Takeaway Fast-Food Consumption and Elevated Diastolic Blood Pressure in US Young Adults: An Exploratory Mediation Analysis of Metabolic and Inflammatory Indicators.

Background: Global takeaway fast-food consumption (TFC) has surged. This study aimed to investigate the association between TFC frequency and diastolic blood pressure (DBP) and to explore the potential mediating roles of metabolic and inflammatory markers. Methods and Results: In this cross-sectional study of 13,062 adults from the National Health and Nutrition Examination Survey (NHANES), we utilized weighted regression and restricted cubic splines (RCS) to evaluate the association between TFC frequency and DBP. We performed exploratory mediation analyses to explore the roles of body mass index (BMI), visceral adiposity index (VAI), cardiometabolic index (CMI), dietary inflammatory index (DII), and insulin resistance (HOMA-IR). In the overall cohort, the main association between TFC frequency and DBP did not reach statistical significance in fully adjusted models. However, restricted cubic spline analysis revealed a linear dose-response trajectory without an evident threshold effect. In exploratory subgroup analyses, a potentially pronounced positive association was noted among females, although the formal interaction test was not statistically significant. Mediation models indicated that the examined metabolic and inflammatory markers did not significantly mediate this relationship, suggesting that the association with diastolic blood pressure may not operate through these specific pathways. Conclusions: While the overall main categorical association did not reach statistical significance, TFC demonstrated a potential continuous trend with DBP, with potential associations observed among females. Notably, this relationship was not mediated by established metabolic or inflammatory indices, suggesting that the association between TFC and blood pressure elevation may exist independent of overt structural obesity. These findings highlight the potential value of incorporating takeaway fast-food consumption into routine dietary screening for early cardiovascular risk assessment in young adults.