Dietary index for gut microbiota (DI-GM), Body mass index (BMI), Atherosclerotic cardiovascular disease (ASCVD), Cohort analysis, National health and nutrition examination survey (NHANES), Nutrition. Foods and food supply, TX341-641, Nutritional diseases. Deficiency diseases, RC620-627

Abstract Background Gut microbes are important for the development of atherosclerotic cardiovascular disease (ASCVD), and the dietary index for gut microbiota (DI-GM), a new measure of gut flora-friendly diets, has not been systematically investigated in relation to ASCVD. Objective This study aimed to evaluate the correlation between DI-GM and the risk of ASCVD in American older adults, also to analyze the mediating role of body mass index (BMI). Methods Researchers selected 2234 elderly participants ≥ 65 years of age from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 for a cross-sectional cohort study. Stratified analyses were taken based on DI-GM quartile. To achieve our research objectives, we employed logistic regression analysis, smooth curve fitting, interaction effects analysis, and mediation analysis. Results After adjusting for confounders, individuals with higher DI-GM had a significantly lower risk of ASCVD (highest quartile vs. lowest quartile OR = 0.73, 95% CI: 0.52–1.01, P 0.05), but age, gender and BMI may modify the association between DI-GM and ASCVD (interaction P