Clinical nutrition ESPEN · 2026
Dietary Variety as a Potential Modifier of Multidomain Intervention Effects on Gait Speed in Older Adults with Mild Cognitive Impairment: A Secondary Analysis of the J-MINT Trial.
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Ogawa Masato, Sugimoto Taiki, Sakurai Takashi, Arai Hidenori, J-MINT study group
Аннотация
BACKGROUND: Multidomain lifestyle interventions benefit older adults, but individual responses vary considerably. Although nutritional counseling is a core component of these programs, whether baseline dietary patterns modify intervention effects remains unknown. In this exploratory secondary analysis of the J-MINT randomized controlled trial, we examined whether baseline dietary variety modifies the effect of a multidomain intervention on gait speed in older adults with mild cognitive impairment (MCI).
METHODS: This secondary analysis of the J-MINT randomized controlled trial included 433 community-dwelling adults aged 65-85 years with MCI. The 18-month intervention comprised vascular risk management, exercise, nutritional counseling, and cognitive training. The primary outcome was usual gait speed at 18 months. Baseline dietary variety was assessed using the Dietary Variety Score (DVS), and effect modification on the intervention effect was examined.
RESULTS: The arm × DVS interaction coefficient for 18-month gait speed was 0.035 m/s per 1-SD increase in baseline DVS (95% CI, 0.001 to 0.071; P = 0.048). The between-arm difference at 18 months was 0.06 m/s (95% CI, 0.01 to 0.12) in the High DVS group and -0.03 m/s (95% CI, -0.11 to 0.04) in the Low DVS group. No indirect effects through appendicular lean mass, muscle strength, or biomarkers were detected.
CONCLUSIONS: In this hypothesis-generating secondary analysis, higher baseline dietary variety was associated with a larger effect of the multidomain intervention on gait speed in older adults with MCI. The interaction was of borderline statistical significance and did not remain statistically significant after adjustment for multiplicity or in sensitivity analyses, although its direction and magnitude were consistent. Dietary variety merits prospective evaluation as a stratification factor in multidomain intervention trials.
REGISTRATION NUMBER OF CLINICAL TRIAL: The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on November 24, 2019 (UMIN000038671) ( https://center6.umin.ac.jp/cgi-open- bin/ctr_e/ctr_view.cgi?recptno = R000044075).
METHODS: This secondary analysis of the J-MINT randomized controlled trial included 433 community-dwelling adults aged 65-85 years with MCI. The 18-month intervention comprised vascular risk management, exercise, nutritional counseling, and cognitive training. The primary outcome was usual gait speed at 18 months. Baseline dietary variety was assessed using the Dietary Variety Score (DVS), and effect modification on the intervention effect was examined.
RESULTS: The arm × DVS interaction coefficient for 18-month gait speed was 0.035 m/s per 1-SD increase in baseline DVS (95% CI, 0.001 to 0.071; P = 0.048). The between-arm difference at 18 months was 0.06 m/s (95% CI, 0.01 to 0.12) in the High DVS group and -0.03 m/s (95% CI, -0.11 to 0.04) in the Low DVS group. No indirect effects through appendicular lean mass, muscle strength, or biomarkers were detected.
CONCLUSIONS: In this hypothesis-generating secondary analysis, higher baseline dietary variety was associated with a larger effect of the multidomain intervention on gait speed in older adults with MCI. The interaction was of borderline statistical significance and did not remain statistically significant after adjustment for multiplicity or in sensitivity analyses, although its direction and magnitude were consistent. Dietary variety merits prospective evaluation as a stratification factor in multidomain intervention trials.
REGISTRATION NUMBER OF CLINICAL TRIAL: The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on November 24, 2019 (UMIN000038671) ( https://center6.umin.ac.jp/cgi-open- bin/ctr_e/ctr_view.cgi?recptno = R000044075).