Association between the dietary index for gut microbiota and advanced cardiovascular‐kidney‐metabolic syndrome among United States adults: A cross‐sectional study

BACKGROUND: Traditional dietary measures, which reflect overall dietary health, provide limited insight into gut microbiota. We hypothesize that a higher dietary index for gut microbiota is associated with decreased incidence of advanced cardiovascular-kidney-metabolic syndrome and aim to investigate this association. METHODS: We analyzed data from the 2007 to 2020 National Health and Nutrition Examination Survey to conduct a cross-sectional study of United States adults. The dietary index for gut microbiota was derived by quantifying and scoring 14 dietary components from the dietary recall interviews, while cardiovascular-kidney-metabolic syndrome was evaluated in accordance with the guidelines issued by the American Heart Association. The relationship between the dietary index for gut microbiota and advanced cardiovascular-kidney-metabolic syndrome was assessed using weighted logistic regression, restricted cubic splines, subgroup, and sensitivity analyses. RESULTS: A total of 14,406 cardiovascular-kidney-metabolic syndrome participants were included, with 9782 classified as non-advanced and 4624 as advanced. After adjusting for potential covariates, both logistic regression and restricted cubic splines revealed a significant negative correlation between the dietary index for gut microbiota and advanced cardiovascular-kidney-metabolic syndrome, with an adjusted odds ratio of 0.57 (95% confidence interval: 0.50, 0.65) for the fourth quartile in comparison to the reference group, which was strengthened in individuals with higher education and non-smokers (both P for interaction