Abstract
Cardiovascular-kidney-metabolic (CKM) syndrome remains highly prevalent worldwide and is associated with substantial mortality. As diet is a key modifiable determinant in the development and progression of CKM syndrome, this study aimed to investigate the associations between dietary nutrient intake and CKM syndrome to inform prevention and management strategies. We integrated data from the Global Burden of Disease (GBD) study and the National Health and Nutrition Examination Survey (NHANES) to provide both global and individual-level insights. Global age-standardized disability-adjusted life years (ASDR) and age-standardized mortality rates (ASMR) attributable to dietary risks were analyzed for six CKM-related diseases. Multinomial logistic regression and weighted Poisson regression were used to assess associations between 26 dietary nutrients and CKM syndrome stages and mortality, and a nutrient-based mortality risk prediction model and nomogram were further developed and validated. Marked regional variations in ASDR and ASMR were observed, particularly in Eastern Europe. Significant differences in nutrient intake patterns were found across CKM syndrome stages. Lower potassium and higher sodium intake were associated with advanced CKM stages. Cholesterol intake was associated with increased all-cause mortality risk, whereas higher intakes of dietary fiber, choline, vitamin K, and PFA 20:4 were associated with reduced mortality risk. The nutrient-based nomogram demonstrated good predictive performance for mortality risk in CKM syndrome. In conclusion, this study integrates global burden estimates with individual-level nutrient data to characterize dietary determinants of CKM syndrome progression and mortality, highlighting modifiable nutrient targets and providing a data-driven framework for dietary risk prediction.