Healthy Dietary Patterns and Risk of Sarcopenia in Adults Aged > 50 Years: A Systematic Review and Meta-Analysis Considering EWGSOP1 and EWGSOP2 Criteria

Sarcopenia is characterized by the progressive loss of skeletal muscle mass and function. Little is known about the dietary patterns and sarcopenia association. The aim of this systematic review and meta-analysis was to evaluate the association between dietary patterns and the risk of sarcopenia in adults over 50 years old, using the European Working Group on Sarcopenia in Older People, EWGSOP1 and EWGSOP2 criteria. This review followed PRISMA guidelines and was registered in PROSPERO (CRD42024423323). A systematic search was conducted in PubMed, Web of Science, and Cochrane Library (July 2024-February 2025). Observational studies in adults aged 50-85 years assessing a priori or a posteriori dietary patterns were included. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted. A random-effects model was used for meta-analysis. I2 and meta-regression was performed to explore heterogeneity sources. Methodological quality was assessed with the Joanna Briggs Institute (JBI) checklist. Eleven studies were included (n = 257-3432). The pooled analysis showed a significant 24% risk reduction in sarcopenia with healthy dietary patterns (OR = 0.76, 95% CI: 0.63-0.92, I2 = 56.2). Unhealthy dietary patterns did not show a significant association (OR = 1.04, 95% CI: 0.66-1.63). Mediterranean (MD) pattern yielded the strongest effect (OR = 0.62, 95% CI: 0.40-0.95). Meta-regression analyses did not identify significant variables. Healthy dietary patterns, particularly the MD, are associated with a lower risk of sarcopenia in adults over 50 years old and represent a promising nutritional strategy for sarcopenia prevention.