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

Abstract

Background Ultra-processing makes food products more convenient, appealing, and profitable. Recent studies show that high ultra-processed food (UPF) intake is associated with the cardio-metabolic disease. Objectives The aim of this study is to investigate the association between UPF consumption and risk 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 food frequency questionnaire. We used multivariable regression analysis to study the association of the proportion (in gram/day) of UPF in the total diet with a composite kidney outcome (incident CKD or a ≥ 30% eGFR decline relative to baseline) and annual change in estimated glomerular filtration rate (eGFR). Results On average, 37.7% of total food intake came from UPF. After 3.6 ± 0.9 years of follow-up, 2 470 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 macro/micronutrient intake or diet quality. Participants in the highest quartile had a more rapid eGFR decline (β –0.17, [95% CI: –0.23, –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.

Metabolomic Markers of Ultra-Processed Food and Incident CKD

“…33,34 The positive association that we observed between N2, N2-dimethylguanosine and ultra-processed foods and between N2, N2-dimethylguanosine and CKD risk was consistent with our hypothesis given our previous study demonstrating that higher ultra-processed food was associated with higher risk of incident CKD. 4 N2, N2dimethylguanosine is a product of transfer ribonucleic acid (tRNA) degradation, and its serum level reflects the rate of tRNA turnover and renal clearance. The circulating level of tRNA degradation products is a marker of oxidative stress.…”

“…Higher ultra-processed food consumption was associated with adverse kidney outcomes in the Atherosclerosis Risk in Communities (ARIC) study conducted in middle-aged adults in the United States, 2 older adults in Spain, 3 and in a northern Netherlands population. 4 The mechanism underlying the association between ultra-processed foods and CKD is not fully understood.…”

Food consumption based on processing level (according to Nova system) during the COVID-19 pandemic among adolescents with immunocompromised conditions: a case-control study

“…During the COVID-19 pandemic, adolescents reported an increase in screen time and changes in eating habits ( 3 , 5 ), such as eating more frequently in front of the TV and snacking, habits that were associated with increased consumption of UPR foods during the pandemic in the general population ( 33 ). This can be worrisome for adolescents with chronic conditions, since increases in UPR food consumption have been associated with a worse prognosis of the underlying disease and increased risk of kidney function decline in the general population ( 34 ), and increased risk of cardiovascular ( 35 ) and inflammatory bowel disease ( 36 ) in adults with clinical conditions. In the current study, however, adolescents with chronic conditions showed an improved dietary pattern compared to healthy peers.…”

Physical activity and nutrition in chronic kidney disease

“…Another general population-based cohort from Netherlands of 78 346 participants free of chronic kidney disease at baseline showed that on average, 37.7% of total food intake came from ultraprocessed foods. Higher ultraprocessed food consumption was associated with a higher risk of a composite kidney outcome (incident chronic kidney disease or ≥30% eGFR decline) and a more rapid eGFR decline, independent of confounders and other dietary indices [61].…”