Association between DASH diet adherence and sarcopenia: the mediating role of adiposity indices

The Dietary Approaches to Stop Hypertension (DASH) dietary pattern demonstrates benefits beyond blood pressure regulation across multiple diseases, yet its relationship with sarcopenia remains poorly understood. To examine associations between DASH diet adherence, sarcopenia, and sarcopenic obesity, while investigating the potential mediating role of adiposity indices. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. Associations between DASH diet adherence and the prevalence of sarcopenia and sarcopenic obesity were evaluated using multivariable weighted logistic regression models. Restricted cubic splines were employed to assess potential nonlinear relationships. Mediation analysis was used to identify potential mediators, while comprehensive sensitivity and subgroup analyses were conducted to verify the robustness of our findings. Among the 8512 study participants (47.71% male, mean age 39.54 ± 11.56 years), 744 (7.52%) presented with sarcopenia and 517 (5.52%) with sarcopenic obesity. After adjustment for multiple confounding factors, each unit increase in DASH diet score was associated with a 7.0% reduction in sarcopenia risk and an 8.0% reduction in sarcopenic obesity risk (OR (95% CI): 0.93 (0.90–0.95) and 0.92 (0.89–0.94), respectively; all P < 0.001). Adiposity indices—waist-to-height ratio and body roundness index—mediated 56.74% and 51.52% of these associations, respectively. The inverse associations between DASH diet adherence and sarcopenia remained consistent across sensitivity analyses and diverse subgroups. Adherence to the DASH dietary pattern is associated with lower odds of sarcopenia and sarcopenic obesity. Further research is needed to confirm the DASH diet’s efficacy as a preventive strategy against sarcopenia.