Mediterranean diets are associated with a lower incidence of metabolic syndrome one year following renal transplantation

Nafar, Mohsen; Noori, Nazanin; Jalali-Farahani, Sara; Hosseinpanah, Farhad; Poorrezagholi, Fatemeh; Ahmadpoor, Pedram; Samadian, Fariba; Faraz, Ahmad; Einollahi, Behzad

doi:10.1038/ki.2009.343

Cited by 35 publications

(27 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In line with our results on NODAT another study showed an association between adherence to a Mediterranean Style diet and a lower incidence of metabolic syndrome after transplantation 32. Prospective cohort studies among patients with cardiovascular disease showed that a Mediterranean Style diet was associated with a lower risk of all-cause mortality 33–35.…”

Section: Discussionsupporting

confidence: 87%

Mediterranean style diet is associated with low risk of new-onset diabetes after renal transplantation

Osté

Corpeleijn

Navis

et al. 2017

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectiveThe incidence of new-onset diabetes after transplantation (NODAT) and premature mortality is high in renal transplant recipients (RTR). We hypothesized that a Mediterranean Style diet protects against NODAT and premature mortality in RTR.Research design and methodsA prospective cohort study of adult RTR with a functioning graft for >1 year. Dietary intake was assessed with a 177-item validated food frequency questionnaire. Patients were divided based on a 9-point Mediterranean Style Diet Score (MDS): low MDS (0–4 points) versus high MDS (5–9 points). A total of 468 RTR were eligible for analyses. Logistic multivariable regression analyses were used to study the association of MDS with NODAT and Cox multivariable regression models for the association with all-cause mortality.ResultsMean±SD age was 51.3±13.2 years and 56.6% were men. About 50% of the patients had a high MDS. During median follow-up of 4.0 (IQR, 0.4–5.4) years, 22 (5%) RTR developed NODAT and 50 (11%) died. High MDS was significantly associated with both a lower risk of NODAT (HR=0.23; 95% CI 0.09 to 0.64; p=0.004) and all-cause mortality (HR=0.51; 95% CI 0.29 to 0.89, p=0.02) compared to low MDS, independent of age and sex. Adjustment for other potential confounders, including total energy intake, physical activity and smoking status, did not materially change the results of the analyses.ConclusionsDietary habits leading to high MDS were associated with lower risk of NODAT. These results suggest that healthy dietary habits are of paramount importance for RTR.

show abstract

Section: Discussionsupporting

confidence: 87%

Mediterranean style diet is associated with low risk of new-onset diabetes after renal transplantation

Osté

Corpeleijn

Navis

et al. 2017

BMJ Open Diab Res Care

View full text Add to dashboard Cite

show abstract

“…However, there were no differences in all-cause mortality between the DASH versus control diets [ 76 ]. The Mediterranean diet has also been associated with lower risk of metabolic syndrome after kidney transplantation [ 77 ]. With respect to kidney disease outcomes, a 15-year observational study demonstrated that adherence to the Mediterranean diet was associated with lower risk of rapid decline in eGFR [ 78 ].…”

Section: Comparison Of Prescribed Dietsmentioning

confidence: 99%

Dietary Approaches in the Management of Diabetic Patients with Kidney Disease

Kalantar-Zadeh

Goldstein-Fuchs

et al. 2017

Nutrients

View full text Add to dashboard Cite

Chronic kidney disease (CKD) is one of the most prevalent complications of diabetes, and patients with diabetic kidney disease (DKD) have a substantially higher risk of cardiovascular disease and death compared to their non-diabetic CKD counterparts. In addition to pharmacologic management strategies, nutritional and dietary interventions in DKD are an essential aspect of management with the potential for ameliorating kidney function decline and preventing the development of other end-organ complications. Among DKD patients with non-dialysis dependent CKD, expert panels recommend lower dietary protein intake of 0.8 g/kg of body weight/day, while higher dietary protein intake (>1.2 g/kg of body weight/day) is advised among diabetic end-stage renal disease patients receiving maintenance dialysis to counteract protein catabolism, dialysate amino acid and protein losses, and protein-energy wasting. Carbohydrates from sugars should be limited to less than 10% of energy intake, and it is also suggested that higher polyunsaturated and monounsaturated fat consumption in lieu of saturated fatty acids, trans-fat, and cholesterol are associated with more favorable outcomes. While guidelines recommend dietary sodium restriction to less than 1.5–2.3 g/day, excessively low sodium intake may be associated with hyponatremia as well as impaired glucose metabolism and insulin sensitivity. As patients with advanced DKD progressing to end-stage renal disease may be prone to the “burnt-out diabetes” phenomenon (i.e., spontaneous resolution of hypoglycemia and frequent hypoglycemic episodes), further studies in this population are particularly needed to determine the safety and efficacy of dietary restrictions in this population.

