Food inflammation index and risks of all-cause and cardiovascular mortality among individuals with cardiovascular-kidney-metabolic syndrome: a nationally representative cohort study from NHANES 1999-2018.

Evidence on the association between the Food Inflammation Index (FII) and mortality risk in individuals with cardiovascular-kidney-metabolic syndrome (CKM) remains limited. This study examined the associations of the FII with all-cause and cardiovascular disease (CVD) mortality in adults with CKM. We included 22,611 adults with CKM from NHANES 1999-2018. The FII was calculated using 24-hour dietary recall data. Multivariable Cox regression, restricted cubic spline, subgroup, and sensitivity analyses were performed. During a median follow-up of 9.3 years (interquartile range, 4.9-13.8 years), corresponding to 217,405 person-years, 3,745 deaths were documented, including 1,180 from CVD. In the fully adjusted model, compared with the lowest FII quartile, the highest FII quartile was associated with higher risks of all-cause mortality (HR, 1.392; 95% CI, 1.218-1.592; P for trend < 0.001) and CVD mortality (HR, 1.337; 95% CI, 1.045-1.709; P for trend = 0.019). Significant nonlinear associations were also observed. Higher FII levels were significantly associated with increased risks of all-cause and CVD mortality among individuals with CKM. These findings suggest that dietary inflammatory burden, as reflected by the FII, may provide useful information for mortality risk assessment in this population.