Background Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. Objective To assess the association between dietary protein sources and incident chronic kidney disease (CKD) Design Prospective cohort Setting Atherosclerosis Risk in Communities (ARIC) study participants from 4 U.S. communities Subjects 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease and had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2. Main outcome measure A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/min/1.73 m2; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Results During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HRQ5 vs. Q1: 1.23, 95% CI: 1.06, 1.42, ptrend = 0.01). In contrast, higher dietary intake of nuts, legumes and low-fat dairy products was associated with lower CKD risk (nuts: HRQ5 vs. Q1: 0.81, 95% CI: 0.72, 0.92, ptrend <0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95% CI: 0.65, 0.85, ptrend <0.001; legumes: HRQ5 vs. Q1: 0.83, 95% CI: 0.72, 0.95, ptrend=0.03). Conclusion There were varied associations of specific dietary protein sources with risk of incident CKD, with red and processed meat being adversely associated with CKD risk and nuts, low-fat dairy products and legumes being protective against the development of CKD.
Galectin-3 has been proposed as a novel biomarker of heart failure and cardiac fibrosis, and may also be associated with fibrosis of other organs such as the kidney. To determine this, we prospectively analyzed data from 9,148 Atherosclerosis Risk in Communities (ARIC) Study participants with measured plasma galectin-3 levels (baseline, visit 4, 1996-98) and without prevalent chronic kidney disease (CKD) or heart failure. We identified 1,983 incident CKD cases through December 31, 2013 over a median follow-up of 16 years. At baseline, galectin-3 was cross-sectionally associated with estimated glomerular filtration rate and urine albumin-to-creatinine ratio; both significant. The results were adjusted for age, sex, race-center, education, physical activity, smoking status, body mass index, systolic blood pressure, anti-hypertensive medication use, history of cardiovascular disease, diabetes, fasting blood glucose, and rs4644 (a single nucleotide polymorphism of galactin-3). There was a significant, graded, and positive association between galectin-3 and incident CKD (quartile 4 vs. 1 hazard ratio: 2.22 [95% confidence interval: 1.89, 2.60]). The association was attenuated but remained significant after adjustment for estimated glomerular filtration rate, urine albumin-to-creatinine ratio, troponin T, and N-terminal pro-brain natriuretic peptide (quartile 4 vs. 1 hazard ratio: 1.75 [95% confidence interval: 1.49, 2.06]), and was stronger among those with hypertension at baseline (significant interaction). Thus, in this community-based population, higher plasma galectin-3 levels were associated with an elevated risk of developing incident CKD, particularly among those with hypertension.
To evaluate the effects of a 12-month exercise intervention using either high-impact step aerobic exercise or moderate-intensity strength training on areal bone mineral density (aBMD) we studied 51 untrained women, aged 20-35 years, for this study. Whole body and heel and wrist aBMD were measured by dual-energy X-ray absorptiometry (DXA, Hologic or PIXI Lunar). Subjects were randomly assigned to: impact-loaded step aerobic exercise (SA, n=15), moderate-intensity lower body strength training (ST, n=16) or non-exercise control (CON, n=20). Data analysis only included those who completed 95% of each training routine and attended at least 80% of all sessions. Group differences in aBMD, leg press strength and urinary cross-link deoxypridinoline (μDPD) were analysed using analysis of variance. After a 12-month intervention, the SA elicited an increase in aBMD of the heel (4.4%, p<0.05) and leg press strength (15%, p<0.05), relative to baseline. Meanwhile, the ST showed an increase in leg press strength (48%, p<0.05) with no significant increase in aBMD at any measured site. Similar and unchanged μDPD was observed in all 3 groups at baseline, 6 and 12 months. In conclusion, a 12-month high-impact step aerobic exercise resulted in a significant increase in the heel aBMD in untrained young women, who complied with the exercise regimen. A moderate intensity strength training intervention of similar duration had no effect on aBMD although leg strength increased significantly.
The purpose of this study was to investigate whether a single 1,350-mg dose of Panax notoginseng (PNG) could enhance aerobic capacity, endurance, and mean blood pressure (MAP) in young adults. We randomly assigned 29 untrained adults, aged 20-35 years, to an experimental (EXP, n = 13) or a control (CON, n = 16) group. For 30 days, the EXP took 1,350 mg per day of PNG capsule and the CON consumed 1,350 mg per day of starch capsule. Measurement variables were taken before and after 30 days of either PNG supplement or placebo. Results show that the EXP improved (p < 0.05) their endurance time by >7 minutes, and lowered (p < 0.05) maximal MAP (from 113 +/- 12 to 109 +/- 14 mm Hg) and Vo2 at the 24th minute (from 32.5 +/- 8 to 27.6 +/- 8 ml.kg-1.min-1) during endurance cycle exercise. Based on this study, we conclude that 1,350 mg per day PNG supplement for 30 days improved endurance time to exhaustion, and lowered MAP and Vo2 during endurance exercise.
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