About

Shivani S Sahni is a Professor of Medicine at Harvard Medical School and an Associate Scientist at the Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife. She directs the Nutrition Program at the Marcus Institute. Dr. Sahni is a Nutritional Epidemiologist with expertise in determining the role of nutritional factors on chronic diseases of aging such as osteoporosis, sarcopenia, frailty, and consequent declines in physical function. Her research focuses on how diet, as a modifiable risk factor, impacts the prevention of musculoskeletal diseases and their consequences among older adults. She received her M.S. and Ph.D. degrees in Nutritional Epidemiology from Tufts University and also holds a Master’s degree in Dietetics from Delhi University, India. In addition to her research, Dr. Sahni dedicates time to teaching nutrition and epidemiology courses at Harvard Medical School and Harvard School of Public Health, and mentors graduate and post-doctoral students. She is the Co-Editor-in-Chief of the Journal of Nutrition and has held several leadership positions within the American Society for Nutrition and the American Society for Bone and Mineral Research.

Research topics

• Biology
• Environmental health
• Medicine
• Evolutionary biology
• Demography
• Internal medicine
• Genetics

Selected publications

• The association of gut microbiome composition with musculoskeletal features in middle-aged and older adults: a two-cohort joint study

  SSRN Electronic Journal · 2026-01-01

  preprintOpen access
  PublisherDOI

• Synbiotic to Attenuate Resorption of the Skeleton (STARS): Design and Participant Recruitment of a Randomized, Double-Blind, Placebo-Controlled Trial to Test the Efficacy of SBD111 Medical Food in Older Women

  SSRN Electronic Journal · 2026-01-01

  preprintOpen accessSenior author
  PublisherDOI

• Digital Advertising for Recruitment of Older Women in Nutrition Research

  Current Developments in Nutrition · 2025-05-01

  articleOpen access1st authorCorresponding
  PublisherDOI

• Ultra-Processed Food and Frailty: Evidence from a Prospective Cohort Study and Implications for Future Research

  Nutrients · 2025-08-14 · 3 citations

  articleOpen access

  Background: Ultra-Processed Foods (UPFs) make up a growing share of older adults’ diets and may contribute to frailty through pro-inflammatory pathways. The objective of this study was to examine the association of UPF intake with frailty development and with annual changes in select frailty components. Methods: This prospective cohort study used data from 2547 participants in the Framingham Offspring Cohort. UPF intake was assessed using a food frequency questionnaire and classified according to the NOVA framework, and frailty was defined by the Fried frailty phenotype. We used cumulative and mixed logistic regression models to examine the association between daily servings of UPF and odds of developing frailty, adjusting for baseline age, education, energy intake, multivitamin use, smoking, self-rated health, history of diabetes, cancer, cardiovascular disease, and diet quality. For the frailty component analysis, we used cumulative linear regression models to assess the association between UPF intake and annual changes in grip strength, gait speed, and weight, further adjusting for BMI and physical activity. We also evaluated potential effect modification by sex and baseline age (<60 vs. ≥60 years). Results: The study population was 55.1% female, with a mean age of 60.3 ± 8.9 years. Over an average follow-up of 10.8 years, 233 participants (9.2%) developed frailty. UPF intake was not associated with frailty development in either the cumulative or mixed regression models. UPF intake was not associated with annual weight change but was inversely associated with annual change in gait speed and with annual change in grip strength in men only. Conclusions: Our findings contribute preliminary evidence that, in middle-aged and older adults, increased UPF intake is not associated with frailty but may be related to worsening muscle strength and function. Further research with a more granular approach to UPF classification is required to translate these findings to practical recommendations and to clarify their clinical significance.

  PublisherOA PDFDOI

• The association of gut microbiome composition with musculoskeletal features in middle-aged and older adults: a two-cohort joint study

