Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T08:05:01.552Z Has data issue: false hasContentIssue false
  • English
  • Français

Adherence to a healthful plant-based diet and risk of chronic kidney disease among individuals with diabetes: A prospective cohort study

Published online by Cambridge University Press:  16 December 2024

A. S. Thompson ,
A. Tresserra-Rimbau ,
A. Jennings ,
N. P. Bondonno ,
C. J. Candussi ,
J. K. O’Neill ,
C. Hill ,
M. Gaggl ,
A. Cassidy  and
T. Kühn
A. S. Thompson
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
A. Tresserra-Rimbau
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK Department of Nutrition, Food Science and Gastronomy, XIA, School of Pharmacy and Food Sciences, INSA, University of Barcelona, 08921 Barcelona, Spain Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
A. Jennings
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
N. P. Bondonno
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK Danish Cancer Institute, Copenhagen, Denmark Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
C. J. Candussi
Affiliation:
University of Vienna, Department of Nutritional Sciences, Vienna, Austria Medical University of Vienna, Center for Public Health, Vienna, Austria
J. K. O’Neill
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
C. Hill
Affiliation:
Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
M. Gaggl
Affiliation:
Medical University of Vienna, Center for Public Health, Vienna, Austria
A. Cassidy
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK
T. Kühn
Affiliation:
The Institute for Global Food Security, School of Biological Sciences, Queen’s University Belfast, Northern Ireland, UK University of Vienna, Department of Nutritional Sciences, Vienna, Austria Medical University of Vienna, Center for Public Health, Vienna, Austria
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Chronic kidney disease (CKD) is highly prevalent among people with diabetes(1,2). While identifying modifiable risk factors to prevent a decline in kidney function among those living with diabetes is pivotal, there is limited evidence on dietary risk factors for CKD. In this study we examined the associations between healthy and less healthy plant-based diets (PBDs) and the risk of CKD among those with diabetes, and to identify potential underlying mechanisms.

We conducted a prospective analysis among 7,747 UK Biobank participants with prevalent diabetes (Type 1 and Type 2). Multivariable Cox proportional hazard regression models were used to examine the associations between healthful and unhealthful plant-based indices (hPDI and uPDI) and the risk of CKD. Fruits, legumes, nuts, tea and coffee, vegetables and whole grains were classified as healthy plant-based foods, whereas fruit juice, potatoes, refined grains, sugary drinks as well as sweets and desserts were classified as unhealthy plant-based foods. Animal-based foods used for the PDIs were grouped into meat, eggs, dairy products, animal fat, seafood or fish, and miscellaneous animal-based foods. Causal mediation analyses were further employed to explore the underlying mechanisms of the observed associations.

Among 7,747 study participants with diabetes, 1,030 developed incident CKD over 10.2 years of follow-up. The mean (SD) age was 58.8 (7.2) years, 6,910 (89.2%) were White, and 3,829 (49.4%) had a BMI over ≥30kg/m2. Higher adherence to a healthy PBD was associated with a 24% lower CKD risk (HRQ4 versus Q1: 0.76 [95%CI: 0.63−0.92], ptrend=0.002), while higher adherence to an unhealthy PBD was associated with a 35% higher risk (HRQ4 versus Q1: 1.35 [95%CI: 1.11-1.65], ptrend=0.006). The observed associations were predominantly mediated by markers of body fatness (proportion mediated: 11-25%) and kidney function (23-89%).

In this prospective cohort study of UK adults with diabetes, adherence to a healthy PBD was associated with lower CKD risk, whereas adherence to an unhealthy PBD was associated with a higher CKD risk. Associations were primarily mediated by markers of lower body fatness and improved kidney function.

Type
Abstract
Information
Proceedings of the Nutrition Society , Volume 83 , Issue OCE4: Nutrition Society Congress 2024, 2–5 July 2024 , November 2024 , E419
Check for updates
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

References

Bikbov, B, Purcell, CA, Levey, AS et al. (2020) Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 The lancet 395, 709–733.CrossRefGoogle Scholar
Couser, WG, Remuzzi, G, Mendis, S et al. (2011) The contribution of chronic kidney disease to the global burden of major noncommunicable diseases Kidney international 80, 1258–1270.CrossRefGoogle Scholar