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Background <p>Chronic low-grade inflammation is a critical mechanism linking diet, gut microbiota, and cardiometabolic diseases. The Gut Microbiota Dietary Index (DI-GM) reflects the balance between gut-beneficial and detrimental dietary components. However, its relationship with the coexistence of central obesity, hypertension, and type 2 diabetes mellitus (T2DM) remains unclear.</p> Objective <p>To explore the relevance between DI-GM and the Risk of T2DM, central obesity, hypertension and their comorbidities among older adults.</p> Methods <p>Using data from 21,577 adults who participated in the National Health and Nutrition Examination Survey (NHANES, 2007–2018), we evaluated the association between DI-GM and central obesity, hypertension, T2DM, and their combinations. The DI-GM (0–14 points) was calculated from 14 dietary components based on two 24-h dietary recalls. Survey-weighted Poisson regression with robust variance estimation was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs), adjusting for sociodemographic, lifestyle, and clinical variables. Restricted cubic spline (RCS) models were used to assess dose–response relationships.</p> Results <p>Participants with higher DI-GM scores (≥ 6) were more likely to be younger, female, non-Hispanic White, and more educated, and had a lower prevalence of obesity and T2DM. After full adjustment, each 1-point increase in DI-GM was associated with a 3% lower prevalence of central obesity (PR = 0.97, 95% CI, 0.95–0.99), hypertension (PR = 0.97, 95% CI, 0.95–0.98), and T2DM (PR = 0.96, 95% CI, 0.94–0.99). The highest DI-GM category (≥ 6) was associated with a 10–15% lower prevalence of these outcomes than the lowest category (0–3). Linear dose–response patterns were observed for all outcomes.</p> Conclusions <p>Higher DI-GM scores, indicative of a gut friendly and anti-inflammatory diet, were significantly associated with lower risks of central obesity, hypertension, T2DM, and their comorbidities. These findings highlight the potential of microbiota-supportive dietary interventions for cardiometabolic disease prevention.</p>

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Gut microbiota dietary index (DI-GM) and the risk of type 2 diabetes mellitus, central obesity, and hypertension among older adults

  • 期刊论文

  • 发表日期：

    2026年5月2日

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  • Shaoliang Dong,
  • Yongde Huang,
  • Hua Zheng,
  • Lan Gong

摘要

Background

Chronic low-grade inflammation is a critical mechanism linking diet, gut microbiota, and cardiometabolic diseases. The Gut Microbiota Dietary Index (DI-GM) reflects the balance between gut-beneficial and detrimental dietary components. However, its relationship with the coexistence of central obesity, hypertension, and type 2 diabetes mellitus (T2DM) remains unclear.

Objective

To explore the relevance between DI-GM and the Risk of T2DM, central obesity, hypertension and their comorbidities among older adults.

Methods

Using data from 21,577 adults who participated in the National Health and Nutrition Examination Survey (NHANES, 2007–2018), we evaluated the association between DI-GM and central obesity, hypertension, T2DM, and their combinations. The DI-GM (0–14 points) was calculated from 14 dietary components based on two 24-h dietary recalls. Survey-weighted Poisson regression with robust variance estimation was used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs), adjusting for sociodemographic, lifestyle, and clinical variables. Restricted cubic spline (RCS) models were used to assess dose–response relationships.

Results

Participants with higher DI-GM scores (≥ 6) were more likely to be younger, female, non-Hispanic White, and more educated, and had a lower prevalence of obesity and T2DM. After full adjustment, each 1-point increase in DI-GM was associated with a 3% lower prevalence of central obesity (PR = 0.97, 95% CI, 0.95–0.99), hypertension (PR = 0.97, 95% CI, 0.95–0.98), and T2DM (PR = 0.96, 95% CI, 0.94–0.99). The highest DI-GM category (≥ 6) was associated with a 10–15% lower prevalence of these outcomes than the lowest category (0–3). Linear dose–response patterns were observed for all outcomes.

Conclusions

Higher DI-GM scores, indicative of a gut friendly and anti-inflammatory diet, were significantly associated with lower risks of central obesity, hypertension, T2DM, and their comorbidities. These findings highlight the potential of microbiota-supportive dietary interventions for cardiometabolic disease prevention.