Journal
AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 110, Issue 3, Pages 713-721Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ajcn/nqz146
Keywords
AHEI; ARIC; DASH; dietary patterns; dietary scores; HEI; kidney disease; Mediterranean; renal disease
Categories
Funding
- NIH/National Heart, Lung, and Blood Institute [T32 HL007024]
- National Institute of Diabetes and Digestive and Kidney Diseases [K01 DK107782]
- National Heart, Lung, and Blood Institute [R21 HL143089]
- National Heart, Lung, and Blood Institute, NIH
- Department of Health and Human Services [HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, HHSN268201700005I]
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Background: Adherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined. Objective: We aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD. Methods: We conducted a prospective analysis in 12,155 participants aged 45-64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2) accompanied by >= 25% decline in estimated glomerular filtration rate, a kidney disease-related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017. Results: There were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk (P-trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1. Conclusion: Higher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.
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