Sex-specific associations between dietary nutrient intake and cardiometabolic biomarkers in older adults with diet-related chronic diseases.

BACKGROUND: Older adults presenting with concurrent type 2 diabetes mellitus (T2DM), arterial hypertension (AH), and obesity face a considerable cardiometabolic challenge. There were no recent studies examining the association between their habitual nutrient consumption and circulating biomarkers in Central Asian populations. We aimed to examine sex-stratified associations between daily nutrient consumption and cardiometabolic biomarkers in community-dwelling older adults aged 60-90 years with concurrent T2DM, AH, and obesity in Central Kazakhstan. METHODS: We enrolled 351 community-dwelling adults aged 60-90 years (80 men, 271 women) from four primary care facilities. Fasting glucose, total cholesterol, creatinine, urea, and triglycerides were assessed. Nutrient adequacy was expressed as percentage of Kazakhstani reference value. Spearman rank correlation, multiple linear regression, and binary logistic regression assessed dietary-biomarker relationships, stratified by sex. RESULTS: We identified the widespread micronutrient inadequacies in both sexes. Median potassium intake reached 34.3% of the reference value in men and 32.9% in women; calcium 33.6 and 38.1%; vitamin C 22.3 and 30.5%; vitamin E 43.7 and 38.9%; thiamine 48.1 and 49.5%. Sodium intake exceeded the reference value in both sexes, more than twofold in men and close to twofold in women. In men, total fat and saturated fat intake correlated with creatinine (rs = 0.242 and 0.250, respectively; p < 0.05), and total fat also correlated with triglycerides (rs = 0.243, p = 0.030). BMI was the leading independent triglyceride predictor (β = 0.572, p < 0.01, R 2 = 0.333). In women, most dietary-biomarker associations were absent, and calcium and riboflavin showed inverse correlations with triglycerides (rs = -0.237, p < 0.001 and rs = -0.164, p = 0.007). CONCLUSION: Older Kazakhstani adults with T2DM, AH, and obesity showed near-universal shortfalls in potassium, calcium, vitamins C and E, and thiamine alongside sodium excess. Dietary-biomarker associations were sex-specific, driven primarily by adiposity in men. Correcting these micronutrient gaps and reducing sodium intake are priorities for chronic disease management in this population.