Evidence map›Paper›PMID 42528766›Full record

ArticleFrontiers in nutrition2026

Planetary health diet index and low muscle mass in adults aged 20-60 years: exploratory evaluation of a dairy-upweighted outcome-specific adaptation.

Jin-Jie He, Xu-Lin Chen, Chao Ning, Qing-Jun Wei

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Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 authors.

Jin-Jie He *Department of Bone and Joint Diseases Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Xu-Lin Chen *Department of Bone and Joint Diseases Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Chao NingDepartment of Bone and Joint Diseases Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Qing-Jun WeiDepartment of Bone and Joint Diseases Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Increasing evidence indicates that the Planetary Health Diet Index (PHDI), proposed within the EAT-Lancet framework, not only supports environmental sustainability but also contributes to the prevention of various diseases. However, the rigorous restriction of animal-sourced proteins in the standard PHDI may overlook the heightened anabolic needs of aging populations. This study primarily aimed to evaluate the association between PHDI-US adherence and low muscle mass (LMM) and to compare this association with other commonly used dietary indices. As a secondary exploratory step, we examined whether an exploratory dairy-upweighted score, derived by multiplying the original PHDI-US total score by the observed dairy intake amount, might show a stronger association with LMM. Methods: Multivariable logistic regression and restricted cubic spline (RCS) models were used to evaluate the association between the Planetary Health Diet Index for the United States (PHDI-US) and low muscle mass (LMM). Random-forest feature-importance analysis was then used to identify the most influential dietary component within the PHDI-US and to derive a dairy-upweighted version of the score (PHDI-Dairy). We then examined the association between dairy intake and LMM in an independent Southern Chinese cohort. Results: In fully adjusted models, higher PHDI-US and Alternative Healthy Eating Index scores were associated with lower odds of LMM, whereas a higher Dietary Inflammatory Index score was associated with higher odds of LMM. Healthy Eating Index and Mediterranean Diet Index scores were not statistically significant in fully adjusted quartile analyses. In exploratory analyses, a dairy-upweighted score (PHDI-Dairy) showed a stronger inverse association with LMM than the original PHDI-US. In a separate hospital-based Southern Chinese cohort, higher dairy intake was associated with lower odds of LMM, providing supportive evidence for the dairy-related finding. Conclusion: PHDI-US was modestly associated with lower odds of LMM, and the exploratory dairy-upweighted score, PHDI-Dairy, showed a stronger inverse association with LMM.

Indexed as

eat-lancetlow muscle massmachine learningmultivariable logistic regressionrestricted cubic spline

Identifiers

PMID42528766
PMCPMC13414832

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.