Specific macronutrient clusters associated with lower mortality risk: Evidence from NHANES 1999–2018

作者：Jiaying Yu, Yang Chen, Defang Li, Lanwei Zhang, Yuting Zhang, Jiaqi Zhang, Jiayu Zhu, Zican Li, Hongxin Fu, Dongwei Guan, Runan Zhang, Liyan Liu, Cheng Wang, Changhao Sun, Rennan Feng · 发表于：Journal of Advanced Research · 年份：2025 · DOI：10.1016/j.jare.2025.02.019 · 被引用次数：8 · 研究领域：Nutrition and Health in Aging、Nutritional Studies and Diet、Clinical Nutrition and Gastroenterology

• A three-dimensional cube approach was employed to categorize macronutrients intake into 24 clusters. • Identified 4 specific Clusters were associated with reduced all-cause mortality. • The three-dimensional cube offered a perspective to explore macronutrients and health outcomes. • Different clusters of macronutrients could be a precondition in nutrition intervene strategy. Accumulating evidence suggest that imbalanced macronutrient composition would increase the risk of chronic diseases. However, previous studies that predominantly focused on individual macronutrients often failed to thoroughly elucidate this complex association. This study aimed to comprehensively analyze the relationship between macronutrient clusters and all-cause mortality. The study included 26,615 adults aged 20–75 years from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. A three-dimensional cube method was employed to categorize clusters of macronutrients intake. The association between dietary macronutrient clusters and all-cause mortality was investigated using Cox proportional hazards modeling and restricted cubic spline (RCS) analysis. Over a weighted median follow-up duration of 7.58 years, 3,998 deaths were recorded. After adjusting for potential confounders, compared with the reference Cluster Pm:Fm:Cmh , 4 specific Clusters were associated with reduced all-cause mortality: Cluster Pm:Fm:Cm (HR: 0.79, 95 % CI: 0.67–0.92), Cluster Pm:Fmh:Cml (HR: 0.76, 95 % CI: 0.61–...