Nutr Metab Cardiovasc Dis. 2025 Jul 5:104218. doi: 10.1016/j.numecd.2025.104218. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: Global Diet Quality Score (GDQS) is a tool for evaluating diet quality and chronic disease risk, the utility of GDQS in reducing cardiovascular disease (CVD) and mortality risk remains unclear. We examined the association between GDQS and non-fatal CVD and all-cause mortality risk among Chinese adults.
METHODS AND RESULTS: We enrolled 9236 participants aged ≥18 years from the China Health and Nutrition Survey (1997-2015). Dietary data were collected via 24-h dietary recall questionnaires. The Cox proportional hazards regression model was utilized to assess the association between GDQS and risk of non-fatal CVD and all-cause mortality. After a median follow-up of 12 and 18 years, 463 incident non-fatal CVD cases and 744 deaths were identified. The highest tertile of GDQS was associated with lower risk of non-fatal CVD [hazard ratio (HR) = 0.67; 95 % confidence interval (CI): 0.52, 0.86], stroke (HR = 0.56; 95 % CI: 0.40, 0.77), and all-cause mortality (HR = 0.34; 95 % CI: 0.27, 0.43) compared to the lowest. Furthermore, the inverse association between GDQS and risk of non-fatal CVD and stroke was significant among males but not among females. Dose-response analysis revealed a linear association between GDQS and non-fatal CVD (P-non-linearity = 0.252) and stroke risk (P-non-linearity = 0.442), whereas a nonlinear inverse relationship was observed for all-cause mortality (P-non-linearity = 0.003).
CONCLUSION: Higher GDQS was linearly inversely associated with risk of non-fatal CVD and stroke, especially in males. Additionally, higher GDQS was associated with reduced risk of all-cause mortality, presenting a nonlinear inverse relationship.
PMID:40885639 | DOI:10.1016/j.numecd.2025.104218