The association between the planetary health diet index and the risk of sarcopenia and protein-energy wasting in patients with chronic kidney disease.

Abstract

Background: The Planetary Health Diet Index (PHDI) is a dietary index that emphasizes plant sources and recommends reducing animal-source food consumption. The relationship between this index and chronic kidney disease (CKD) has not been studied. This study aimed to examine the association between sarcopenia and protein-energy wasting (PEW) with PHDI in CKD patients.

Methods: The present study was a cross-sectional one, conducted in Shiraz, Fars province, Iran. Patients were selected from Motahari and Imam Reza clinics between January to October 2022. The guideline of the Asian Working Group for Sarcopenia (AWGS) was used to assess sarcopenia. PEW was identified based on the four criteria of the International Society of Renal Nutrition and Metabolism (ISRNM). PHDI was calculated according to the reference diet suggested by the EAT-Lancet Commission. Logistic regression was used to evaluate the association between PHDI and odds ratio (OR) of sarcopenia and PEW.

Results: In the multivariable analysis, in both crude and adjusted models, no significant association was seen between a unit change in the PHDI score and the odds of sarcopenia and PEW (P > 0.05 for both). In comparison to scores lower than the mean of PHDI score, in the crude model, no significant association was found between scores higher than the mean of PHDI score and sarcopenia and PEW. However, in the adjusted model, the odds of sarcopenia were significantly lower in participants with a PHDI score higher than the mean compared to those with a PHDI score lower than the mean of (OR = 0.249, 95% confidence interval (CI): 0.070-0.881, P = 0.031).

Conclusion: This study showed that a high adherence to PHDI is associated with a reduced odds of sarcopenia in CKD patients. However, it did not have a significant effect on reducing the odds of PEW in these patients.