ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1657218
Association and Optimization of the Planetary Health Diet Index (PHDI) with Hyperuricemia
Provisionally accepted
- 1Department of Clinical Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
- 2Department of Neurosurgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
- 3First Affiliated Hospital, Guangxi Medical University, Nanning, China
- 4Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Background: Hyperuricaemia (HUA) is a common metabolic disease that has become a global public health burden. The Planetary Health Diet Index for the United States (PHDI-US), a sustainable dietary pattern emphasising a plant-based diet, has great potential for chronic disease prevention and control, but its relationship with HUA is unclear. Methods: This study was based on nationally representative NHANES data. Multivariate logistic regression and restricted cubic spline models were used to assess the association between raw PHDI-US and HUA. The key dietary component Dairy was identified by machine learning, the optimized PHDI-Dairy index was constructed, and the association between dairy intake and HUA risk was verified in an independent self-built cohort. Results: Primitive PHDI-US was significantly negatively correlated with the risk of HUA, but its protective effect was weaker than traditional dietary indices such as AHEI, AEI, and MEDI. Machine learning results show that Dairy is the most critical component in PHDI-US composition. The PHDI-Dairy index, constructed after optimizing the weight of dairy products, was more negatively correlated with the risk of HUA, and the protection efficiency was better than that of other dietary indices. External validation further confirmed that increased dairy intake was associated with a low risk of HUA. Conclusion: PHDI-US was negatively correlated with the risk of HUA. After optimizing the weighting of dairy products, PHDI-Dairy demonstrated a significantly enhanced protective effect, outperforming both the original PHDI and other dietary indices. This result highlights its potential as a nutritional intervention tool for chronic diseases, contributing to both public health and environmental sustainability.
Keywords: Planetary Health Diet Index, Hyperuricemia, NHANES, Environmental protection, machine learning, restricted cubic splines
Received: 01 Jul 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Tan, Qin, Li, Ruan and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi-Zhen Gong, Department of Clinical Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
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