Adherence to the Mediterranean Diet Is Associated With Renal Function Among Healthy Adults: The Attica Study

Chrysοhoou, Christina; Panagiotakos, Demosthenes B.; Pitsavos, Christos; Skoumas, John; Zeibekis, Akis; Kastorini, C.-M.; Masoura, Constantina; Tsetsekou, Efi; Kambaxis, M.; Papaioannou, Nina; Metaxa, V.

doi:10.1016/s0735-1097(10)60540-2

Cited by 18 publications

(34 citation statements)

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“…In addition, it also shows that a low adherence to a Mediterranean diet linked to worse survival rates among individuals with CKD. Our observed association between low MDS adherence and the presence of CKD expands a recent study in a younger cohort (24). Consistent with this concept, high polyunsaturated fatty acid intake, especially of marine origin, has been considered as renally protective (35,36), whereas high saturated fatty acid intake may deteriorate kidney function Figure 1.…”

Section: Discussionsupporting

confidence: 87%

“…Because such risk factors are highly prevalent in CKD and contribute to its onset, it is plausible to hypothesize that adoption of this healthy dietary lifestyle may link to better preserved renal function. Limited research offering mixed results has, however, investigated this issue (24)(25)(26), and errors inherent to dietary assessment methods could have contributed to these divergent findings (27). We tested this hypothesis in a Swedish population-based cohort of elderly men of similar age, devoting particular efforts to minimize reporting biases in dietary recalls.…”

Section: Introductionmentioning

confidence: 99%

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Mediterranean Diet, Kidney Function, and Mortality in Men with CKD

Huang

Jiménez-Moleón

Lindholm

et al. 2013

Clinical Journal of the American Society of Nephrology

127

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SummaryBackground and objectives Adherence to a Mediterranean diet may link to a better preserved kidney function in the community as well as a favorable cardiometabolic profile and reduced mortality risk in individuals with manifest CKD.Design, setting, participants, & measurements Dietary habits were determined by 7-day dietary records in a population-based cohort of 1110 Swedish men (age 70 years) from 1991 to 1995, 506 of whom were considered to have CKD because of a GFR,60 ml/min per 1.73 m 2 . A Mediterranean Diet Score was calculated, and participants were categorized as having low, medium, or high adherence. Adequate dietary reporters were identified with Goldberg cutoffs (n=597). Deaths were registered during a median follow-up of 9.9 years.Results Compared with low adherents, medium and high adherents were 23% and 42% less likely to have CKD, respectively (adjusted odds ratio [95% confidence interval]=0.77 [0.57 to 1.05] and 0.58 [0.38 to 0.87], respectively, P for trend=0.04). Among those individuals with CKD, phosphate intake and net endogenous acid production were progressively lower across increasing adherence groups. No differences were observed regarding other cardiometabolic risk factors across adherence groups. As many as 168 (33%) CKD individuals died during followup. Compared with low adherents, proportional hazards regression associated medium and high adherents to a 25% and 23% lower mortality risk, respectively (adjusted hazard ratio [95% confidence interval]=0.75 [0.52 to 1.06] and 0.77 [0.44 to 1.36], respectively, P for trend=0.10). Sensitivity analyses showed significant and stronger associations when only adequate dietary reporters were considered.Conclusions Adherence to a Mediterranean dietary pattern is associated with lower likelihood of CKD in elderly men. A greater adherence to this diet independently predicted survival in those patients with manifest CKD. Clinical trials are warranted to test the hypothesis that following such a diet could improve outcomes (independent of other healthy lifestyles) in CKD patients.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Mediterranean Diet, Kidney Function, and Mortality in Men with CKD

Huang

Jiménez-Moleón

Lindholm

et al. 2013

Clinical Journal of the American Society of Nephrology

127

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“…Prior studies examining Mediterranean-style diets and kidney function have been inconsistent, potentially because of important limitations that we attempted to address. Cross-sectional analyses have suggested a beneficial association with albuminuria, creatinine clearance, and CKD (18)(19)(20)(21). By contrast, reported outcomes from the Nurses' Health Study (NHS) and the Prevención con Dieta Mediterránea (PREDIMED) randomized clinical trial (which used the Mediterranean diet for primary prevention of cardiovascular disease) (12) differed from ours.…”

