Background Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m 2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m 2 ) and the association of dietary pattern with the outcomes aforementioned. Results Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12–1.45, P <  0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31–1.77, P <  0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41–1.72, P <  0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89–2.27, P <  0.01) weight status, increased cardiovascular risk by 10–31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02–1.29, P <  0.05). Conclusions The RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults. Electronic supplementary material The online version of this article (10.1186/s12937-019-0452-4) contains supplementary material, which is available to authorized users.

The study determined the association of sleep duration and insomnia symptoms with the components of metabolic syndrome and inflammation in middle-aged and older adults with metabolic syndrome in Taiwan. This cross-sectional study used the database compiled in Taiwan between 2004–2013. A total of 26,016 volunteers aged 35 years and above were selected. Metabolic syndrome was defined according to the International Diabetes Federation. Compared with regular sleep duration (6–8 h/day), short (<6 h/day) or long sleep duration (>8 h/day) and insomnia symptoms significantly increased the odds ratios of high waist circumference, high blood pressure, low high-density lipoprotein-cholesterol, high triglycerides, high fasting blood glucose, and high C-reactive protein. Insomnia symptoms did not modify the effects of sleep duration on the components of metabolic syndrome and inflammation. Our study suggests that short or long sleep duration and insomnia symptoms may have an adverse effect on metabolic syndrome and inflammation.

Alkaline electrolyzed water (AEW) and walking are strongly recommended for ameliorating oxidative stress and inflammation. Nevertheless, there is a lack of information on the combination of both on alleviating inflammation, oxidative stress, and improving the quality of life (QoL). We investigated the synergistic effects of drinking AEW and walking on advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), malondialdehyde (MDA), white blood cells (WBCs), neutrophil-lymphocyte ratio (NLR) and QoL. In total, 81 eligible patients with type 2 diabetes (T2DM) were randomly allocated via single blind to four groups: consumed 2 L/day of AEW (n = 20), instructed to walk for 150 min/week (n = 20), received a combination of AEW and walking (n = 20), and continue their habitual diet and activity (n = 21). Data were collected and analyzed before and after 8 weeks of intervention. Our results showed a significant interaction between the group and time, with both AEW and walking independently and synergistically ameliorating AGEs, AOPPs, MDA, NLR and WBCs levels. Moreover, the AEW group had a higher physical and total QoL score. The walking group and the combined group had higher scores in physical, mental and total QoL compared to the control group. The synergistic effect of AEW and regular walking are an advisable treatment for patients with T2DM.

Dietary patterns have been proposed to be related to dyslipidemia and hyperglycemia. This study investigated the correlation of dietary patterns with components of dyslipidemia and fasting plasma glucose (FPG) among young and middle-aged adults (aged between 20 and 50 years) with dyslipidemia and abnormal FPG in Taiwan. This cross-sectional study used the database compiled in Taiwan between 2001 to 2010. A total of 13,609 subjects aged between 20 and 50 years were selected. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Elevated FPG level was defined according to the American Diabetes Association. The factor analysis was conducted to identify three dietary patterns. Higher scores of the meat–convenience dietary pattern (high intake of deep-fried and processed food, sauces, sugar-added beverages, meat and organ meats, instant noodles, rice or flour cooked in oil, and eggs) had no association with components of dyslipidemia and abnormal FPG. Higher scores of the vegetables–fruits–seafood dietary pattern (high intake of vegetables, vegetables with oil or dressing, fruits, seafood, legumes, soy products, and rice or flour products) was inversely associated with hypercholesterolemia and positively associated with hyperglycemia. Higher scores of the dairy–complex carbohydrate dietary pattern (high intake of dairy products, milk, root crops, jam or honey, and whole grains) was inversely correlated with hypertriglycemia and low high-density lipoprotein cholesterol level. Our results support that the dietary pattern may have a role in the prevention and management of dyslipidemia and abnormal fasting plasma glucose.

Inadequate dietary intake, poor nutritional status, heavy smoking, and alcohol consumption are associated with the risk of anemia. The objective of this study was to investigate the associations between dietary patterns, lifestyle, nutritional status, and anemia-related biomarkers among adults using a multivariable regression model. Taiwanese adults aged 20–45 years (n = 118,924, 43,055 men and 75,869 women) were obtained from the Mei Jau Health Management Institution database, between 2001 and 2015, for data analysis. The anemia–inflammation-related dietary pattern was derived by reduced rank regression analysis. Dietary patterns with high intakes of eggs, meat, organ meats, rice or flour products, fried foods, sugary beverages, and processed foods significantly increased the risk of anemia, and was associated with decreased hemoglobin, hematocrit, and red blood cells, but increased white blood cells and C-reactive protein levels. Moreover, current alcohol drinkers, as well as people who were underweight, overweight, obese, and central obese, were more likely to increase their risk of anemia by 46%, 20%, 23%, 34%, and 28%, respectively. Interestingly, participants who are current or past smokers were inversely associated with risk of anemia. In conclusion, adherence to the anemia–inflammation dietary pattern was associated with an increased risk of anemia in Taiwanese adults. Furthermore, abnormal weight status and alcohol drinking were correlated with an increased risk of anemia.

