Association between dietary live microbial intake and all-cause and cause-specific mortality in obese adults: A...

ObjectiveThis study investigates the association between dietary live microbial intake and mortality among obese adults.MethodsFrom the 1999-2018 cycles of the U.S. National Health and Nutrition Examination Survey (NHANES), we included 22,746 adults with obesity and categorized them into three groups according to consumption of foods with medium or high microbial content (MedHi): G1 (no intake), G2 (>0 and below the median), and G3 (at or above the median). Associations with all-cause, CVD, and cancer mortality were examined using Kaplan-Meier curves and fully adjusted Cox proportional hazards models. Additionally, dose-response and sensitivity analyses were performed to further explore these relationships.ResultsOver a median follow-up period of 9.67 years, a total of 3,792 deaths occurred, comprising 952 CVD-related and 866 cancer-related deaths. Compared to G1, participants in G3 had a 16% lower risk of all-cause mortality (hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.77-0.92) and an 18% lower risk of CVD mortality (HR = 0.82, 95% CI: 0.69-0.98). However, no significant association was observed between dietary live microbial intake and cancer mortality. Dose-response modelling revealed an inverse approximately linear association between dietary live microbial intake and both all-cause and CVD mortality.ConclusionsThese findings suggest that higher dietary exposure to live microbes is associated with lower risks of all-cause and CVD mortality in individuals with obesity, highlighting a potential target for obesity-oriented health policies and preventive strategies.