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Background <p>The Diet Index for Gut Microbiota (DI-GM) is a novel measure of this diet-microbiota link, however, evidence regarding its association with stroke remains limited, and the potential indirect association by phenotypic age and body mass index (BMI) are not well characterized.</p> Methods <p>We analyzed data from 34,881 participants in the NHANES (1999–2018). The DI-GM was derived from dietary recalls. Weighted multivariable logistic regression assessed its association with stroke, while mediation analyses evaluated the roles of phenotypic age and BMI. Subgroup and restricted cubic spline (RCS) analyses were also performed.</p> Results <p>Higher levels of DI-GM and a favorable gut microbiota score were associated with lower stroke prevalence (DI-GM: OR = 0.93, 95% CI = 0.88, 0.98; favorable gut microbiota score: OR = 0.87, 95% CI = 0.82, 0.93). RCS suggested an approximately linear inverse association between DI-GM and stroke prevalence. Indirect association analyses indicated potential indirect associations via phenotypic age (proportion 13.18%, 95% CI 6.74%–39.89%; <i>P</i> = 0.002) and BMI (5.24%, 95% CI 0.85%–15.87%; <i>P</i> = 0.026). No significant interactions were observed across prespecified subgroups.</p> Conclusions <p>The DI-GM was negatively associated with stroke prevalence. Mediation analyses suggested statistically significant indirect association by phenotypic age and BMI. In conclusion, there is a need of new research to definitely establish causality and to understand if interventions on diet in order to modify microbiota can really reduce the prevalence of stroke.</p>

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Association between the newly introduced Diet Index for Gut Microbiota (DI-GM) and stroke prevalence: potential indirect associations via phenotypic age and body mass index (BMI)

  • 期刊论文

  • 发表日期：

    2026年3月21日

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  • Li Ke,
  • Ying Li,
  • Wenli Xing,
  • Sili Jiang,
  • Lei Zhao

摘要

Background

The Diet Index for Gut Microbiota (DI-GM) is a novel measure of this diet-microbiota link, however, evidence regarding its association with stroke remains limited, and the potential indirect association by phenotypic age and body mass index (BMI) are not well characterized.

Methods

We analyzed data from 34,881 participants in the NHANES (1999–2018). The DI-GM was derived from dietary recalls. Weighted multivariable logistic regression assessed its association with stroke, while mediation analyses evaluated the roles of phenotypic age and BMI. Subgroup and restricted cubic spline (RCS) analyses were also performed.

Results

Higher levels of DI-GM and a favorable gut microbiota score were associated with lower stroke prevalence (DI-GM: OR = 0.93, 95% CI = 0.88, 0.98; favorable gut microbiota score: OR = 0.87, 95% CI = 0.82, 0.93). RCS suggested an approximately linear inverse association between DI-GM and stroke prevalence. Indirect association analyses indicated potential indirect associations via phenotypic age (proportion 13.18%, 95% CI 6.74%–39.89%; P = 0.002) and BMI (5.24%, 95% CI 0.85%–15.87%; P = 0.026). No significant interactions were observed across prespecified subgroups.

Conclusions

The DI-GM was negatively associated with stroke prevalence. Mediation analyses suggested statistically significant indirect association by phenotypic age and BMI. In conclusion, there is a need of new research to definitely establish causality and to understand if interventions on diet in order to modify microbiota can really reduce the prevalence of stroke.