Background Dietary patterns were associated with the risk of chronic disease development and outcome-related diseases. In this study, we aimed to compare the correlation between dietary patterns and metabolic syndrome (MetS) using two methods for identifying dietary patterns. Methods The participants (n = 25,569) aged ≥40 years with impaired kidney function were retrieved from Mei Jau (MJ) Health Screening database from 2008 to 2010. Dietary patterns were identified by principal component analysis (PCA) and reduced rank regression (RRR) from twenty-two food groups using PROC FACTOR and PROC PLS functions. Results We identified two similar dietary pattern characteristics (high intakes of deep fried foods, preserved or processed foods, dipping sauce, meat, sugary drinks, organ meats, jam/honey, fried rice/flour products, instant noodles and eggs) derived by PCA and RRR. Logistic regression analysis revealed that RRR-derived dietary pattern scores were positively associated with an odds ratio (OR = 1.70, 95% CI: 1.56, 1.86) of having MetS than PCA-derived dietary pattern scores (OR = 1.38, 95% CI: 1.27, 1.51). The correlations between RRR-derived dietary pattern scores and elevated systolic and diastolic blood pressure (OR = 1.30 for both) or low high density lipoprotein cholesterol in women (OR = 1.32) were statistically significant but not significant in PCA-derived dietary pattern scores. Conclusions Our findings suggest that RRR gives better results when studying behavior related dietary patterns in association with MetS. RRR may be more preferable to provide dietary information for developing dietary guidelines among people with MetS. Further studies with prospective measurements are needed to verify whether RRR is a useful analytic tool for the association between dietary patterns and other chronic diseases.

Dyslipidemia, anemia, and inflammation are associated with declined kidney function. This study investigated the association of inflammatory dietary pattern with dyslipidemia, anemia, and kidney function biomarkers among middle-aged and older Taiwanese adults with declined kidney function. Biochemical data and food frequency questionnaire were obtained from 41,128 participants with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 and positive urinary protein. Inflammatory dietary pattern was identified by reduced rank regression with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (N/L) as response variables. Males had higher prevalence of dyslipidemia and higher inflammatory markers, but lower prevalence of anemia and lower eGFR levels compared to females. Inflammatory dietary pattern characterized with low intakes of seafood, grains, vegetables, and fruits but high intakes of meat, eggs, preserved/processed foods, and sugary drinks was associated with an increased risk of dyslipidemia by 21% in males and an increased risk of anemia by 28–47% in both genders. Furthermore, high consumption of inflammatory dietary pattern was associated with reduced eGFR (males β = −0.85, 95% CI −1.26 to −0.43, females β = −0.53, 95% CI −0.98 to −0.08) and increased N/L and/or CRP in both genders. In conclusion, inflammatory dietary pattern is positively associated with dyslipidemia, anemia, and decreased kidney function in middle-aged and older adults with declined kidney function.

Background Anemia and electrolyte disturbances are adverse outcomes of chronic kidney disease (CKD). This study explored the association between metabolic parameters with anemia and electrolyte and mineral disorders among CKD patients in Taiwan. Methods This cross-sectional study with a total of 2176 CKD stages 3–5 patients were collected from the Department of Nephrology at Shuang Ho Hospital, Taipei Medical University through the “Chronic Kidney Disease Common Care Network” database from December 2008 to April 2019. A multivariable-adjusted logistic regression expressed as odd ratios (OR) was performed to assess the association of metabolic parameters with anemia and electrolyte and mineral disorders. Results Elevated diastolic blood pressure, fasting blood glucose, and glycated hemoglobin A1c (HbA1c) were associated with presence of anemia. Similarly, elevated fasting blood glucose and HbA1c were associated with hyponatremia (OR = 1.59 and 1.58, P for both < 0.01) and hypercalcemia (OR = 1.38 and 1.33, P for both < 0.05). There was no significant association in serum lipid levels with presence of anemia. However, total triglycerides, total cholesterol and low-density lipoprotein-cholesterol were only associated with presence of hypercalcemia (OR = 1.43, 1.95 and 3.08, respectively, P for all < 0.05). Conclusions Elevated diastolic blood pressure, fasting blood glucose, HbA1c and blood lipids are associated with anemia or electrolyte and mineral disorders in CKD patients.