  medRxiv · 2025-02-21

  preprintOpen access

  Abstract Background Bones and muscles are connected anatomically, and functionally. Preliminary evidence has shown the gut microbiome influences the aging process of bone and muscle in animal studies. However, such evidence in humans is still scarce. This study aimed to assess the microbiome-bone and microbiome-muscle associations in two cohorts of community-dwelling older adults. Methods We leveraged information from two large population-based cohorts, i.e., the Rotterdam Study (mean age 62.7 ± 5.6 years; n=1,249) and the Framingham Heart Study (mean age 55.2 ± 9.1 years; n=1,227). For individuals included in this study, gut microbiome 16S rRNA sequencing, musculoskeletal phenotyping derived from DXA images, lifestyle and socioeconomic data, and medication records were available. Per cohort, the 16S rRNA sequencing data, derived from stool, were processed with the DADA2 pipeline and taxonomies were assigned using the SILVA reference database. In addition, the microbiome functional potential was obtained with PICRUSt2. Further, we investigated the association between the human gut microbiome (alpha diversity, genera and predicted functional pathways) and appendicular lean mass (ALM), femoral neck bone mineral density (FN-BMD) and trabecular bone score (TBS) using multilinear regression models controlling for multiple confounders, and performed a joint analysis from both cohorts. Sex-stratified analyses were also conducted. Results The gut microbiome alpha diversity was not associated with either tested phenotype after accounting for multiple-testing (P>1.67e-02). In the joint analysis, lower abundance of Oscillibacter (beta= −.51, 95%CI [−0.74, −.29]), Anaerotruncus (beta=-0.41, 95%CI [−0.61, - 0.21]), Eisenbergiella (beta=-0.39, 95%CI [−0.59, −.19]) and higher abundance of Agathobacter (beta=0.40, 95%CI [0.20, 0.60]) were associated with higher ALM (P<2.0e-04). Lower abundance of Anaerotruncus (beta=-0.32, 95%CI [−0.45, −.19]), Hungatella (beta=-0.26, 95%CI [−0.38, −.15]) and Clostridiales bacterium DTU089 (beta=-0.37, 95%CI [−0.55, −.19]) was associated with higher ALM only in females (P< 2.0e-04). Moreover, the biotin biosynthesis II pathway was positively associated with ALM (beta=0.44, 95% CI [0.24, 0.64]) (P<1.90e-04) in females while no associations were observed in males. We did not observe any robust association of bone traits with gut microbiome features. Conclusion Our results indicate that specific genera are associated with ALM in middle-aged and older adults and these associations can present in a sex-specific manner. Overall, our study suggests that the gut microbiome is linked to muscle aging in middle-aged and older adults. However, larger sample sizes are still needed to underpin the specific microbiome features involved.

  PublisherOA PDFDOI

• ASSOCIATION OF PRO-INFLAMMATORY DIET WITH FRAILTY ONSET AMONG ADULTS WITH AND WITHOUT DEPRESSIVE SYMPTOMS

  Innovation in Aging · 2024-12-01

  articleOpen accessSenior author

  Abstract Dietary inflammation is associated with increased risk of frailty. Those with depressive symptoms may be at higher risk of frailty onset since they typically have higher levels of inflammation. The study objective was to determine the association between a pro-inflammatory diet and frailty onset in those with and without clinically relevant depressive symptoms. This prospective study included 1,701 non-frail individuals with self-reported baseline (1998-2001) data available for the evaluation of energy-adjusted dietary inflammatory index (E-DIITM) (calculated from food frequency questionnaires), depressive symptoms (from the Center for Epidemiologic Studies Depression; CES-D), and follow-up frailty measurements (2011-2014). Frailty was defined as fulfilling ≥3 Fried frailty criteria. Results are presented by baseline CES-D scores <16 or ≥16 points, which denotes the absence or presence of clinically relevant depressive symptoms, respectively. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (95% CI) between E-DII and frailty onset, adjusting for confounders. In all study participants, mean (standard deviation; SD) age was 58(8) years and E-DII was -1.95 (2.20; range: -6.71 to +5.40, higher scores denote a more pro-inflammatory diet), and 45% were male. In those without clinically relevant depressive symptoms, one-unit higher E-DII score was associated with 14% increased odds (95% CI:1.05-1.24) of frailty. In those with depressive symptoms, one-unit higher E-DII score was associated with 55% increased odds of frailty (95% CI: 1.13-2.13). The association between inflammatory diet and increased odds of frailty appeared somewhat stronger among those with depressive symptoms. This preliminary finding warrants further investigation.

  PublisherOA PDFDOI

• Abstract 4140399: The Importance of Measuring Body Composition in Determining Cardiorespiratory Fitness Across the Adult Age Range

  Circulation · 2024-11-12

  article

  Background: Maintaining cardiorespiratory fitness (CRF) is essential for healthy aging and is linked to lower risk of age-related cardiovascular diseases and frailty. However, the relations of body composition metrics and CRF levels across the adult age range are poorly understood. Hypothesis: Healthy body composition, characterized by higher lean mass and lower visceral and total adiposity, is associated with greater oxygen (O 2 ) uptake during exercise across age and sex. Aims: To investigate relations of components of body composition with O 2 uptake measures during exercise and to evaluate how age and sex affect the associations. Methods: Framingham Heart Study participants (n=2742) underwent dual-energy X-ray absorptiometry (DXA) for body composition assessment and maximal cardiopulmonary exercise testing on a cycle ergometer at the same exam cycle. Sex-stratified linear models between DXA and O 2 uptake measures were adjusted for age, height, HDL/total cholesterol, smoking, systolic blood pressure, hypertension treatment, diabetes, and physical activity index. Results: The study sample had a mean age of 54±9 years, was 54% women, 9% non-white, and had a peak O 2 uptake [VO 2 ] 95±20% of predicted. Higher lean mass was associated with higher peak VO 2 in ml/min in both men and women (β for standard deviation (SD) difference in log-transformed peak VO 2 for a 1-SD higher value of lean mass was 0.49 in men and 0.57 in women, P<0.0001 for both). Conversely, measures of total and visceral fat mass were associated with higher peak VO 2 in women (β= 0.14-0.15, P<0.0001) but not in men (P>0.05). The variance explained (adjusted R 2 ) in peak VO 2 was higher for lean mass than other DXA measures: lean mass, age, and height explained 45-47% of the variance in peak VO 2 in men and women, while age, height, and other DXA measures explained ≤37%. Furthermore, individuals with higher observed lean mass than predicted based on age, sex, and BMI had higher observed peak VO 2 , consistent with the finding that higher lean mass is associated with higher peak VO 2 across age and sex (Figure). Conclusion: Maintaining lean mass across the adult age range is linked with higher peak VO 2 , which may have important implications for promoting healthy aging.

