Gender differences in dietary management of individuals with diabetes: A cohort

Youqi Zhang ¹ Meng Yan ² Liu Ji ¹ Jianjun Wu ^1* Fan Yang ^1*

• ¹ The Second Affiliated Hospital of Harbin Medical University, Harbin, China
• ² Department of Pathology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China

Objective: To investigate the impact of diet on cardiovascular (CV)/all-cause mortality among individuals with diabetes, and to explore whether this relationship changes by gender.We collected data from the National Health and Nutrition Examination Survey (NHANES) database pertaining to 5,875 individuals with diabetes (3,068 males and 2,807 females) and used the Healthy Eating Index (HEI), the Alternative Healthy Eating Index (AHEI), and the alternative Mediterranean Diet (aMED) index to assess diet quality. Multivariate Cox models were used to determine the association between dietary quality scores and CV/all-cause mortality, stratified by genders. Dose-response relationships were assessed using the Restricted Cubic Spline (RCS). As a secondary objective, a further analysis was conducted on the connection between CV/all-cause mortality and different dietary components.Results: During a median 9.25-year follow-up period, we observed 1,488 all-cause deaths, including 486 CV deaths. In gender-stratified analyses, each standard deviation increase in diet quality scores was significantly associated with reduced risks of CV mortality in males (P < 0.05). No significant associations were observed in females (P > 0.05). Among the component scores of the aMED, legume intake was unfavorable for males with diabetes but was remarkably associated with lower CV/all-cause mortality in females.In the diabetic population, high dietary scores are significantly associated with lower CV/all-cause mortality in males but not in females.