Association and optimization of the Planetary Health Diet Index with hyperuricemia

Area of Science:

• Nutritional Epidemiology
• Metabolic Diseases
• Public Health Nutrition

Background:

• Hyperuricaemia (HUA) represents a significant global metabolic health challenge.
• The Planetary Health Diet Index for the United States (PHDI-US), a sustainable dietary pattern, shows promise for chronic disease management, but its specific impact on HUA remains under investigation.

Purpose of the Study:

• To investigate the association between the PHDI-US and HUA risk.
• To identify key dietary components within the PHDI-US influencing HUA.
• To develop and validate an optimized dietary index for HUA prevention.

Main Methods:

• Analysis of nationally representative NHANES data.
• Application of multivariate logistic regression and restricted cubic spline models.
• Machine learning to identify critical dietary components and construction of an optimized PHDI-Dairy index.
• External cohort validation of dairy intake and HUA risk.

Main Results:

• The original PHDI-US showed a negative correlation with HUA risk, though less potent than other established indices.
• Machine learning identified dairy as the most influential component of the PHDI-US.
• The optimized PHDI-Dairy index demonstrated a stronger negative association with HUA risk and superior protective efficiency.
• External validation confirmed that higher dairy consumption is associated with reduced HUA risk.

Conclusions:

• The PHDI-US is associated with a reduced risk of hyperuricaemia.
• Optimizing the PHDI-US to emphasize dairy intake (PHDI-Dairy) significantly enhances its protective effect against HUA.
• The PHDI-Dairy index shows potential as a targeted nutritional strategy for managing HUA and promoting public health and environmental sustainability.