4.7 Article

Ultraprocessed food consumption and kidney function decline in a population-based cohort in the Netherlands

Journal

AMERICAN JOURNAL OF CLINICAL NUTRITION
Volume 116, Issue 1, Pages 263-273

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1093/ajcn/nqac073

Keywords

ultraprocessed foods; chronic kidney disease; kidney function decline; eGFR change; Lifelines

Funding

  1. Dutch Ministry of Health, Welfare and Sport
  2. Dutch Ministry of Economic Affairs
  3. University Medical Center Groningen
  4. Province in the North of the Netherlands
  5. Province in the North of the (Drenthe)
  6. European Union [754425]
  7. Province in the North of the Friesland
  8. Province in the North of the Groningen
  9. Marie Curie Actions (MSCA) [754425] Funding Source: Marie Curie Actions (MSCA)

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This study investigates the association between ultraprocessed food consumption and the risk of kidney function decline in the general population. The results show that higher intake of ultraprocessed food is associated with an increased risk of kidney disease and a more rapid decline in kidney function, independent of other dietary factors.
Background Ultraprocessing makes food products more convenient, appealing, and profitable. Recent studies show that high ultraprocessed food (UPF) intake is associated with cardiometabolic diseases. Objectives The aim of this study is to investigate the association between UPF consumption and risks of kidney function decline in the general population. Methods In a prospective, general population-based Lifelines cohort from Northern Netherlands, 78,346 participants free of chronic kidney disease (CKD) at baseline responded to a 110-item FFQ. We used a multivariable regression analysis to study the associations of the proportion (in grams/day) of UPFs in the total diet with a composite kidney outcome [incident CKD or a >= 30% estimated glomerular filtration rate (eGFR) decline relative to baseline] and annual change in eGFR. Results On average, 37.7% of total food intake came from UPFs. After 3.6 +/- 0.9 years of follow-up, 2470 participants (3.2%) reached the composite kidney outcome. Participants in the highest quartile of UPF consumption were associated with a higher risk of the composite kidney outcome (OR, 1.27; 95% CI, 1.09-1.47; P = 0.003) compared with those in the lowest quartile, regardless of their macro- or micronutrient intake or diet quality. Participants in the highest quartile had a more rapid eGFR decline (beta, -0.17; 95% CI, -0.23 to -0.11; P < 0.001) compared with those in the lowest quartile. Associations were generally consistent across different subgroups. Conclusions Higher UPF consumption was associated with a higher risk of a composite kidney outcome (incident CKD or >= 30% eGFR decline) and a more rapid eGFR decline in the general population, independent of confounders and other dietary indices.

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