Study: High ultra-processed food diets linked with CKD progression, mortality
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Key takeaways:
- Median ultra-processed food intake was 5.6 servings per day.
- Researchers found 1,047 CKD progression events during a median follow-up period of 7 years.
Eating more ultra-processed foods may be associated with chronic kidney disease progression and higher risk for all-cause mortality in adults with CKD, data show.
“Ultra-processed foods use ingredients and processes that are not commonly used in culinary preparations and contain few, if any, intact unprocessed foods,” the authors wrote in the study. “We investigated associations between ultra-processed food intake and CKD progression, all-cause mortality and incident [cardiovascular disease].”
In the prospective cohort study, researchers enrolled 2,616 patients with a reduced eGFR of 20 mL/min/1.73 m2 to 70 mL/min/1.73 m2 2003 to 2008 in seven U.S. clinical centers. Researchers tracked participants’ progress using dietary questionnaires and conducted clinic visits and phone calls every 6 months. Scientists categorized ultra-processed food intake by servings per day using the NOVA system, which categorizes foods by their level of processing, and adjusted for patient demographic, lifestyle and health variables. Primary outcomes were CKD progression of at least 50% or initiation of kidney replacement therapy, all-cause mortality and incident cardiovascular disease.
The median ultra-processed food intake was 5.6 servings per day, according to the study. Results showed an association between high ultra-processed food diet and increased risk of CKD progression. Researchers observed 1,047 CKD progression events during a median follow-up period of 7 years. Participants in the highest tertile faced a 22% higher risk vs. those in the lowest tertile. In addition, 1,104 deaths occurred during a median follow-up of 14 years, the findings show. The impact of the association varied based on baseline kidney function. While greater intake was connected to a higher risk among individuals with CKD stages 1 and 2 (eGFR 60 mL/min/1.73 m2), no link was found in stages 3a through 5.
“We hypothesize that the lack of association in people with more advanced disease could be explained by reverse causation or lower protein contents of highly processed diets,” Valerie K. Sullivan, PhD, RDN, of the department of epidemiology at Johns Hopkins University School of Medicine in Baltimore, told Healio. “Diet may be more influential at earlier stages of kidney disease than for those with more advanced kidney disease.”
Dietary guidance in CKD has traditionally “focused on nutrient restrictions,” Sullivan said. “Our findings contribute to a growing body of literature supporting a more holistic approach to dietary guidance that focuses more broadly on patterns of foods consumed.”
Despite limitations such as self-reported diets, the study showed “greater ultra-processed food consumption was associated with a higher risk of CKD progression,” the researchers wrote. “Patients with kidney disease may benefit from greater consumption of fresh, whole and homemade or hand-prepared foods and fewer highly processed foods.”
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