Longitudinal joint trajectories of the dietary inflammatory index and physical activity and risk of incident cardiometabolic multimorbidity among women: evidence from the China Health and Nutrition Survey
- 1Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chengdu Medical College
- 2Department of Orthopedics, The First Affiliated Hospital of Chengdu Medical College
- 3Department of Dermatology and Venereology, The First Affiliated Hospital of Chengdu Medical College
Abstract
Objective: To examine the association between long-term joint trajectories of the dietary inflammatory index (DII) and physical activity (PA) and the risk of incident cardiometabolic multimorbidity (CMM) among Chinese women.
Methods: Data were drawn from the China Health and Nutrition Survey 2004–2015. A total of 3,970 adult women without CMM at baseline were included. DII and PA were repeatedly assessed from 2004 to 2011, and joint trajectories were identified via group-based trajectory modeling. CMM was defined as the first co-occurrence of ≥2 of hypertension, diabetes, stroke, and heart disease. Cox models evaluated associations between trajectory and incident CMM, with subgroup and sensitivity analyses performed.
Results: During follow-up, 400 participants (10.1%) developed incident CMM. Three joint trajectories were identified: lower DII + moderately active ( n = 559, 14.1%), moderate DII + highly active ( n = 541, 13.6%), and higher DII + inactive ( n = 2,870, 72.3%). Compared with the lower DII + moderately active group, higher DII + inactive group showed significantly higher CMM risk (HR = 1.62, 95% CI: 1.14–2.31; p = 0.007), whereas the moderate DII + highly active group did not. No significant effect modification was observed across subgroups. The association persisted in sensitivity analyses.
Conclusion: A sustained pattern of higher dietary inflammation with lower physical activity was associated with elevated incident CMM risk in Chinese women, providing longitudinal evidence for earlier risk identification based on behavioral exposures.
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BibTeX
@article{li2026longitudinal,
title = {{Longitudinal joint trajectories of the dietary inflammatory index and physical activity and risk of incident cardiometabolic multimorbidity among women: evidence from the China Health and Nutrition Survey}},
author = {Shaoxing Li and Xiangjie Liu and Kai Gong and Yu Tian and Hua Yu},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1916853},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1916853/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Longitudinal joint trajectories of the dietary inflammatory index and physical activity and risk of incident cardiometabolic multimorbidity among women: evidence from the China Health and Nutrition Survey
AU - Shaoxing Li
AU - Xiangjie Liu
AU - Kai Gong
AU - Yu Tian
AU - Hua Yu
PY - 2026
DA - 2026/10/20
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1916853
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1916853/full
AB - Objective: To examine the association between long-term joint trajectories of the dietary inflammatory index (DII) and physical activity (PA) and the risk of incident cardiometabolic multimorbidity (CMM) among Chinese women. Methods: Data were drawn from the China Health and Nutrition Survey 2004–2015. A total of 3,970 adult women without CMM at baseline were included. DII and PA were repeatedly assessed from 2004 to 2011, and joint trajectories were identified via group-based trajectory modeling. CMM was defined as the first co-occurrence of ≥2 of hypertension, diabetes, stroke, and heart disease. Cox models evaluated associations between trajectory and incident CMM, with subgroup and sensitivity analyses performed. Results: During follow-up, 400 participants (10.1%) developed incident CMM. Three joint trajectories were identified: lower DII + moderately active ( n = 559, 14.1%), moderate DII + highly active ( n = 541, 13.6%), and higher DII + inactive ( n = 2,870, 72.3%). Compared with the lower DII + moderately active group, higher DII + inactive group showed significantly higher CMM risk (HR = 1.62, 95% CI: 1.14–2.31; p = 0.007), whereas the moderate DII + highly active group did not. No significant effect modification was observed across subgroups. The association persisted in sensitivity analyses. Conclusion: A sustained pattern of higher dietary inflammation with lower physical activity was associated with elevated incident CMM risk in Chinese women, providing longitudinal evidence for earlier risk identification based on behavioral exposures.
SN - 2296-2565
ER -