Associations of dietary factors and early-life agricultural occupational background with body composition among older adults with type 2 diabetes in suburban Chengdu: A cross-sectional study

This study aimed to investigate the associations of early-life agricultural occupational background and dietary factors with body composition among older adults with type 2 diabetes mellitus (T2DM) in suburban Chengdu. A total of 448 inpatients with T2DM admitted between January and August 2025 were enrolled. Group differences were assessed using nonparametric tests. Multivariable logistic regression was used to identify factors associated with abnormal skeletal muscle index (SMI). Multivariable linear regression was used in the primary analysis to examine factors associated with phase angle (PhA), and sensitivity analyses were performed using binary logistic regression after dichotomizing PhA according to sex-specific cutoff values. Of the participants, 213 (47.54%) had an agricultural occupational background. SMI and PhA differed significantly by sex, body mass index, age, and occupational background (all P < .05). In the agricultural group, poultry intake was associated with lower odds of abnormal SMI (odds ratio [OR] = 0.957, 95% confidence interval [CI] = 0.923-0.993, P = .019), and older age (OR = 1.132, 95% CI = 1.032-1.241, P = .009) and higher visceral fat area (OR = 1.044, 95% CI = 1.021-1.067, P < .001) were associated with higher odds. In the nonagricultural group, beef and mutton intake was associated with lower odds of abnormal SMI (OR = 0.969, 95% CI = 0.948-0.991, P = .006). Age was negatively associated with PhA (β = -0.029, 95% CI = -0.045 to -0.013, P < .001), while SMI was positively associated with PhA (β = 0.387, 95% CI = 0.224-0.551, P < .001) in the agricultural group. In the nonagricultural group, age, duration of diabetes, and visceral fat area were negatively associated with PhA, and body mass index was positively associated with PhA (all P < .001). Sensitivity analyses generally supported the robustness of associations for age and adiposity-related indicators. Older adults with T2DM and an agricultural occupational background had less favorable body composition. Age was the most consistent factor associated with PhA, while muscle-related factors were more prominent in the agricultural group and adiposity-related factors in the nonagricultural group, suggesting that both occupational background and dietary characteristics should be considered when developing individualized nutritional interventions for this population.