Association of the Healthy Eating Index 2020 and Gastrointestinal Diseases: A Large National Cross-Sectional Study

Despite evidence on diet's effect on gastrointestinal (GI) disease risk, the link between dietary quality and GI disease risk remains underexplored. This cross-sectional study included 10 223 participants from NHANES 2013-2018. The HEI-2020 score as exposure; GI diseases as outcomes; covariates included sex, age, race, education levels, marital status, family income-to-poverty ratio, smoke exposure, alcohol drinking, physical activity, BMI level, hypertension, and diabetes. The results showed that GI diseases case had a higher proportion of women, not married, poverty, smoker, high BMI, hypertension, and diabetes, and low HEI-2020 score. Multivariate logistic regression model showed that HEI-2020 was negatively correlated with GI diseases, especially among high BMI and not diabetes. Besides, total fruits, greens and beans, total protein foods, seafood and plant were shown to be the most influential factors in GI diseases. The findings indicated an inverse relationship between the HEI-2020 and GI diseases, suggesting that the risk of GI diseases was lower with high the HEI-2020 scores. Additionally, the key component "greens and beans" revealed a consistent inverse association across most subgroups. In conclusion, a diet of high quality, characterized by the consumption of fruits, greens and beans, protein food and seafood, may hold potential benefits for the prevention of GI diseases.