Diet-gut microbiota interaction Index and heart failure risk in diabetes and prediabetes: evidence from NHANES...

Diabetes and prediabetes markedly increase the risk of heart failure (HF), but the role of diet-gut microbiota interactions remains unclear. This study examined the association between the Dietary Index for Gut Microbiota (DI-GM) and HF risk among individuals with diabetes or prediabetes.

Data were obtained from 15 219 adults with diabetes or prediabetes in the US National Health and Nutrition Examination Survey (NHANES) 2007-2018. DI-GM scores were calculated from two 24-h dietary recalls covering 14 food groups linked to gut microbiota. Associations between DI-GM and prevalent HF were estimated using weighted logistic regression and restricted cubic spline models, adjusting for demographic, lifestyle, and metabolic factors.

Participants had a mean age of 56.50 ± 15.68 years, and 48.14% were women. Higher DI-GM scores were independently associated with lower HF risk (adjusted odds ratio [OR] per 1-point increase = 0.93, 95% confidence interval [CI] 0.89-0.98; P = .005). Compared with scores 0-3, DI-GM ≥ 6 was linked to 27% lower HF risk (OR = 0.73, 95% CI 0.58-0.92; P = .007). The inverse association was stronger in prediabetes (OR = 0.89, 95% CI 0.82-0.96; P = .004) but not significant in diabetes.

Higher DI-GM was associated with lower HF risk, particularly in prediabetes. Microbiota-related dietary patterns may play a role in HF prevention among metabolically at-risk populations.