Dietary Patterns and Cardiometabolic Risk: A Network Analysis Study in the Wuling Mountain Region of China

Abstract Background Unhealthy dietary intake is strongly associated with the incidence of cardiometabolic risk factors and constitutes a major cause of cardiovascular disease (CVD) related death globally. The study aimed to examine the complex, multidimensional relationships among dietary patterns and cardiometabolic risk factors in middle-aged and older adults of the Miao ethnicity of China. Methods A cross-sectional study encompassed 261 middle-aged and older adults was conducted in area inhabited by the Miao ethnicity, located within the Wuling Mountain Area of China.Demographic characteristics and dietary intake were assessed via a questionnaire, while metabolic indicators were obtained through medical examination. Dietary patterns were derived using PCA, and a Gaussian Graphical Model was estimated to examine the conditional dependence relationships among dietary patterns, and cardiometabolic parameters. Results Diverse, Plant-based, Ethnic-specific, and High-starch and Sugar-sweetened Beverage patterns were indentified in middle-aged and older adults of the Miao ethnicity. A diversified dietary pattern is more common among individuals under 65, while a plant-based pattern is more prevalent in those aged 65 and older. Network analysis identified skeletal muscle mass (SMM) as the most key node, with highest degree centrality (9) and a high betweenness centrality (17), particularly among adults aged 65 years and older. Moreover, the Plant-based dietary pattern demonstrated the highest closeness centrality (0.963) and a relatively high betweenness centrality (17) in individuals under 65 years. The Diverse pattern with the highest closeness (0.635) and the second-highest betweenness (33) was a key secondary hub among adults aged 65 years and older. Conclusions Four major dietary patterns were found in middle-aged and older adults of the Miao ethnicity in the Wuling Mountain Area of China. SMM as the principal nexus between diet and cardiometabolic health, represented the potential key target for preventing cardiovascular risk. The diversified pattern may represent a promising intervention for addressing cardiometabolic risk in adults over 65 in this region.