Chicken and Fish Diet Reduces Glomerular Hyperfiltration in IDDM Patients

Pecis, Miriam; Azevedo, Mirela Jobim de; Gross, Jorge Luiz

doi:10.2337/diacare.17.7.665

Cited by 57 publications

(22 citation statements)

References 29 publications

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“…In addition, several smaller studies of type 1 diabetic patients have indicated that dietary protein is not associated with the occurrence or progression of diabetic renal disease (37)(38)(39). Our findings are also in agreement with those of Pecis et al (15), who found that GFR was reduced in hyperfiltrating patients not only after a low-protein diet, but also after a switch from a red meat to a fish and chicken diet, still containing the usual amounts of protein. Thus, fish protein may decrease renal workload, thereby reducing the risk for future development of diabetic nephropathy.…”

Section: Multivariate Analysessupporting

confidence: 93%

“…None of the patients were restricted to a low-protein diet. Although it has been shown in several studies that different protein sources may have different effects on renal function (9,14,15), not many epidemiological reports have analyzed the risk of different eating habits on the presence of microalbuminuria in young type 1 diabetic patients. The European IDDM Diabetes Complications Study Group (35) found an association between dietary protein intake and urinary AER in 2,696 patients with type 1 diabetes.…”

Section: Multivariate Analysesmentioning

confidence: 99%

“…Dietary protein of animal origin is proposed to exert a heavier burden on renal hemodynamics than vegetable protein (9,14). In addition, a substitution of red meat with white meat (chicken and fish), in otherwise normal amounts of dietary protein, reduces GFR in hyperfiltrating patients (15).…”

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confidence: 99%

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Higher Intakes of Fish Protein Are Related to a Lower Risk of Microalbuminuria in Young Swedish Type 1 Diabetic Patients

et al. 2001

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OBJECTIVE -To examine the influence of dietary intake from various protein and fat sources on the occurrence of microalbuminuria in type 1 diabetic patients.RESEARCH DESIGN AND METHODS -In this nested case control study, 1,150 patients with diabetes duration Ͼ5 years reported dietary habits for the previous 12 months and submitted urinary samples for the analysis of albumin excretion rate (AER). A total of 75 cases of albuminuria (overnight AER Ն15 g/min) were identified and compared with 225 durationmatched control subjects.RESULTS -Neither mean protein, fat intake, average fish protein intake (control subjects 4.56 Ϯ 3.83 g/day and cases 3.82 Ϯ 2.87 g/day; P ϭ 0.12), nor intake of meat and vegetable protein differed between the cases of albuminuria and the control subjects. High consumers of fish protein (greater than the 75th percentile) (12 cases and 63 control subjects, mean intake 9.35 g fish protein/day, i.e., ϳ53 g fish/day) had lower odds ratios (ORs) for microalbuminuria than individuals consuming less fish protein (mean 2.72 g/day) (crude OR 0.49 and 95% CI 0.25-0.97). When adjusted for known confounding factors, such as HbA 1c , mean arterial pressure, diabetes duration, age, sex, smoking, BMI, country region, and total energy, individuals with a high intake of fish protein and fish fat showed a reduction in the risk for microalbuminuria (OR 0.22 and 0.31, respectively; 95% CI 0.09 -0.56 and 0.13-0.76, respectively). When fish protein and fat were adjusted for each other, a high intake of fish protein but not of fish fat was still significantly associated with a decrease in the risk for microalbuminuria.CONCLUSIONS -Total protein and fat intake were not associated with the presence of microalbuminuria, but a diet including a high amount of fish protein seemed to lessen the risk. Diabetes Care 24:805-810, 2001

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Section: Multivariate Analysessupporting

confidence: 93%

Section: Multivariate Analysesmentioning

confidence: 99%

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Higher Intakes of Fish Protein Are Related to a Lower Risk of Microalbuminuria in Young Swedish Type 1 Diabetic Patients

et al. 2001

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“…Another alternative is to use a qualitative test for proteinuria (dipstick) (33) or a quantitative measurement of protein in a (60,61), and dietary factors, such as the amount and source of protein (62)(63)(64) and fat (65) in the diet.…”

