Association of dietary live microbe intake with all-cause and cardiovascular mortality in an older population: Evidence from NHANES 2003-2018

Background: The relationship between dietary live microbe intake, non-dietary prebiotics/probiotics, and mortality in older adults remains unclear.

Methods: Participants from the National Health and Nutrition Examination Survey 2003-2018 were included. Participants were categorized into three groups based on estimated live microbe intake: low, medium, and high. Additionally, they were divided by their consumption of foods with medium or high microbial content. Text mining was employed to identify the use of non-dietary prebiotics and probiotics by analyzing the names and ingredients of dietary supplements and drugs. Associations between live microbe intake, non-dietary prebiotics/probiotics, and all-cause or cardiovascular mortality were assessed using Kaplan-Meier survival curves and Cox regression models. Inverse Probability of Treatment Weighting was used for sensitivity analysis RESULT: A total of 7882 participants were included in the study. During a mean follow-up of 8.08 years, all-cause mortality was 18 % lower in older adults with high dietary live microbe intake in fully adjusted models (HR, 0.82; 95 %CI 0.70-0.96), and cardiovascular mortality was reduced by 23 % (HR, 0.77; 95 %CI 0.61-0.98). The risk of all-cause mortality was reduced by 21 % in the G3 group compared with the G1 group (HR, 0.79; 95 % CI 0.69-0.89) and a 29 % reduction in the risk of cardiovascular disease-specific death (HR, 0.71;95 %CI 0.59-0.86). In addition, we also observed that nondietary prebiotic and probiotic supplement intake was also associated with a reduced risk of mortality in an older US population.

Conclusion: In older U.S. adults, higher dietary live microorganisms and non-dietary probiotics/prebiotics intake was associated with a reduced risk of all-cause and cardiovascular mortality.