Study Links Long-Term Food Pairings to Cardiometabolic Health Outcomes

A recent study published in the journal *Engineering* has unveiled significant insights into how long-term food pairings, rather than isolated food items, play a crucial role in influencing cardiometabolic health. This groundbreaking research was spearheaded by a collaborative team of scientists from various institutions, including the First Affiliated Hospital of Nanjing Medical University and the Guangdong Provincial Institute of Public Health. The study analyzed extensive data from two prominent cohorts: the National Health and Nutrition Examination Survey (NHANES) conducted in the United States and the Guangdong Gut Microbiome Project (GGMP) in China.

The findings indicate that the long-term balance and imbalance in food intake, encapsulated in distinct food pairing patterns, are independently associated with various cardiometabolic traits and can significantly modulate gut microbial functionalities. This research introduces the concept of long-term food pairing patterns, categorized into additive food pairing patterns (AFPs) and subtractive food pairing patterns (SFPs). The former assumes synergistic effects between two foods, while the latter assumes antagonistic effects.

Utilizing normalized monthly consumption frequencies of individual foods, researchers identified 1,759 cardiometabolic-related long-term food pairing patterns from the NHANES cohort and 306 from the GGMP cohort, achieving a false discovery rate of less than 0.05. Remarkably, approximately 80.8% of pairing foods were not individually associated with cardiometabolic traits when compared to single foods, underscoring the critical role of combined food pairings in health outcomes. Moreover, the study found that long-term food pairing patterns exhibited weak correlations with single food intake frequencies and various dietary indices such as the Healthy Eating Index 2020 (HEI2020) and the Dietary Approaches to Stop Hypertension (DASH) index. This suggests that food pairing patterns offer unique insights into dietary impacts on health, beyond conventional dietary indicators.

The consistency of associations between food pairing patterns and cardiometabolic traits across Eastern and Western populations at the hyper food classification group level highlights the study's broad relevance, despite significant differences in individual food intake patterns. Furthermore, the research delves into the mediating role of the gut microbiome in the relationship between long-term food pairing patterns and cardiometabolic traits. Mediation analysis revealed that 72.7% of long-term food pairing patterns influenced cardiometabolic traits through 31 microbial genera, with *Clostridium sensu stricto 1* emerging as a predominant player. **Dr. Qian Deng**, the lead author of the study and a researcher at the First Affiliated Hospital of Nanjing Medical University, stated, "Our findings indicate that the combined effects of food pairings are essential in understanding their influence on health outcomes."

The study emphasizes the importance of considering food intake balance when developing dietary strategies aimed at enhancing cardiometabolic health. Potentially, personalized dietary recommendations incorporating long-term food pairing patterns could yield a more comprehensive understanding of diet's impact on health than focusing solely on individual foods or dietary metrics.

Despite these promising insights, the study acknowledges several limitations, including its observational nature and the possibility of recall bias in food frequency questionnaires. Future research could benefit from exploring causal relationships between food pairing patterns, gut microbiome interactions, and cardiometabolic health through longitudinal studies or controlled trials.

In conclusion, the research opens new avenues for developing precision nutritional strategies that may significantly improve cardiometabolic health by emphasizing the importance of long-term food pairing patterns. As Dr. Deng aptly summarizes, "This research provides a foundation for enhancing our understanding of dietary influences on health outcomes, paving the way for future innovations in nutrition science."

**Source:** Deng, Q., et al. (2025). Food pairing pattern independently associated with cardiometabolic traits beyond dietary indices across eastern and western populations. *Engineering*. doi.org/10.1016/j.eng.2025.02.015.