Although there are established dietary guidelines for hypertension treatment and cardiovascular disease prevention, there are no such dietary guidelines for kidney disease prevention
Analysis of a long-term study of participants whose eating habits resembled a DASH Diet strongly indicates that maintaining a heart-healthy diet shows robust benefits to kidney health.
These findings, published online in the American Journal of Kidney Diseases (AJKD), come at a time when kidney disease is being increasingly recognised as a major public health problem, on the same level as heart disease, diabetes and breast cancer.
'Dietary guidelines exist for people with active kidney disease, but there are no diet recommendations for preventing kidney disease,' says Kevin Longino, CEO of National Kidney Foundation and a kidney patient. 'This new study suggests a novel approach in helping to prevent kidney disease,' he added. Two of the leading causes of kidney disease are high blood pressure and diabetes, which can often be traced to dietary factors.
The Dietary Approaches to Stop Hypertension (DASH) diet is commonly recommended for hypertension treatment and cardiovascular disease prevention. The DASH diet is high in fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, and low in red and processed meats, sugar-sweetened beverages and sodium. It is known to have health benefits for hypertension, cardiovascular disease, diabetes, stroke and overall mortality.
The research team, headed by Casey M. Rebholz, PhD, MS, MPH, of Johns Hopkins Bloomberg School of Public Health, analysed findings from the Atherosclerosis Risk in Communities (ARIC) Study, which was conducted from 1987 to 2013, and supported by the National Heart, Lung, and Blood Institute.
The 14,882 study participants were middle-aged (45–64) men and women, predominantly African-American and Caucasian, and enrolled from four US communities: Forsyth County, North Carolina; Jackson, Mississippi; suburbs of Minneapolis, Minnesota; and Washington County, Maryland. The subjects were not advised to follow a DASH diet, but analysed how closely their diet matched it during the normal course of their lives.
One in three American adults is at risk for kidney disease: 26 million American adults have kidney disease — and most aren't aware of it. Risk factors for kidney disease include diabetes, high blood pressure, family history and age. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3.5 times more likely, and Hispanics 1.5 times more likely, to experience kidney failure.
'I was surprised and encouraged by the robustness of the findings as relatively little is known about healthy dietary patterns for reducing the risk of kidney disease. If we are able to modify dietary intake, there is great potential for reducing the costly societal and individual burden of kidney disease in the US population,' said Dr Rebholz.
'The main message is the same for healthcare professionals and the general population: the DASH diet, which is widely recommended for reducing blood pressure and the risk of cardiovascular and other chronic conditions, may also protect against kidney disease for generally healthy individuals.'
Another significant finding was a relationship between higher intake of heart-healthy proteins, from nuts, legumes, and low-fat dairy products, with a reduced risk for kidney disease. The investigators also found that higher intake of red and processed meat was associated with a higher risk of kidney disease. Current guidelines for people with kidney disease recommend reduction of overall dietary protein, but they do not distinguish between types of protein.