show abstract

“…Another recent study using food frequency questionnaires in 160 kidney transplant recipients indicated that a Mediterranean dietary pattern is associated with a reduced risk of metabolic syndrome in these patients (56). The long‐term outcomes of such a diet were not examined in this study and the relevance of these findings to MHD patients is questionable.…”

Section: Consequences Of Qualitative Deficiencies In Nutritional Intakementioning

confidence: 99%

Epidemiology of Dietary Nutrient Intake in ESRD

Kövesdy

Shinaberger

Kalantar-Zadeh

2010

Seminars in Dialysis

View full text Add to dashboard Cite

Protein-energy wasting (PEW) is one of the strongest risk factors of adverse outcomes in patients with chronic kidney disease (CKD) including those with end stage renal disease (ESRD) who undergo maintenance dialysis treatment. One important determinant of PEW in this patient population is an inadequate amount of protein and energy intake. Compounding the problem are the many qualitative nutritional deficiencies that arise because of the altered dietary habits of dialysis patients. Many of these alterations are iatrogenically induced, and albeit well intentioned, they could induce unintended harmful effects. In order to determine the best possible diet in ESRD patients, one must first understand the complex interplay between the quantity and quality of nutrient intake in these patients, and their impact on relevant clinical outcomes. We review available studies examining the association of nutritional intake with clinical outcomes in ESRD, stressing the complicated and often difficult-to-study interrelationship between quantitative and qualitative aspects of nutrient intake in nutritional epidemiology. The currently recommended higher protein intake of 1.2 g/kg/day may be associated with a higher phosphorus and potassium burden and with worsening hyperphosphatemia and hyperkalemia, whereas dietary control of phosphorus and potassium by restricting protein intake may increase the risk of PEW. We assess the relevance of associative studies by examining the biologic plausibility of underlying mechanisms of action and emphasize areas in need of further research.Patients with end stage renal disease (ESRD) on dialysis experience exceptionally high mortality rates, mainly from causes related to cardiovascular disease (CVD) and infections.(1) Multiple novel risk factors have been invoked to explain the large excess mortality seen in ESRD patients, but measures of nutritional status have invariably emerged as some of the strongest predicators of adverse outcomes in this patient population.(2-9)In order to alleviate the nomenclatural confusion arising from this complexity an expert panel has recently recommended the use of the term protein-energy wasting (PEW) to incorporate all the different aspects of malnutrition and other metabolic or nutritional derangements such as inflammation in patients with CKD.(10) Based on this definition a diagnosis of PEW can be made by using the following criteria: (1) biochemical measures (serum albumin, prealbumin, transferrin and cholesterol); (2) measures of body mass (body mass index [BMI], unintentional weight loss and total body fat), (3) measures of muscle mass (total muscle mass, mid-arm muscle circumference and creatinine appearance); (4) measures of dietary intake (dietary protein and energy intake) and (5) integrative nutritional scoring systems (subjective global assessment of nutrition and malnutrition-inflammation score).The impact of PEW on outcomes is considered to be complex, and in spite of the strong associations with mortality it remains unclear if some or all ...

show abstract

Mediterranean diets are associated with a lower incidence of metabolic syndrome one year following renal transplantation

Cited by 35 publications

References 38 publications

Mediterranean style diet is associated with low risk of new-onset diabetes after renal transplantation

Mediterranean style diet is associated with low risk of new-onset diabetes after renal transplantation

Dietary Approaches in the Management of Diabetic Patients with Kidney Disease

Epidemiology of Dietary Nutrient Intake in ESRD

Contact Info

Product

Resources

About