Mediterranean style diet is associated with low risk of new-onset diabetes after renal transplantation

Abstract

ObjectiveThe incidence of new-onset diabetes after transplantation (NODAT) and premature mortality is high in renal transplant recipients (RTR). We hypothesized that a Mediterranean Style diet protects against NODAT and premature mortality in RTR.Research design and methodsA prospective cohort study of adult RTR with a functioning graft for >1 year. Dietary intake was assessed with a 177-item validated food frequency questionnaire. Patients were divided based on a 9-point Mediterranean Style Diet Score (MDS): low MDS (0–4 points) versus high MDS (5–9 points). A total of 468 RTR were eligible for analyses. Logistic multivariable regression analyses were used to study the association of MDS with NODAT and Cox multivariable regression models for the association with all-cause mortality.ResultsMean±SD age was 51.3±13.2 years and 56.6% were men. About 50% of the patients had a high MDS. During median follow-up of 4.0 (IQR, 0.4–5.4) years, 22 (5%) RTR developed NODAT and 50 (11%) died. High MDS was significantly associated with both a lower risk of NODAT (HR=0.23; 95% CI 0.09 to 0.64; p=0.004) and all-cause mortality (HR=0.51; 95% CI 0.29 to 0.89, p=0.02) compared to low MDS, independent of age and sex. Adjustment for other potential confounders, including total energy intake, physical activity and smoking status, did not materially change the results of the analyses.ConclusionsDietary habits leading to high MDS were associated with lower risk of NODAT. These results suggest that healthy dietary habits are of paramount importance for RTR.

Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

“…Dietary patterns can directly be translated into dietary recommendations to be used in clinical practice 7, 8. Previously, we found that a Mediterranean‐style diet is associated with a lower risk of new‐onset diabetes and all‐cause mortality after renal transplantation 9. In contrast to the Mediterranean diet, which is based on a diet traditionally consumed by the inhabitants of regions surrounding the Mediterranean sea, the Dietary Approaches to Stop Hypertension (DASH) diet features a high intake of fruits, vegetables, whole grains (complex carbohydrates), low‐fat dairy products, legumes and nuts, and a low intake of sodium, sweetened beverages, and red processed meat 10, 11…”

“…7,8 Previously, we found that a Mediterranean-style diet is associated with a lower risk of new-onset diabetes and all-cause mortality after renal transplantation. 9 In contrast to the Mediterranean diet, which is based on a diet traditionally consumed by the inhabitants of regions surrounding the Mediterranean sea, the Dietary Approaches to Stop Hypertension (DASH) diet features a high intake of fruits, vegetables, whole grains (complex carbohydrates), low-fat dairy products, legumes and nuts, and a low intake of sodium, sweetened beverages, and red processed meat. 10,11 Originally, the DASH diet was developed to reduce blood pressure, and considering that hypertension is associated with graft failure [12][13][14] and mortality in RTR, 15 the DASH diet might greatly benefit RTR.…”

Vitamin B12 status in kidney transplant recipients: association with dietary intake, body adiposity and immunosuppression

“…In the present study, including KTR with a minimum of 6 months of transplantation, B 12 deficiency prevalence (cut-off < 200 pg/ml) was 14 %. Some authors have evaluated the dietary intake in KTR (48)(49)(50) , but only one study evaluated the intake of B 12 (48) , that was considered adequate in 94 % of the patients. In the present study, we found that a lower percentage of the participants (64 %) presented adequate B 12 intake.…”

Renal sulfate reabsorption in healthy individuals and renal transplant recipients

“…Validation of the FFQ in RTR was assessed as previously reported (Oste et al. ). Dietary data were converted into daily nutrient intake using the Dutch Food Composition Table of 2006 (National Institute for Public Health and the Environment, .)…”

“…All FFQs were checked for completeness by a trained researcher, and inconsistent answers were verified with the patients. Validation of the FFQ in RTR was assessed as previously reported (Oste et al 2017). Dietary data were converted into daily nutrient intake using the Dutch Food Composition Table of 2006 (National Institute for Public Health and the Environment, 2013.)…”