Meat–Carbohydrate Dietary Pattern and Elevated Serum Uric Acid in Children and Adolescents: Mediating Role of Obesity in a Cross-Sectional Study

<b>Background:</b> Elevated serum uric acid (SUA) levels in young people have become a significant public health concern. Dietary habits are a key factor influencing SUA levels. This study aimed to investigate dietary patterns (DPs) of children and adolescents and their associations with SUA. <b>Methods:</b> This cross-sectional study included children and adolescents in Guangzhou, China. We used structured questionnaires to collect data on demographics, lifestyle, and dietary intake, and we collected blood samples for biochemical analysis. DPs were identified by factor analysis. We used robust linear regression to examine the association between these patterns and SUA levels. Parallel mediation analysis was utilized to assess the mediating role of body mass index (BMI) <i>Z</i>-score and waist circumference (WC). <b>Results:</b> The study encompassed 4100 children and adolescents between ages 9-17. The median SUA level was 374 (IQR: 319, 438) μmol/L and the prevalence of hyperuricemia was 41.7%. We identified four DPs, including plant-based, snack-beverage, highprotein, and meat-carbohydrate patterns. There was a positive correlation between the meat-carbohydrate pattern and SUA (β = 3.67 μmol/L, 95% CI: 1.22-6.12). The Q4 group of the highprotein pattern was associated with higher SUA levels (9.17 μmol/L, 95% CI: 2.41-15.93) compared to the Q1 group. BMI <i>Z</i>-score and WC mediated the association between the meat-carbohydrate pattern and SUA. <b>Conclusions:</b> Our findings suggest that BMI <i>Z</i>-score and WC mediated the association between the meat-carbohydrate pattern and SUA. This study emphasizes the significance of targeted dietary interventions for weight control in addressing the increasing SUA levels in children and adolescents. Future research could focus on exploring the molecular mechanisms, developing personalized dietary intervention programs, and conducting multicenter prospective cohort studies.