Dietary subnetwork strength differs by sex in opposite directions between sudden cardiac arrest cases and community controls

Lifestyle behaviors, including diet, physical activity, sleep, and smoking, form interconnected patterns that differ by sex and risk context. We analyzed 1,466 individuals with sudden cardiac arrest (SCA) and 2,619 community controls from a multicenter case–control study. Seven lifestyle indicators captured smoking, regular physical activity, sleep duration, and intake of red meat, fish, fruit, and vegetables. Mixed graphical models were estimated separately for control women, control men, case women, and case men. Dietary subnetwork strength (D) was defined as the sum of the absolute edge weights among dietary behaviors. Sex-specific contrasts in dietary subnetwork strength differed between cases and controls. In the primary analysis, D was higher in men than in women among controls (3.22 vs 2.93) and higher in women than in men among cases (4.35 vs 3.14). Resampling-based inference supported the sex-by-SCA difference-in-differences contrast for D (estimate, − 1.94; 95% CI, − 3.75 to − 0.14). The global network contrast was less precise and included zero. These findings suggest that SCA-related sex differences were most evident in the clustering of dietary behaviors, rather than in isolated lifestyle factors or overall lifestyle network strength. Network-based assessment may help identify subgroup-specific behavioral organization and guide sex-specific, pattern-level lifestyle research and prevention hypotheses.

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Publication Details

Journal
Scientific Reports
Published
2026-08-03
DOI
https://doi.org/10.1038/s41598-026-64518-4
Primary Topic
Health, Environment, Cognitive Aging
Type
article
Field-Weighted Citation Impact
0.00

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article

Dietary subnetwork strength differs by sex in opposite directions between sudden cardiac arrest cases and community controls

Koo Hyun Kang, Hyun Ho Ryu, Mi-Jin Lee, Sung Oh Hwang et al.
Scientific Reports
Health, Environment, Cognitive Aging
article

Dietary subnetwork strength differs by sex in opposite directions between sudden cardiac arrest cases and community controls

Koo Hyun Kang, Hyun Ho Ryu, Mi-Jin Lee, Sung Oh Hwang, Sang Do Shin, Yeonho You, Gyo Jin Ahn, Seung Min Park, Jong-Hak Park, Ju Ok Park, In‐Cheol Park, Su Jin Kim, Yong Won Kim, Sang Chul Kim, Young Hwan Lee, Jonghwan Shin, Kyoung-Chul Cha, Min Seob Sim, Won Young Kim, Epidemiologic Surveillance (CAPTURES) project investigators The Cardiac Arrest Pursuit Trial with Unique Registration, Sung Bum Oh
article en

Abstract

Lifestyle behaviors, including diet, physical activity, sleep, and smoking, form interconnected patterns that differ by sex and risk context. We analyzed 1,466 individuals with sudden cardiac arrest (SCA) and 2,619 community controls from a multicenter case–control study. Seven lifestyle indicators captured smoking, regular physical activity, sleep duration, and intake of red meat, fish, fruit, and vegetables. Mixed graphical models were estimated separately for control women, control men, case women, and case men. Dietary subnetwork strength (D) was defined as the sum of the absolute edge weights among dietary behaviors. Sex-specific contrasts in dietary subnetwork strength differed between cases and controls. In the primary analysis, D was higher in men than in women among controls (3.22 vs 2.93) and higher in women than in men among cases (4.35 vs 3.14). Resampling-based inference supported the sex-by-SCA difference-in-differences contrast for D (estimate, − 1.94; 95% CI, − 3.75 to − 0.14). The global network contrast was less precise and included zero. These findings suggest that SCA-related sex differences were most evident in the clustering of dietary behaviors, rather than in isolated lifestyle factors or overall lifestyle network strength. Network-based assessment may help identify subgroup-specific behavioral organization and guide sex-specific, pattern-level lifestyle research and prevention hypotheses.

Scientific Reports
Seoul National University (KR), Yonsei University (KR), Soonchunhyang University (KR), Severance Hospital (KR), Korea University Medical Center (KR), Asan Medical Center (KR), Samsung Medical Center (KR), Seoul National University Hospital (KR), Seoul National University Bundang Hospital (KR), Ansan University (KR), The Catholic University of Korea St. Vincent's Hospital (KR), Chonnam National University Hospital (KR), Hallym University Kangnam Sacred Heart Hospital (KR), SNUH SMG-SNU Boramae Medical Center (KR), Dongguk University Ilsan Hospital (KR), Chungnam National University Hospital (KR), Hallym University Dongtan Sacred Heart Hospital (KR), Chungbuk National University Hospital (KR), Dankook University Hospital (KR), Bucheon University (KR), Sungkyunkwan University (KR)
Korea Disease Control and Prevention Agency
Good health and well-being
Openalex Percentile: Top 11%
Health, Environment, Cognitive Aging
DOIOpen Access PDFOpenAlex
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