The role of diet and physical activity in post-transplant weight gain after renal transplantation

Background Long-term survival of renal transplant recipients (RTR) has not improved over the past 20yr. The question rises to what extent lifestyle factors play a role in post-transplant weight gain and its associated risks after transplantation. Methods Twenty-six RTR were measured for body weight, body composition, blood lipids, renal function, dietary intake, and physical activity at six wk, and three, six, and 12months after transplantation. Results Weight gain ranged between -2.4kg and 19.5kg and was largely due to increase in body fat. RTR who remained body fat stable, showed more daily physical activity (p=0.014), tended to consume less energy from drinks and dairy (p=0.054), consumed less mono- and disaccharides (sugars) (p=0.021) and ate more vegetables (p=0.043) compared with those who gained body fat. Gain in body fat was strongly related to total cholesterol (r=0.46, p=0.017) and triglyceride (r=0.511, p=0.011) at one yr after transplantation. Conclusions Gain in adiposity after renal transplantation is related to lifestyle factors such as high consumption of energy-rich drinks, high intake of mono- and disaccharides and low daily physical activity. RCTs are needed to investigate potential benefits of lifestyle intervention on long-term morbidity and mortality.