Abstract: Background　Sarcopenia significantly influences the treatment outcomes and prognosis of colorectal cancer patients，and dietary patterns show a notable correlation with sarcopenia. Elucidating the characteristics of Chinese healthy dietary patterns and their association with sarcopenia is crucial for developing targeted nutritional interventions based on traditional Chinese dietary practices. Objective　To explore the correlation between Chinese healthy dietary pattern and sarcopenia in colorectal cancer patients，utilizing the Chinese Healthy Eating Index（CHEI）. Methods　From July 2024 to May 2025，a total of 326 colorectal cancer patients from Tangshan People's Hospital，North China University of Science and Technology Affiliated Hospital，and Kailuan General Hospital were enrolled as study subjects. The Chinese Healthy Eating Index （CHEI） and various diagnostic indicators of sarcopenia were collected. After adjusting for covariates，binary Logistic regression analysis and restricted cubic spline models were employed to examine the associations between the total CHEI score and its dietary components with low muscle mass，decreased muscle strength，impaired physical function and sarcopenia in colorectal cancer patients. Results　Among the 326 patients，195 were male（59.82%） and 131 were female（40.18%），with an average age of（64.0±8.8） years. Among them，there were 49 cases（15.03%） with reduced muscle mass，and the CHEI score was 50 （40，55）. Muscle strength was reduced in 220 cases（67.48%），and the CHEI score was 55（45，60）. Physical function declined in 217 cases（66.56%），with CHEI scores of 55（45，60）. There were 46 patients（14.11%） with sarcopenia，with a CHEI score of 47.5（40，55）. Binary Logistic regression analysis results indicated that CHEI scores were negatively associated with the risk of low muscle mass（OR=0.934，95%CI=0.891-0.979，P=0.004），impaired physical function（OR=0.968，95%CI=0.942-0.995，P=0.020），and sarcopenia（OR=0.931，95%CI=0.889-0.975，P=0.003）. Rstricted cubic spline model showed a linear dose-response relationship between CHEI and the occurrence of low muscle mass（Poverall trend=0.019，Pnon-linear=0.216，Plinear=0.004），impaired physical function（Poverall trend=0.095，Pnon-linear=0.617，Plinear=0.020），and sarcopenia （Poverall trend=0.038，Pnon-linear=0.467，Plinear=0.002）. Analysis of the correlation between various dietary components and low muscle mass，impaired physical function，and sarcopenia revealed that scores for fruits（OR=0.880，95%CI=0.786-0.985，P=0.026），legumes（OR=0.480，95%CI=0.290-0.794，P=0.004），poultry intake（OR=0.799，95%CI=0.644-0.991，P=0.041），and sodium（OR=0.897，95%CI=0.805-1.000，P=0.049） were negatively correlated with the risk of low muscle mass. Scores for whole grains（OR=0.839，95%CI=0.714-0.986，P=0.033） and seafood（OR=0.848，95%CI=0.730-0.985，P=0.031） were negatively correlated with the risk of impaired physical function，while red meat（OR=1.256，95%CI=1.048-1.506，P=0.014） was positively correlated with the risk of impaired physical function. Grains（OR=1.608，95%CI=1.115-2.317，P=0.011） showed a significant positive correlation with the risk of sarcopenia. Scores for fruits（OR=0.886，95%CI=0.788-0.996，P=0.043），legumes（OR=0.409，95%CI=0.238-0.703，P=0.001），and poultry（OR=0.731，95%CI=0.584-0.916，P=0.007） were negatively correlated with the risk of sarcopenia.Conclusion　The Chinese Healthy Eating Index is positively associated with a reduced risk of low muscle mass，impaired physical function，and sarcopenia in colorectal cancer patients，showing a linear dose-response relationship. Adequate intake of fruits，legumes，poultry，whole grains，and seafood，moderate red meat consumption，and controlled intake of sodium and grains may help lower the risk of sarcopenia in colorectal cancer patients.

