Weekly nut consumption may promote kidney health for women with past gestational diabetes
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For women with a history of gestational diabetes, moderate nut consumption – defined here as “weekly” – appeared to have a beneficial effect on kidney function.
“In a recent prospective cohort study, women with prior gestational diabetes mellitus (GDM) compared with women without a history of GDM had an increased risk for subclinical renal dysfunction as indicated by an increased estimated glomerular filtration rate (eGFR) and elevated urinary albumin-to-creatinine ratio (UACR) 9 [to] 16 years after the index pregnancy,” Aparna S. Ajjarapu, BA, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development at NIH, and colleagues wrote. “Findings from this study along with others suggest that women with a history of GDM represent a population at an increased risk for impaired renal function. Therefore, identifying potentially modifiable factors to prevent renal dysfunction, such as dietary factors, is essential, particularly among women with a history of GDM.”
According to the researchers, while nut consumption has been shown to decrease risk for other chronic conditions (including type 2 diabetes, metabolic syndrome and cardiovascular disease), there have been few studies examining its impact on kidney function prior to a diagnosis of chronic kidney disease.
“As such,” they contended, “the limited research on the role of nuts in maintaining kidney health, particularly in populations at increased risk, presents an important data gap that needs to be addressed.”
To better understand the potential association between nut intake and kidney function, Ajjarapu and colleagues assessed 330 women with a history of gestational diabetes who had participated in the Diabetes & Women’s Health Study. That study consisted of a cohort of 91,827 women who had been pregnant in Denmark between 1996 and 2002.
For this study, the women participated in a follow-up clinical examination between 2012 and 2014, with the researchers determining height, weight, blood pressure, UACR and eGFR. All participants were free of chronic diseases.
Nut intake within the past year, determined using a food frequency questionnaire, was classified as none ( 1 serving per month), monthly (two to three servings per month), weekly (one to six servings per week) or daily ( 1 serving per day). One serving of nuts was defined as 28 g, with participants consuming an average of 0.2 servings (6.8 g) per day.
After adjusting for age, results showed that compared to women who consumed nuts weekly, UACR was significantly higher for women who consumed nuts rarely, monthly or daily. After adjusting for other confounders, including BMI, researchers found women who rarely consumed nuts had 86.2% greater adjusted UACR values than women who consumed nuts weekly. On the other hand, women who consumed nuts daily had 117.4% greater adjusted UACR values vs. those who consumed nuts weekly.
In addition, while daily nut consumers had 9.2% greater adjusted eGFR values than those who consumed nuts weekly, no differences were observed in eGFR between women who consumed nuts rarely or monthly.
Researchers noted women who consumed nuts daily were more likely to have a lower BMI and a higher education, as well as more frequent exercise. Women who consumed nuts more frequently also had higher overall energy intake and higher intake of vegetables, red meat, sugars-sweetened beverages and alcohol.
“Increasing consumption of nuts, up to weekly, was associated with progressively decreasing UACR values, which may suggest a possible protective role of nuts with respect to kidney health,” Ajjarapu and colleagues concluded. “The significantly greater UACR and eGFR values among daily nut consumers compared with weekly consumers may suggest an increased risk for adverse renal outcomes among this group, though clinical significance of higher eGFR values in this group is unclear as few participants had values indicative of glomerular hyperfiltration.”
Based on these results, researchers recommend further studies with larger sample sizes be conducted to confirm whether weekly nut intake can aid in preventing renal impairment in patients at high risk of kidney dysfunction.
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