Association between the Planetary Health Diet Index and chronic constipation and diarrhea risk in general population: A cross-sectional analysis of NHANES

Diet is an important factor influencing chronic constipation and diarrhea. This investigation proposes to examine the correlation between the Planetary Health Diet Index (PHDI), a new dietary scoring system, and the risk of chronic constipation and diarrhea in the general population. Data on 13,669 adults (≥20 years) were extracted from the 2005 to 2010 National Health and Nutrition Examination Survey. The PHDI was calculated by two 24-hour dietary recall interviews and consisted of scores from 15 food groups with a total score range of 0 to 140. Multivariable logistical regression analyses were employed to examine the correlation between PHDI and chronic constipation/diarrhea, and presented as odds (OR) and 95% confidence interval. Subgroup evaluations were carried out according to population and disease characteristics. The weighted quantile sum analysis was applied to evaluate the effect of total PHDI and its components on chronic constipation. Among these 13,669 participants, 1027 reported chronic constipation, 1061 had chronic diarrhea, and 11,581 maintained normal bowels. The second (63.69-66.67) (OR = 0.73 [0.57-0.92]) and third (>66.67) tertiles (OR = 0.68 [0.54-0.85]) of PHDI were connected to lower odds of chronic constipation versus the first tertile of PHDI (<63.69). No significant correlation was identified between PHDI and chronic diarrhea (P > .05). There was a nonlinear link of PHDI with chronic constipation (Poverall < .001, Pnonlinear < .001), and the risk of chronic constipation in individuals decreased with the increase in PHDI. Subgroup analysis indicated that the connection between PHDI and chronic constipation risk was more obvious in populations aged <65 years, those without diabetes, and those with dyslipidemia (P < .05). The weighted quantile sum analysis demonstrated that the overall mixed exposure effect of PHDI on the risk of chronic constipation was 0.96 (95% confidence interval: 0.94-0.97) (P < .001). Among the contributions of each component to PHDI, "added sugar and fruit juices" contributed the most to the effect of PHDI, followed by "saturated oils and transfat," while "legumes" and "nuts and seeds" contributed the least. A high PHDI is correlated with a lower risk of chronic constipation in the general population, which may suggest the potential benefits of dietary modification.