  PublisherDOI

• A 3-Month Comparison of Blueberry and Date Consumption among Older Adults: Rationale, Protocol, and Initial Recruitment for a Randomized Controlled Trial (Preprint)

  2024-07-05

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> Although anthocyanin-rich foods have been associated with health benefits, it is unclear how well these effects extend to older adults and common geriatric syndromes. In addition, many studies have relied upon supplements or food extracts, and the effects of whole-food supplementation remain uncertain. </sec> <sec> <title>OBJECTIVE</title> To determine the effectiveness of highbush blueberry supplementation, compared with an isocaloric serving of Deglet Noor dates, on blood pressure, physical function, falls, cognition, and other domains relevant to older adults. </sec> <sec> <title>METHODS</title> We are conducting a single-center randomized controlled trial among older adults residing in the greater Boston, MA region. Eligible participants include women and men aged 70 years and older. The trial was planned for conduct at a single congregate living facility for older adults, but after the COVID-19 pandemic hit, the initial recruitment was moved to an alternate senior congregate living facility and has subsequently been expanded to a second facility and the larger community. Participants are randomized on a 1:1 basis to consume 1 cup of frozen blueberries or 2-3 pitted dates daily for 3 months. Following a one-week wash-out, participants attend a fasting baseline visit that includes phlebotomy, questionnaires, functional assessments, anthropometric measurements and 24-hour electrocardiographic monitoring and ambulatory blood pressure monitoring. Participants return after 3 months for identical measurements. Recruitment was planned for 70 individuals with 15% attrition. </sec> <sec> <title>RESULTS</title> Recruitment for the trial began in April 2022 and ended in April 2024, when the originally planned number of completers was reached. The final population included 61 participants with a median age of 76 years (range 70-94 years), 56% women, and 53% assigned to blueberries. The demographic characteristics of enrolled participants demonstrate the tradeoffs of recruitment based in senior congregate living facilities, with unusually advanced ages but limited racial diversity and a fixed pool of potential participants. </sec> <sec> <title>CONCLUSIONS</title> This randomized trial will test the effectiveness of whole highbush blueberry supplementation, compared with an isocaloric serving of dates, upon physiological and clinical parameters of interest to older adults. With its emphasis on whole foods, its results will add to a growing number of studies that test the effects of anthocyanins on common chronic diseases of aging. </sec> <sec> <title>CLINICALTRIAL</title> The trial is registered at clinicaltrials.gov (NCT05358210). </sec>

  PublisherDOI

• Higher intake of dietary flavonols, specifically dietary quercetin, is associated with lower odds of frailty onset over 12 years of follow-up among adults in the Framingham Heart Study

  American Journal of Clinical Nutrition · 2023-04-13 · 30 citations

  articleOpen accessSenior authorCorresponding
  PublisherOA PDFDOI

• Association of Vascular Health Measures and Physical Function: A Prospective Analysis in the Framingham Heart Study

  The Journals of Gerontology Series A · 2023-05-15 · 3 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study. METHODS: The cross-sectional study (1998-2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid-femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates. RESULTS: In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: -0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: -0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength. CONCLUSIONS: Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.

  PublisherOA PDFDOI

Recent grants

• Novel Factors for Muscle Mass and Strength in Adults

  NIH · $1.1M · 2016–2020

• NIH Grant R03AR062808

  NIH · $83k · 2015

Frequent coauthors

• Douglas P. Kiel

  Hebrew SeniorLife

  246 shared

• Marian T. Hannan

  Beth Israel Deaconess Medical Center

  228 shared

• Courtney L. Millar

  Harvard University

  95 shared

• Alyssa B. Dufour

  Beth Israel Deaconess Medical Center

  82 shared

• Robert R. McLean

  Navitas Systems (United States)

  65 shared

• Kelsey M. Mangano

  University of Massachusetts Lowell

  62 shared

• Katherine L. Tucker

  62 shared

• Kenneth J. Mukamal

  Harvard University

  35 shared

Education

• PhD, Nutritional Epidemiology

  Tufts University

  2008

• MS, Nutritional Epidemiology

  Tufts University

  2004

• MSc, Nutrition, Lady Irwin College

  Lady Irwin College, Delhi University

  2001

• BSc, Home Science/Nutrition

  Lady Irwin College, Delhi University

  1999