Key words: Colorectal cancer, Chinese healthy dietary pattern, Muscle strength, Muscle mass, Physical function, Sarcopenia, Restricted cubic spline

摘要： 背景　肌肉减少症对结直肠癌患者的治疗和预后具有显著影响，饮食模式和肌肉减少症显著相关。明确中国健康饮食模式与其相关性，对基于中国健康饮食模式实施肌肉减少症的干预意义重大。目的　利用中国健康饮食指数（CHEI）探究结直肠癌患者的中国健康饮食模式与肌肉减少症的相关性。方法　2024年7月—2025年5月选取唐山市人民医院、华北理工大学附属医院、开滦总医院收治的326例结直肠癌患者为研究对象，收集CHEI和肌肉减少症诊断各项指标，采用二元Logistic回归分析和限制性立方样条模型，分析结直肠癌患者CHEI总分和各饮食成分与肌肉质量减少、身体功能下降以及肌肉减少症的相关性。结果　326例患者中，男195例（59.82%），女131例（40.18%），平均年龄（64.0±8.8）岁。其中肌肉质量减少49例（15.03%），CHEI得分为50（40，55）分；肌肉力量降低220例（67.48%），CHEI得分为55（45，60）分；身体功能下降217例（66.56%），CHEI得分为55（45，60）分；肌肉减少症患者46例（14.11%），CHEI得分为47.5（40，55）分。二元Logistic回归分析结果显示：CHEI得分与肌肉质量减少（OR=0.934，95%CI=0.891~0.979，P=0.004）、身体功能下降（OR=0.968，95%CI=0.942~0.995，P=0.020）和肌肉减少症（OR=0.931，95%CI=0.889~0.975，P=0.003）的发生风险均呈负相关。限制性立方样条模型结果显示：CHEI与肌肉质量减少（P总趋势=0.019，P非线性=0.216，P线性=0.004）、身体功能下降（P总趋势=0.095，P非线性=0.617，P线性=0.020）和肌肉减少症（P总趋势=0.038，P非线性=0.467，P线性=0.002）的发生呈线性剂量—反应关系。各饮食成分与肌肉质量减少、身体功能下降以及肌肉减少症的相关性分析结果显示，水果（OR=0.880，95%CI=0.786~0.985，P=0.026）、豆类（OR=0.480，95%CI=0.290~0.794，P=0.004）、家禽摄入（OR=0.799，95%CI=0.644~0.991，P=0.041）和钠（OR=0.897，95%CI=0.805~1.000，P=0.049）的得分与肌肉质量下降的风险呈负相关；全谷物（OR=0.839，95%CI=0.714~0.986，P=0.033）、海鲜（OR=0.848，95%CI=0.730~0.985，P=0.031）与身体功能下降的风险呈负相关，红肉（OR=1.256，95%CI=1.048~1.506，P=0.014）与身体功能下降风险呈正相关；谷物（OR=1.608，95%CI=1.115~2.317，P=0.011）与肌肉减少症风险呈显著正相关；水果（OR=0.886，95%CI=0.788~0.996，P=0.043）、豆类（OR=0.409，95%CI=0.238~0.703，P=0.001）与家禽（OR=0.731，95%CI=0.584~0.916，P=0.007）的得分与肌肉减少症风险呈负相关。结论　中国健康饮食模式与结直肠癌患者肌肉质量减少、身体功能下降和肌肉减少症风险降低呈正相关，且存在线性剂量—反应关系。充足摄入水果、豆类、家禽、全谷物及海鲜，适当放宽对红肉摄入的限制，并控制钠和谷物的过量摄入均有助于降低结直肠癌患者肌肉减少症的发生风险。

关键词: 结直肠癌, 中国健康饮食模式, 肌肉力量, 身体功能, 肌肉质量, 肌肉减少症, 限制性立方样条模型