Good Adherence to the Mediterranean Diet Lowered Risk of Renal Glomerular Impairment in Children: A Longitudinal Study

Abstract

Healthy diet patterns have a positive effect on chronic non-communicable diseases in the pediatric population, but the evidence is limited on the association between kidney impairment and adherence to a Mediterranean diet. We aim to determine the associations between Mediterranean diet adherence and longitudinal tubular and glomerular impairment in children. Based on four waves of urine assays conducted from October 2018 to November 2019, we assayed urinary β2-microglobulin (β2-MG) and microalbumin (MA) excretion to determine transient renal tubular and glomerular impairment during the follow-up of the child cohort (PROC) study in Beijing, China. We assessed Mediterranean diet adherence using the 16-item Mediterranean Diet Quality Index in children and adolescents (KIDMED) among 1914 primary school children. Poor, intermediate, and good adherence rates for the Mediterranean diet were 9.0% (KIDMED index 0–3), 54.4% (KIDMED index 4–7) and 36.5% (KIDMED index 8–12), respectively. A short sleep duration was more prevalent in children with lower Mediterranean diet adherence, with no significant differences presenting in the other demographic and lifestyle covariates. The results of linear mixed-effects models showed that a higher urinary MA excretion was inversely associated with a higher KIDMED score (β = −0.216, 95%CI: −0.358, −0.074, p = 0.003), after adjusting for sex, age, BMI z-score, SBP z-score, screen time, sleep duration and physical activity. Furthermore, in generalized linear mixed-effects models, consistent results found that transient renal glomerular impairment was less likely to develop in children with intermediate Mediterranean diet adherence (aOR = 0.68, 95%CI: 0.47, 0.99, p = 0.044) and in children with good Mediterranean diet adherence (aOR = 0.60, 95%CI: 0.40, 0.90, p = 0.014), taking poor Mediterranean diet adherence as a reference. We visualized the longitudinal associations between each item of the KIDMED test and kidney impairment via a forest plot and identified the main protective eating behaviors. Children who adhere well to the Mediterranean diet have a lower risk of transient glomerular impairment, underscoring the necessity of the early childhood development of healthy eating patterns to protect kidney health.

Food Frequency Questionnaire Personalisation Using Multi-Target Regression

“…The FFQ in the LBC application is based on a Mediterranean diet, which has been shown to have a wide range of benefits for health [ 3 ], for instance, preventing chronic diseases [ 4 , 5 ]. The FFQ used in the LBC application consists of 24 questions and returns feedback on 11 aspects of nutrition, which users can set as goals to follow.…”

Dietary, Lifestyle, and Children Health

“…The Mediterranean diet is one of the dietary patterns with the healthiest outcomes, which has a positive role in protecting people from chronic non-communicable diseases. A longitudinal study found that children who adhere well to the Mediterranean diet have a lower risk of transient glomerular impairment [ 12 ]. Another randomized pilot trial indicated that a nutritional intervention based on the Mediterranean diet helps to reduce high glycated hemoglobin (HbA1c) and insulin levels and, therefore, to reduce the prevalence of prediabetes [ 13 ].…”