-induced changes in airway inflammation in adults with asthma. Nutrients, 2022, 14(20): 4392.
- 17. 黄利, 杨国超, 王敏娟, 等. 膳食炎症指数的研究进展及应用. 实用医药杂志, 2019, 36(6): 572-576.
- 18. 袁平戈. 膳食炎症指数. 肝博士, 2023(3): 31-32.
- 19. Shivappa N, Hébert JR, Karamati M, et al. Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran. Eur J Nutr, 2016, 55(2): 561-568.
- 20. Hariharan R, Odjidja EN, Scott D, et al. The dietary inflammatory index, obesity, type 2 diabetes, and cardiovascular risk factors and diseases. Obes Rev, 2022, 23(1): e13349.
- 21. 陈婷婷, 赵嘉琪, 冉明奇. 膳食炎症指数与癌症关系的研究进展. 重庆医学, 2021, 50(2): 333-337.
- 22. 赵赛赛. 膳食炎症指数与骨质密度和骨质疏松症的关联研究. 长春: 吉林大学, 2023.
- 23. Cervo MMC, Scott D, Seibel MJ, et al. Proinflammatory diet increases circulating inflammatory biomarkers and falls risk in community-dwelling older men. J Nutr, 2020, 150(2): 373-381.
- 24. Li R, Zhan W, Huang X, et al. Association of Dietary Inflammatory Index (DII) and depressive disorders. J Inflamm Res, 2021, 14: 6959-6973.
- 25. Malesza IJ, Malesza M, Walkowiak J, et al. High-fat, western-style diet, systemic inflammation, and gut microbiota: a narrative review. Cells, 2021, 10(11): 3164.
- 26. Shivappa N, Hébert JR, Rietzschel ER, et al. Associations between dietary inflammatory index and inflammatory markers in the Asklepios Study. Br J Nutr, 2015, 113(4): 665-671.
- 27. Shivappa N, Steck SE, Hurley TG, et al. A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS). Public Health Nutr, 2014, 17(8): 1825-1833.
- 28. Mazidi M, Shivappa N, Wirth MD, et al. Dietary inflammatory index and cardiometabolic risk in US adults. Atherosclerosis, 2018, 276: 23-27.
- 29. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr, 1997, 127(5 Suppl): 990S-991S.
- 30. Bellafronte NT, Sizoto GR, Vega-Piris L, et al. Bed-side measures for diagnosis of low muscle mass, sarcopenia, obesity, and sarcopenic obesity in patients with chronic kidney disease under non-dialysis-dependent, dialysis dependent and kidney transplant therapy. PLoS One, 2020, 15(11): e0242671.
- 31. Consensus development conference: prophylaxis and treatment of osteoporosis. Osteoporos Int, 1991, 1(2): 114-117.
- 32. Binkley N, Buehring B. Beyond FRAX: it’s time to consider “sarco-osteopenia”. J Clin Densitom, 2009, 12(4): 413-416.
- 33. Kobayashi K, Imagama S, Ando K, et al. Epidemiology and effect on physical function of osteosarcopenia in community-dwelling elderly people in Japan. Mod Rheumatol, 2020, 30(3): 592-597.
- 34. Reiss J, Iglseder B, Alzner R, et al. Sarcopenia and osteoporosis are interrelated in geriatric inpatients. Z Gerontol Geriatr, 2019, 52(7): 688-693.
- 35. Wang YJ, Wang Y, Zhan JK, et al. Sarco-osteoporosis: prevalence and association with frailty in Chinese community-dwelling older adults. Int J Endocrinol, 2015, 2015: 482940.
- 36. Fahimfar N, Zahedi Tajrishi F, Gharibzadeh S, et al. Prevalence of osteosarcopenia and its association with cardiovascular risk factors in Iranian older people: Bushehr Elderly Health (BEH) Program. Calcif Tissue Int, 2020, 106(4): 364-370.
- 37. Drey M, Sieber CC, Bertsch T, et al. Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clin Exp Res, 2016, 28(5): 895-899.
- 38. Huo YR, Suriyaarachchi P, Gomez F, et al. Phenotype of osteosarcopenia in older individuals with a history of falling. J Am Med Dir Assoc, 2015, 16(4): 290-295.
