**5. Conclusions**

A pro-inflammatory diet, as indicated by higher DII score, is associated with lower muscle mass, poorer muscle function and increased likelihood for the combination of low muscle mass and low muscle function among older Australian men and women. These results support the notion that a pro-inflammatory diet negatively affects muscle mass and muscle function and exacerbates the risk of developing sarcopenia. Future studies could consider the relationship between DII and the sarcopenia trajectory and investigate whether anti-inflammatory dietary interventions could reduce the risk of sarcopenia.

**Author Contributions:** Conceptualisation, M.G., K.L.H.-K., N.K.H. and J.A.P.; methodology, M.G., K.L.H.-K., N.K.H., M.M., N.S., J.R.H. and J.A.P.; software, N.S. and J.R.H.; validation, M.G., M.M., N.S., J.R.H. and J.A.P.; formal analysis, M.G., M.M., N.S., J.R.H. and J.A.P.; investigation, M.G., K.L.H.-K., N.S., J.R.H. and A.O.; resources, N.S., J.R.H. and J.A.P.; data curation, J.A.P.; writing— original draft preparation, M.G.; writing—review and editing, M.G., K.L.H.-K., N.K.H., M.M., N.S., J.R.H., A.O. and J.A.P.; visualisation, M.G.; supervision, J.A.P.; project administration, J.A.P.; funding acquisition, J.A.P. All authors have read and agreed to the published version of the manuscript.

**Funding:** The Geelong Osteoporosis Study was funded by the National Health and Medical Research Council (NHMRC) Australia, gran<sup>t</sup> numbers 251638, 628582 and 299831.

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Barwon Health Human Research Ethics Committee (projects 92/01 and 00/56).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. **Data Availability Statement:** The data that support the findings of this study are available from the corresponding author upon reasonable request.

**Acknowledgments:** The authors thank G. Giles of the Cancer Epidemiology Centre of The Cancer Council Victoria for permission to use the Dietary Questionnaire for Epidemiological Studies (Version 2), Melbourne: The Cancer Council Victoria, Australia, 1996.

**Conflicts of Interest:** K.L.H.-K. was supported by an Alfred Deakin Postdoctoral Research Fellowship. She has received funding from the Prolia BCGP Competitive Grant Program and Amgen Investigator Sponsored Studies Grant. N.K.H. was supported by a Dean's Research Postdoctoral Fellowship (Deakin University). A.O. is supported by a Future Leader Fellowship (#101160) from the Heart Foundation Australia and Wilson Foundation. She has received research funding from National Health and Medical Research Council (NHMRC) Australia, Australian Research Council, University of Melbourne, Deakin University, Sanofi, Meat and Livestock Australia and Woolworths Limited and Honoraria from Novartis. The Food and Mood Centre with which A.O. is affiliated has received funding from the Fernwood Foundation, the A2 Milk Company and Be Fit Foods. J.A.P. has received funding from the NHMRC, the Medical Research Future Fund (MRFF) Australia, Barwon Health, Deakin University, Amgen, The BUPA Foundation, Osteoporosis Australia, Australian and New Zealand Bone and Mineral Society, the Geelong Community Foundation, the Western Alliance and the Norman Beischer Foundation. J.R.H. owns controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII®) from the University of South Carolina in order to develop computer and smart phone applications for patient counselling and dietary intervention in clinical settings. N.S. is an employee of CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.
