Dietary patterns linked to gut microbiota and their association with gynecologic cancers: NHANES 2011–2018

PURPOSE: The diet-induced gut microbiota (DI-GM) score captures diet quality relevant to microbial health. However, its association with gynecological cancer (GC) remains unclear. The aim of this study was to investigate the association between DI-GM scores and gynecological cancer risk in U.S. women. METHODS: We analyzed data from 8,512 adult women aged ≥ 20 years from The U.S. National Health and Nutrition Examination Survey (NHANES) 2011-2018. DI-GM scores reflected intake of 14 food groups classified as beneficial or harmful to gut microbial health. Multivariable survey-weighted logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for covariates. RESULTS: Women with GC had significantly lower DI-GM scores than those without (mean 4.7 vs. 5.0; p = 0.031). Higher DI-GM scores were associated with reduced GC risk (adjusted OR per unit increase: 0.92; 95% CI 0.87-0.98; p = 0.011). Participants with DI-GM ≥ 6 had 27% lower odds of GC compared to those with scores 0-3 (p = 0.037). The beneficial component of DI-GM was independently associated with lower GC risk. No significant effect modification was observed in stratified analyses. CONCLUSION: Greater adherence to a microbiota-friendly diet may lower gynecological cancer risk in women.