Multidimensional links between dietary behavior and cardiometabolic comorbidities: a network analysis.

BACKGROUND

The burden of cardiometabolic comorbidities-such as hypertension, diabetes, dyslipidemia, and nonalcoholic fatty liver disease (NAFLD)-attributable to unhealthy dietary behaviors is increasing, particularly among working-age populations. This study aimed to investigate the complex interactions between dietary behaviors and cardiometabolic comorbidities using network analysis.

METHODS

This cross-sectional study enrolled 1,427 corporate employees aged 18-50 years in Shanghai, China, who underwent routine health check-ups from July to December 2022. Demographic characteristics and dietary behaviors were assessed via a self-reported questionnaire, while metabolic indicators were obtained through clinical evaluations. Mixed graphical models were used to construct a network identifying associations among demographic factors, unhealthy dietary behaviors, and six cardiometabolic comorbidities: hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, and NAFLD.

RESULTS

Among participants, 49.5% had at least one cardiometabolic comorbidity. Network analyses revealed that interactions among demographic factors, various dietary behaviors, and cardiometabolic comorbidities formed a complex structure, with frequent meat consumption (2.03) and eating out (2.00) exhibiting high centrality in the network. Further sensitivity analyses indicated that eating before bedtime (2.01) emerged as a central node when modifiable demographic factors were included in the model.

CONCLUSIONS

This study identifies specific unhealthy dietary behaviors that are strongly linked to early manifestations of cardiometabolic comorbidities in working-age adults. The findings suggest that these behaviors may serve as effective targets for dietary interventions and public health strategies aimed at metabolic disease prevention.