- 39. Silva TRD, Martins CC, Ferreira LL, et al. Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women. Climacteric, 2019, 22(2): 162-168.
- 40. Hashemi R, Motlagh AD, Heshmat R, et al. Diet and its relationship to sarcopenia in community dwelling Iranian elderly: a cross sectional study. Nutrition, 2015, 31(1): 97-104.
- 41. Robinson S, Granic A, Sayer AA. Nutrition and muscle strength, as the key component of sarcopenia: an overview of current evidence. Nutrients, 2019, 11(12): 2942.
- 42. Su Y, Yeung SSY, Chen YM, et al. The associations of dietary inflammatory potential with musculoskeletal health in Chinese community-dwelling older people: the Mr. OS and Ms. OS (Hong Kong) Cohort Study. J Bone Miner Res, 2022, 37(6): 1179-1187.
- 43. Visser M, Pahor M, Taaffe DR, et al. Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: the Health ABC Study. J Gerontol A Biol Sci Med Sci, 2002, 57(5): M326-M332.
- 44. Schaap LA, Pluijm SM, Deeg DJ, et al. Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med, 2006, 119(6): 526.e9-526.e17.
- 45. Ganesan K, Teklehaimanot S, Tran TH, et al. Relationship of C-reactive protein and bone mineral density in community-dwelling elderly females. J Natl Med Assoc, 2005, 97(3): 329-333.
- 46. Al-Daghri NM, Aziz I, Yakout S, et al. Inflammation as a contributing factor among postmenopausal Saudi women with osteoporosis. Medicine (Baltimore), 2017, 96(4): e5780.
- 47. Schett G. Effects of inflammatory and anti-inflammatory cytokines on the bone. Eur J Clin Invest, 2011, 41(12): 1361-1366.
- 48. Kawao N, Kaji H. Interactions between muscle tissues and bone metabolism. J Cell Biochem, 2015, 116(5): 687-695.
- 49. Stefanaki C, Pervanidou P, Boschiero D, et al. Chronic stress and body composition disorders: implications for health and disease. Hormones (Athens), 2018, 17(1): 33-43.
- 50. Kim HS, Sohn C, Kwon M, et al. Positive association between dietary inflammatory index and the risk of osteoporosis: results from the KoGES_Health Examinee (HEXA) cohort study. Nutrients, 2018, 10(12): 1999.
- 51. Wang L, Ye C, Zhao F, et al. Association between the dietary inflammatory index and the risk of fracture in chinese adults: longitudinal study. JMIR Public Health Surveill, 2023, 9: e43501.
- 52. Linton C, Wright HH, Wadsworth DP, et al. Dietary Inflammatory Index and associations with sarcopenia symptomology in community-dwelling older adults. Nutrients, 2022, 14(24): 5319.
- 53. Esmaeily Z, Daei S, Rezaei M, et al. Association between dietary inflammatory potential and the probable sarcopenia among community-dwelling older adults: a cross-sectional study. BMC Geriatr, 2022, 22(1): 834.
- 54. Su Y, Elshorbagy A, Turner C, et al. The association of circulating amino acids and dietary inflammatory potential with muscle health in Chinese community-dwelling older people. Nutrients, 2022, 14(12): 2471.
- 55. 樊海源. 膳食炎症指数与肌肉衰减症关系研究及风险预测模型的应用. 乌鲁木齐: 新疆医科大学, 2023.
- 56. Bian D, Liu X, Wang C, et al. Association between Dietary Inflammatory Index and sarcopenia in Crohn’s disease patients. Nutrients, 2022, 14(4): 901.
- 57. Orchard T, Yildiz V, Steck SE, et al. Dietary inflammatory index, bone mineral density, and risk of fracture in postmenopausal women: results from the Women’s Health Initiative. J Bone Miner Res, 2017, 32(5): 1136-1146.
- 58. 杨国超. 老年人膳食炎症指数与骨量关系的研究. 西安: 西安医学院, 2019.
- 59. Fang Y, Zhu J, Fan J, et al. Dietary Inflammatory Index in relation to bone mineral density, osteoporosis risk and fracture risk: a systematic review and meta-analysis. Osteoporos Int, 2021, 32(4): 633-643.