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<p>Lifestyle behaviors, including diet, physical activity, sleep, and smoking, form interconnected patterns that differ by sex and risk context. We analyzed 1,466 individuals with sudden cardiac arrest (SCA) and 2,619 community controls from a multicenter case–control study. Seven lifestyle indicators captured smoking, regular physical activity, sleep duration, and intake of red meat, fish, fruit, and vegetables. Mixed graphical models were estimated separately for control women, control men, case women, and case men. Dietary subnetwork strength (D) was defined as the sum of the absolute edge weights among dietary behaviors. Sex-specific contrasts in dietary subnetwork strength differed between cases and controls. In the primary analysis, D was higher in men than in women among controls (3.22 vs 2.93) and higher in women than in men among cases (4.35 vs 3.14). Resampling-based inference supported the sex-by-SCA difference-in-differences contrast for D (estimate, − 1.94; 95% CI, − 3.75 to − 0.14). The global network contrast was less precise and included zero. These findings suggest that SCA-related sex differences were most evident in the clustering of dietary behaviors, rather than in isolated lifestyle factors or overall lifestyle network strength. Network-based assessment may help identify subgroup-specific behavioral organization and guide sex-specific, pattern-level lifestyle research and prevention hypotheses.</p>

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Dietary subnetwork strength differs by sex in opposite directions between sudden cardiac arrest cases and community controls

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Gyo Jin Ahn,
  • Sung Oh Hwang,
  • Kyoung-Chul Cha,
  • Sang Do Shin,
  • Mi Jin Lee,
  • Jong-Hak Park,
  • Su Jin Kim,
  • Sung Bum Oh,
  • Jonghwan Shin,
  • Seung Min Park,
  • Min Seob Sim,
  • Won Young Kim,
  • In-Cheol Park,
  • Hyun Ho Ryu,
  • Yeonho You,
  • Sang-Chul Kim,
  • Ju Ok Park,
  • Su Jin Kim,
  • Koo Hyun Kang,
  • Young Hwan Lee,
  • Yong Won Kim

摘要

Lifestyle behaviors, including diet, physical activity, sleep, and smoking, form interconnected patterns that differ by sex and risk context. We analyzed 1,466 individuals with sudden cardiac arrest (SCA) and 2,619 community controls from a multicenter case–control study. Seven lifestyle indicators captured smoking, regular physical activity, sleep duration, and intake of red meat, fish, fruit, and vegetables. Mixed graphical models were estimated separately for control women, control men, case women, and case men. Dietary subnetwork strength (D) was defined as the sum of the absolute edge weights among dietary behaviors. Sex-specific contrasts in dietary subnetwork strength differed between cases and controls. In the primary analysis, D was higher in men than in women among controls (3.22 vs 2.93) and higher in women than in men among cases (4.35 vs 3.14). Resampling-based inference supported the sex-by-SCA difference-in-differences contrast for D (estimate, − 1.94; 95% CI, − 3.75 to − 0.14). The global network contrast was less precise and included zero. These findings suggest that SCA-related sex differences were most evident in the clustering of dietary behaviors, rather than in isolated lifestyle factors or overall lifestyle network strength. Network-based assessment may help identify subgroup-specific behavioral organization and guide sex-specific, pattern-level lifestyle research and prevention hypotheses.