Dietary diversity score and incident peptic ulcer in Chinese older adults: a prospective cohort study
- 1Department of Colorectal Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
- 2Department of Pediatric Health Care, Zhangzi County Maternal and Child Health Family Planning Service Center, Changzhi, Shanxi, China
Abstract
ObjectiveTo examine the association between dietary diversity score (DDS) and incident peptic ulcer among older Chinese adults.MethodsWe analyzed four waves of CLHLS data (2008–2018) from 13,274 ulcer-free adults aged ≥65 years with complete covariate data. DDS (0–9) was derived from a 9-item food frequency questionnaire. Cox proportional hazards models and restricted cubic splines were used to estimate hazard ratios, adjusting for sociodemographic, lifestyle, and health-related covariates. Sensitivity analyses included competing-risk models, lagged exposure updates, hospital-confirmed diagnoses, and multiple imputation.ResultsIn fully adjusted models, each 1-point increase in DDS was associated with a lower risk of incident ulcer (HR = 0.944, 95% CI 0.904–0.986; p = 0.009). Compared with the lowest tertile, the highest tertile had a 24% lower risk (HR = 0.757, 95% CI 0.618–0.927; p = 0.007), with an approximately linear dose–response relationship (p for nonlinearity = 0.655). The association was consistent in most subgroups but was absent among participants with disability in activities of daily living (p for interaction = 0.004). Findings were robust across sensitivity analyses, although the association attenuated to null after 3 years of follow-up and in the 6-year landmark analysis, suggesting that the effect was mainly evident during early follow-up.ConclusionHigher dietary diversity was associated with a lower risk of incident peptic ulcer among older Chinese adults, particularly during early follow-up and among functionally independent individuals. Randomized trials are needed to confirm causality and evaluate the intervention potential of dietary diversity.
Related
- Baseline peak expiratory flow and incident hip fracture in older Chinese adults : A prospective CHARLS cohort study
- Sleep duration, sarcopenia, and incident depressive symptoms in Chinese middle-aged and older adults : A prospective cohort study based on CHARLS
- Circadian syndrome and incident non-neoplastic digestive disease in middle-aged and older Chinese adults: a prospective cohort study
- Baseline estimated pulse wave velocity (ePWV) and its longitudinal change are associated with incident frailty in older Chinese adults: a prospective cohort study
- Association of platelet count with incident motoric cognitive risk syndrome among Chinese adults aged 60 years or older: a national prospective cohort study.
BibTeX
@article{wang2026dietary,
title = {{Dietary diversity score and incident peptic ulcer in Chinese older adults: a prospective cohort study}},
author = {Kai Wang and Xiaodan Li},
journal = {Frontiers in Nutrition},
year = {2026},
month = oct,
doi = {10.3389/fnut.2026.1984205},
url = {https://doi.org/10.3389/fnut.2026.1984205},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dietary diversity score and incident peptic ulcer in Chinese older adults: a prospective cohort study
AU - Kai Wang
AU - Xiaodan Li
PY - 2026
DA - 2026/10/26
JO - Frontiers in Nutrition
DO - 10.3389/fnut.2026.1984205
UR - https://doi.org/10.3389/fnut.2026.1984205
AB - ObjectiveTo examine the association between dietary diversity score (DDS) and incident peptic ulcer among older Chinese adults.MethodsWe analyzed four waves of CLHLS data (2008–2018) from 13,274 ulcer-free adults aged ≥65 years with complete covariate data. DDS (0–9) was derived from a 9-item food frequency questionnaire. Cox proportional hazards models and restricted cubic splines were used to estimate hazard ratios, adjusting for sociodemographic, lifestyle, and health-related covariates. Sensitivity analyses included competing-risk models, lagged exposure updates, hospital-confirmed diagnoses, and multiple imputation.ResultsIn fully adjusted models, each 1-point increase in DDS was associated with a lower risk of incident ulcer (HR = 0.944, 95% CI 0.904–0.986; p = 0.009). Compared with the lowest tertile, the highest tertile had a 24% lower risk (HR = 0.757, 95% CI 0.618–0.927; p = 0.007), with an approximately linear dose–response relationship (p for nonlinearity = 0.655). The association was consistent in most subgroups but was absent among participants with disability in activities of daily living (p for interaction = 0.004). Findings were robust across sensitivity analyses, although the association attenuated to null after 3 years of follow-up and in the 6-year landmark analysis, suggesting that the effect was mainly evident during early follow-up.ConclusionHigher dietary diversity was associated with a lower risk of incident peptic ulcer among older Chinese adults, particularly during early follow-up and among functionally independent individuals. Randomized trials are needed to confirm causality and evaluate the intervention potential of dietary diversity.
SN - 2296-861X
ER -