The association between four dietary indices and mortality risk in cardiovascular disease patients.

IF 4.1 2区医学 Q2 NUTRITION & DIETETICS

Nutrition & Metabolism Pub Date : 2025-07-01 DOI:10.1186/s12986-025-00966-5

Mengshan Pan, Tongle Yin, Ying Yang, Feiyun Zhu, Jiamin Xu, Rucheng Chen, Weijun Zheng

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Abstract

Background: The Planetary Healthy Diet Index-United States, the Healthy Diet Index, the Mediterranean Diet, and the Dietary Inflammation Index were linked to mortality rates in cardiovascular patients. This study investigated the relationship between these dietary patterns and all-cause mortality risk in U.S. cardiovascular patients from 2005 to 2006 to 2017-2018.

Methods: Data were collected from adults aged 19 years and older participating in the National Health and Nutrition Examination Survey from 2005 to 2006 to 2017-2018. Dietary patterns were assessed for each survey cycle using 24-hour dietary recalls, and scores for the four dietary indices were calculated. Survey-weighted multivariable Cox proportional hazards regression models evaluated associations between these indices and all-cause and cause-specific mortality among patients with cardiovascular disease, using hazard ratios across quartiles and per 1-SD increment.

Results: This study included 3,088 patients with cardiovascular disease. In the partially adjusted model, the Planetary Healthy Diet Index-United States (HR = 0.81; 95% CI: 0.75-0.87; P < 0.001), Healthy Eating Index (HR = 0.85; 95% CI: 0.78-0.93; P < 0.001), and the Mediterranean Diet (HR = 0.82; 95% CI: 0.75-0.90; P < 0.001) were each associated with a reduced risk of all-cause mortality. In contrast, the Dietary Inflammatory Index was associated with an increased risk of all-cause mortality (HR = 1.25; 95% CI: 1.14-1.37; P < 0.001). In the fully adjusted model, the Planetary Healthy Diet Index-United States (HR = 0.89; 95% CI: 0.81-0.97; P = 0.005) remained significantly associated with a lower risk of all-cause mortality, whereas the Dietary Inflammation Index (HR = 1.20; 95% CI: 1.07-1.34; P = 0.002) continued to show a significant association with increased mortality risk.

Conclusions: Among cardiovascular disease patients, higher adherence to the Healthy Eating Index, Mediterranean Diet, and Planetary Healthy Diet Index-United States was linked to lower all-cause mortality, while higher Dietary Inflammation Index scores were linked to increased mortality. The Mediterranean Diet and Planetary Healthy Diet Index-United States were inversely associated with mortality in congestive heart failure patients, whereas Dietary Inflammation Index was positively associated with mortality in this group and in those with angina pectoris.

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四种饮食指标与心血管疾病患者死亡风险的关系

背景：美国的行星健康饮食指数、健康饮食指数、地中海饮食和饮食炎症指数与心血管患者的死亡率有关。本研究调查了2005年至2006年至2017-2018年美国心血管患者这些饮食模式与全因死亡风险之间的关系。方法：收集2005 - 2006年至2017-2018年参加全国健康与营养检查调查的19岁及以上成年人的数据。采用24小时饮食回顾法对每个调查周期的饮食模式进行评估，并计算四项饮食指数的得分。调查加权多变量Cox比例风险回归模型使用四分位数和每1-SD增量的风险比来评估这些指标与心血管疾病患者全因死亡率和病因特异性死亡率之间的关联。结果：本研究纳入3088例心血管疾病患者。在部分调整模型中，行星健康饮食指数-美国(HR = 0.81；95% ci: 0.75-0.87；结论：在心血管疾病患者中，越坚持健康饮食指数、地中海饮食和行星健康饮食指数-美国与较低的全因死亡率有关，而较高的饮食炎症指数评分与死亡率增加有关。地中海饮食和行星健康饮食指数-美国与充血性心力衰竭患者的死亡率呈负相关，而饮食炎症指数与该组和心绞痛患者的死亡率呈正相关。

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来源期刊

Nutrition & Metabolism 医学-营养学

CiteScore

8.40

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition & Metabolism publishes studies with a clear focus on nutrition and metabolism with applications ranging from nutrition needs, exercise physiology, clinical and population studies, as well as the underlying mechanisms in these aspects. The areas of interest for Nutrition & Metabolism encompass studies in molecular nutrition in the context of obesity, diabetes, lipedemias, metabolic syndrome and exercise physiology. Manuscripts related to molecular, cellular and human metabolism, nutrient sensing and nutrient–gene interactions are also in interest, as are submissions that have employed new and innovative strategies like metabolomics/lipidomics or other omic-based biomarkers to predict nutritional status and metabolic diseases. Key areas we wish to encourage submissions from include: -how diet and specific nutrients interact with genes, proteins or metabolites to influence metabolic phenotypes and disease outcomes; -the role of epigenetic factors and the microbiome in the pathogenesis of metabolic diseases and their influence on metabolic responses to diet and food components; -how diet and other environmental factors affect epigenetics and microbiota; the extent to which genetic and nongenetic factors modify personal metabolic responses to diet and food compositions and the mechanisms involved; -how specific biologic networks and nutrient sensing mechanisms attribute to metabolic variability.