Dietary intakes of cysteine, glutamate, proline, and tryptophan are associated with hypertension risk in Chinese children and adolescents: a national cross-sectional study integrating machine learning

Objective The aim of the study was to examine the relationships between dietary intake of amino acids and the risk of hypertension and to find some important amino acids as the targets of intervention in Chinese children and adolescents. Methods The 2016–2019 China Children and Lactating Women Nutrition and Health Surveillance (CCLWNHS) was used to draw data and included 12,187 children and adolescents aged 6–18 years. A validated food frequency questionnaire (FFQ) was used to determine dietary intake with a weighing procedure. After the process of feature selection based on the Boruta algorithm, multivariate logistic regression was used to determine the relationships between amino acids and hypertension. The predictive performance was assessed through the development of XGBoost, LightGBM, NB and NN models. The SHapley Additive exPlanations (SHAP) approach was used to identify key features. Stratified analyses, interaction tests, and restricted cubic spline analyses were done as well. Results Cysteine, phenylalanine, histidine, glutamic acid, and proline were positively related to the risk of hypertension in the fully adjusted multivariate model (ORs: 2.000, 1.649, 1.387, 1.052, and 1.105, respectively), and threonine, valine, alanine, and tryptophan were negatively related (ORs: 0.587, 0.704, 0.809, and 0.516). LightGBM was the most successful predictive model (AUC = 0.793). SHAP analysis revealed that the core amino acids that affected the risk of hypertension were cysteine, glutamic acid, tryptophan, and proline. Sensitivity analyses showed that the relationships of these amino acids with hypertension were different in the subgroups based on age, sex, school type, physical activity level, and energy intake, and had a linear dose–response relationship. Conclusion A greater intake of cysteine, glutamic acid and proline through the diet is linked to a higher risk of hypertension among Chinese children and adolescents but tryptophan is protective. Such results give a scientific foundation on the development of specific nutritional intervention programs and optimization of protein consumption to prevent early hypertension in life.