Food variety score and all-cause mortality in stroke survivors: Minimal mediating effect of adiposity indices (A cross-sectional study with prospective mortality follow-up using NHANES 2005-2018).

Authors

Mei Qi, Xiaoqiang Li, Qin Wang, Jianli He, Yaqing Zeng

Published in

Science progress. Volume 109. Issue 4. Pages 368504261494043. Epub Oct 09, 2026.

Abstract

ObjectiveTo investigate the association between Food Variety Score (FVS) and all-cause mortality among US stroke survivors, and to evaluate the mediating role of novel adiposity indices.MethodsThis population-based cross-sectional study included 1,186 eligible adult stroke survivors from NHANES 2005-2018 (7 cycles), with prospective all-cause mortality follow-up via National Death Index (NDI) linkage. Weighted Cox proportional hazards regression, restricted cubic splines, and counterfactual-based causal mediation analyses were applied with full covariate adjustment.ResultsOver a median follow-up of 69.0 months, 385 deaths occurred. Higher FVS was independently associated with lower all-cause mortality in a linear dose-dependent manner. Each 1-unit increase in FVS yielded a fully adjusted HR of 0.96 (95% CI: 0.93-0.98, P < 0.001); the highest versus lowest FVS quartile showed a 49% lower risk (HR = 0.51, 95% CI: 0.35-0.75). In exploratory mediation analyses, adiposity indices exhibited minimal overall mediating effects; only the visceral fat marker ABSI Z-score showed a weak but statistically significant indirect effect, which should be interpreted cautiously given the cross-sectional measurement of exposure and mediators; BRI and WHtR were non-significant. In exploratory subgroup analyses, age was the only variable showing a statistically significant interaction with FVS, though this finding requires cautious interpretation.ConclusionsGreater dietary diversity is independently associated with lower all-cause mortality in US stroke survivors, with the association largely independent of adiposity pathways. These observational findings support the potential value of dietary diversity as a simple, feasible, and low-cost nutritional strategy for post-stroke secondary prevention, but causal inference is not warranted given the study design.

PMID:
42853091
Bibliographic data and abstract were imported from PubMed on 09 Oct 2026.

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