Section: Stages Clinical Features and Clinicalmentioning

confidence: 99%

Diabetic Nephropathy: Diagnosis, Prevention, and Treatment

et al. 2005

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Diabetic nephropathy is the leading cause of kidney disease in patients starting renal replacement therapy and affects ϳ40% of type 1 and type 2 diabetic patients. It increases the risk of death, mainly from cardiovascular causes, and is defined by increased urinary albumin excretion (UAE) in the absence of other renal diseases. Diabetic nephropathy is categorized into stages: microalbuminuria (UAE Ͼ20 g/min and Յ199 g/min) and macroalbuminuria (UAE Ն200 g/min). Hyperglycemia, increased blood pressure levels, and genetic predisposition are the main risk factors for the development of diabetic nephropathy. Elevated serum lipids, smoking habits, and the amount and origin of dietary protein also seem to play a role as risk factors. Screening for microalbuminuria should be performed yearly, starting 5 years after diagnosis in type 1 diabetes or earlier in the presence of puberty or poor metabolic control. In patients with type 2 diabetes, screening should be performed at diagnosis and yearly thereafter. Patients with micro-and macroalbuminuria should undergo an evaluation regarding the presence of comorbid associations, especially retinopathy and macrovascular disease. Achieving the best metabolic control (A1c Ͻ7%), treating hypertension (Ͻ130/80 mmHg or Ͻ125/75 mmHg if proteinuria Ͼ1.0 g/24 h and increased serum creatinine), using drugs with blockade effect on the reninangiotensin-aldosterone system, and treating dyslipidemia (LDL cholesterol Ͻ100 mg/dl) are effective strategies for preventing the development of microalbuminuria, in delaying the progression to more advanced stages of nephropathy and in reducing cardiovascular mortality in patients with type 1 and type 2 diabetes. Diabetes Care 28:176 -188, 2005DEFINITION AND EPIDEMIOLOGY -Diabetic nephropathy is the leading cause of chronic kidney disease in patients starting renal replacement therapy (1) and is associated with increased cardiovascular mortality (2). Diabetic nephropathy has been classically defined by the presence of proteinuria Ͼ0.5 g/24 h. This stage has been referred to as overt nephropathy, clinical nephropathy, proteinuria, or macroalbuminuria. In the early 1980s, seminal studies from Europe revealed that small amounts of albumin in the urine, not usually detected by conventional methods, were predictive of the later development of proteinuria in type 1 (3-5) and type 2 (6) diabetic patients. This stage of renal involvement was termed microalbuminuria or incipient nephropathy.The cumulative incidence of microalbuminuria in patients with type 1 diabetes was 12.6% over 7.3 years according to the European Diabetes (EURODIAB) Prospective Complications Study Group (7) and ϳ33% in an 18-year follow-up study in Denmark (8). In patients with type 2 diabetes, the incidence of microalbuminuria was 2.0% per year and the prevalence 10 years after diagnosis 25% in the U.K. Prospective Diabetes Study (UKPDS) (9). Proteinuria occurs in 15-40% of patients with type 1 diabetes, with a peak incidence around 15-20 years of diabetes (8,10,11). In patients with t...

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“…When predominantly plant protein replaced animal protein in three studies of type 1 diabetic subjects, the amount of protein consumed was also reduced significantly (653)(654)(655). Any beneficial effects may have been from reduction in the amount or change in the protein source.…”

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confidence: 99%

Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications

et al. 2002

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Chicken and Fish Diet Reduces Glomerular Hyperfiltration in IDDM Patients

Abstract: A normoproteic diet with chicken and fish as the only meat protein source decreases the GFR in the hyperfiltering normoalbuminuric IDDM patients. The GFR reduction after this diet is similar to that observed after an LPD.

Cited by 57 publications

References 29 publications

Higher Intakes of Fish Protein Are Related to a Lower Risk of Microalbuminuria in Young Swedish Type 1 Diabetic Patients

Higher Intakes of Fish Protein Are Related to a Lower Risk of Microalbuminuria in Young Swedish Type 1 Diabetic Patients

Diabetic Nephropathy: Diagnosis, Prevention, and Treatment

Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications

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