Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio
Abstract Background Cancer-related deaths and environmental issues pose significant global challenges. The Planetary Health Diet (PHD) is a healthy dietary pattern that simultaneously promotes human health and ecology. This study aims to investigate the association between the Planetary Health Diet...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | Nutrition Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12937-025-01097-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849715668762492928 |
|---|---|
| author | Haolin Chen Qinglong Yang Huihui Zheng Jianhui Tan Jiayi Xie Miaojie Xu Xue Ouyang Zhiyang Li Yexi Chen |
| author_facet | Haolin Chen Qinglong Yang Huihui Zheng Jianhui Tan Jiayi Xie Miaojie Xu Xue Ouyang Zhiyang Li Yexi Chen |
| author_sort | Haolin Chen |
| collection | DOAJ |
| description | Abstract Background Cancer-related deaths and environmental issues pose significant global challenges. The Planetary Health Diet (PHD) is a healthy dietary pattern that simultaneously promotes human health and ecology. This study aims to investigate the association between the Planetary Health Diet Index (PHDI) and mortality among cancer survivors, as well as the mediating role of inflammation between PHDI and all-cause mortality. Methods This study analyzed data from 3,442 cancer survivors enrolled in the United States National Health and Nutrition Examination Survey between 1999 and 2018. To investigate the association between PHDI and mortality, we applied weighted multivariate Cox proportional hazards regression, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis. The mediating effects of the Systemic Immune-Inflammation Index (SII) and Neutrophil-to-Lymphocyte Ratio (NLR) were assessed using the bootstrap method with 1000 simulations. Results In the fully adjusted model, each 10-point PHDI increase correlated with a 9% decrease in all-cause mortality (HR, 0.91; 95% CI, 0.86–0.95), a 10% decrease in cancer mortality (HR, 0.90; 95% CI, 0.83–0.99), and a 10% decrease in non-cancer mortality (HR, 0.90; 95% CI, 0.85–0.96). The PHDI was significantly inversely correlated with SII and NLR, which were positively related to all-cause mortality. The mediation proportions of SII and NLR between the PHDI and all-cause mortality were 6.52% and 8.52%, respectively. Conclusions Adherence to the PHD is associated with reduced all-cause, cancer, and non-cancer mortality among cancer survivors. Additionally, SII and NLR may mediate the relationship between PHDI and all-cause mortality. |
| format | Article |
| id | doaj-art-e92c6a5628ba47488a413f19c5865931 |
| institution | DOAJ |
| issn | 1475-2891 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition Journal |
| spelling | doaj-art-e92c6a5628ba47488a413f19c58659312025-08-20T03:13:15ZengBMCNutrition Journal1475-28912025-02-0124111110.1186/s12937-025-01097-6Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratioHaolin Chen0Qinglong Yang1Huihui Zheng2Jianhui Tan3Jiayi Xie4Miaojie Xu5Xue Ouyang6Zhiyang Li7Yexi Chen8Department of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Urology, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeDepartment of Thyroid, Breast and Hernia Surgery, General Surgery, The Second Affiliated Hospital of Shantou University Medical CollegeAbstract Background Cancer-related deaths and environmental issues pose significant global challenges. The Planetary Health Diet (PHD) is a healthy dietary pattern that simultaneously promotes human health and ecology. This study aims to investigate the association between the Planetary Health Diet Index (PHDI) and mortality among cancer survivors, as well as the mediating role of inflammation between PHDI and all-cause mortality. Methods This study analyzed data from 3,442 cancer survivors enrolled in the United States National Health and Nutrition Examination Survey between 1999 and 2018. To investigate the association between PHDI and mortality, we applied weighted multivariate Cox proportional hazards regression, restricted cubic spline analysis, subgroup analysis, and sensitivity analysis. The mediating effects of the Systemic Immune-Inflammation Index (SII) and Neutrophil-to-Lymphocyte Ratio (NLR) were assessed using the bootstrap method with 1000 simulations. Results In the fully adjusted model, each 10-point PHDI increase correlated with a 9% decrease in all-cause mortality (HR, 0.91; 95% CI, 0.86–0.95), a 10% decrease in cancer mortality (HR, 0.90; 95% CI, 0.83–0.99), and a 10% decrease in non-cancer mortality (HR, 0.90; 95% CI, 0.85–0.96). The PHDI was significantly inversely correlated with SII and NLR, which were positively related to all-cause mortality. The mediation proportions of SII and NLR between the PHDI and all-cause mortality were 6.52% and 8.52%, respectively. Conclusions Adherence to the PHD is associated with reduced all-cause, cancer, and non-cancer mortality among cancer survivors. Additionally, SII and NLR may mediate the relationship between PHDI and all-cause mortality.https://doi.org/10.1186/s12937-025-01097-6Planetary Health DietMortalityCancerSystemic immune-inflammation indexNeutrophil-to-lymphocyte ratio |
| spellingShingle | Haolin Chen Qinglong Yang Huihui Zheng Jianhui Tan Jiayi Xie Miaojie Xu Xue Ouyang Zhiyang Li Yexi Chen Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio Nutrition Journal Planetary Health Diet Mortality Cancer Systemic immune-inflammation index Neutrophil-to-lymphocyte ratio |
| title | Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio |
| title_full | Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio |
| title_fullStr | Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio |
| title_full_unstemmed | Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio |
| title_short | Planetary health diet index and mortality among US cancer survivors: mediating roles of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio |
| title_sort | planetary health diet index and mortality among us cancer survivors mediating roles of systemic immune inflammation index and neutrophil to lymphocyte ratio |
| topic | Planetary Health Diet Mortality Cancer Systemic immune-inflammation index Neutrophil-to-lymphocyte ratio |
| url | https://doi.org/10.1186/s12937-025-01097-6 |
| work_keys_str_mv | AT haolinchen planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT qinglongyang planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT huihuizheng planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT jianhuitan planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT jiayixie planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT miaojiexu planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT xueouyang planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT zhiyangli planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio AT yexichen planetaryhealthdietindexandmortalityamonguscancersurvivorsmediatingrolesofsystemicimmuneinflammationindexandneutrophiltolymphocyteratio |