Section: Discussionmentioning

confidence: 63%

“…Purported mechanisms of action, including improvements in BP (14,15), lipid profile (15), endothelial function (16), and inflammation (17), may benefit the kidney as well. Few studies have examined relationships between a Mediterranean-style diet and kidney function, but their results are inconclusive due to cross-sectional study design (18)(19)(20)(21), limited demographics (6,18), or short duration (22). The purpose of this observational analysis was to characterize the effect of varying degrees of a Mediterranean-style diet on long-term kidney function in a community-based, prospective cohort.…”

Section: Introductionmentioning

confidence: 99%

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Khatri¹,

Moon

Scarmeas

et al. 2014

Clinical Journal of the American Society of Nephrology

113

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Background and objectives Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function.Design, setting, participants, & measurements This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR,60 ml/min per 1.73 m 2 using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline ($2.5 ml/min per 1.73 m 2 per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors.Results Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m 2 . Incident eGFR,60 ml/min per 1.73 m 2 developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR,60 ml/min per 1.73 m 2 (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98).Conclusions A Mediterranean diet was associated with a reduced incidence of eGFR,60 ml/min per 1.73 m 2 and upper quartile of eGFR decline in a multiethnic cohort.

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“…‡Of the 74 incident diabetic retinopathy cases, 32 were excluded. middle-aged individuals from different populations (34)(35)(36). Contrary to our hypothesis, in the present post hoc analysis, we could not show a significant protective effect of the MedDiet+ EVOO or the MedDiet+Nuts on diabetic nephropathy, even after performing sensitivity analysis evaluating nephropathy diagnosis according to incident impaired GFR and incident albuminuria.…”

Section: Discussionmentioning

confidence: 99%

Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial

et al. 2015

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OBJECTIVETo date no clinical trials have evaluated the role of dietary patterns on the incidence of microvascular diabetes complications. We hypothesized that a nutritional intervention based on the Mediterranean diet (MedDiet) would have greater protective effect on diabetic retinopathy and nephropathy than a lowfat control diet. RESEARCH DESIGN AND METHODSThis was a post hoc analysis of a cohort of patients with type 2 diabetes participating in the PREvención con DIeta MEDiterránea (PREDIMED) study, a multicenter randomized nutritional intervention trial conducted in a population at high cardiovascular risk. Individuals with type 2 diabetes who were free of microvascular complications at enrollment (n = 3,614, aged 55-80 years) were randomly assigned to one of three dietary interventions: MedDiet supplemented with extravirgin olive oil (MedDiet+EVOO), MedDiet supplemented with mixed nuts (MedDiet+Nuts), or a low-fat control diet. Two independent outcomes were considered: new onset of diabetic retinopathy and nephropathy. Hazard ratios (HRs) were calculated using multivariable-adjusted Cox regression. RESULTSDuring a median follow-up of 6.0 years, we identified 74 new cases of retinopathy and 168 of nephropathy. Compared with the control diet, multivariable-adjusted HRs for diabetic retinopathy were 0.56 (95% CI 0.32-0.97) for the ) for the MedDiet+Nuts. No between-group differences were found for nephropathy. When the yearly updated information on adherence to the MedDiet was considered, the HR for retinopathy in the highest versus the lowest quintile was 0.34 (0.13-0.89; P = 0.001 for trend). No significant associations were found for nephropathy. CONCLUSIONSA MedDiet enriched with EVOO may protect against diabetic retinopathy but not diabetic nephropathy.

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Adherence to the Mediterranean Diet Is Associated With Renal Function Among Healthy Adults: The Attica Study

Cited by 18 publications

References 0 publications

Mediterranean Diet, Kidney Function, and Mortality in Men with CKD

Mediterranean Diet, Kidney Function, and Mortality in Men with CKD

The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Mediterranean Diet, Retinopathy, Nephropathy, and Microvascular Diabetes Complications: A Post Hoc Analysis of a Randomized Trial

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