Dietary Live Microbes Intake Associated with Biological Aging and Mortality

Abstract Purpose This observational study aimed to investigate associations between dietary live microbe intake and mortality, as well as biological aging. Methods Adults from the 1999-2018 National Health and Nutrition Examination Survey were categorized into low, medium, and high dietary live microbe groups. Foods with medium and high live microbe content were aggregated into a medium-high consumption category. The outcomes included all-cause, cardiovascular, and cancer mortality, along with biological age (BA) acceleration assessed by the Klemera-Doubal method (KDM) and PhenoAge. Multiple regression analyses and mediation analyses were conducted to assess associations, adjusting for potential confounders. Results A total of 34,133 adults were included in our analyses. Over an average follow-up period of 9.92 years, 5,462 deaths occurred. In multivariate adjusted models, every 100 grams of medium-high group foods consumed was associated with reduced all-cause mortality (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.91 to 0.97, P < 0.001) and cardiovascular mortality (HR 0.91, 95% CI 0.86 to 0.96, P < 0.001), but not with cancer mortality (HR 1.01, 95% CI 0.95 to 1.07, P = 0.768). Every 100 grams medium-high group foods consumption was associated with decreased KDM BA acceleration (fully adjusted regression coefficient -0.09, 95% CI -0.15 to -0.04, P = 0.001) and PhenoAge acceleration (fully adjusted regression coefficient -0.07, 95% CI -0.11 to -0.03, P < 0.001). Mediation analysis showed that BA acceleration partially mediated live microbes-mortality associations. Conclusion Our results suggest that higher dietary live microbe intake is associated with lower mortality risk and slower biological aging. However, further research is needed to verify these findings.