Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

Abstract

Background/Objectives: Mediterranean diet has favorable effects on the cardiovascular system, whereas albuminuria is associated with atherosclerosis progression. The aim of the study was to assess the relationships of adherence rates to the Mediterranean diet with albumin to creatinine ratio (ACR), in a cohort of Greek adolescents who participated in the Leontio Lyceum ALbuminuria (3L) study. Subjects/Methods: In a total of 365 adolescents 12-17 years of age included in 3L study, ACR values were determined in a morning-spot urine. Results: The Mediterranean diet Quality Index for children and adolescents (KIDMED) was estimated and accordingly subjects were divided into those with high (X8), average (4-7) and low (p3) score. Adolescents with low (n ¼ 153, 42%) compared with those with average (n ¼ 187, 51.2%) and high (n ¼ 25, 6.8%) KIDMED score were characterized by greater ACR values (22.4 vs 13.4 vs 12.1 mg/g, Po0.05) even after adjustment for confounders. In the total population, KIDMED score was related to body mass index (r ¼ 0.122, P ¼ 0.02), waist circumference (r ¼ 0.118, P ¼ 0.02), systolic blood pressure (BP) (r ¼ 0.119, P ¼ 0.023), whereas it was negatively associated with ACR (r ¼ À0.111, P ¼ 0.041). Regarding ACR, it was associated with age (r ¼ À0.11, P ¼ 0.044), male sex (r ¼ 0.16, P ¼ 0.003), body mass index (r ¼ À0.131, P ¼ 0.016) and systolic BP (r ¼ À0.144, P ¼ 0.008). Conclusions: Adolescents who adhere to the Mediterranean diet exhibit lower levels of albuminuria, independently of demographic and hemodynamic confounders. The inverse relation of KIDMED index with ACR suggests a close link of accelerated vascular damage reflected by albuminuria with low adherence to this favorable diet of the Mediterranean basin.

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

“…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.…”

“…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.…”

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

“…Alkali-inducing fruits and vegetables, important components of a Mediterranean diet, may improve metabolic acidosis and attenuate kidney injury (22,23,38). The aforementioned beneficial effects of this dietary pattern on the cardiometabolic profile as well as albuminuria (25) are also believed to contribute at least subclinically, because they play an essential role in the pathogenesis and progression of renal diseases (39)(40)(41). Of note, a recent interventional study showed improvement of renal function after 1 year of following a Mediterranean-like dietary pattern in elderly individuals at high risk of coronary heart disease (26).…”

“…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.…”

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

“…‡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.…”