Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain.
Clinical Nutrition and Dietetics Unit, Department of Endocrinology and Nutrition, 12 de Octubre Hospital, 28041 Madrid, Spain.
Nutrients. 2022 Jan 19;14(3):432. doi: 10.3390/nu14030432.
Chronic kidney disease entails a high disease burden that is progressively increasing due to population aging. However, evidence on the effect of the Mediterranean diet on renal function is limited, in particular among older adults in Mediterranean countries.
Prospective cohort study with 975 community-dwelling adults aged ≥ 60 recruited during 2008-2010 in Spain and followed up to 2015. At baseline, food consumption was obtained using a validated dietary history. Two Mediterranean dietary patterns were used: (i) An a priori-defined pattern, the Mediterranean Diet Adherence Screener (MEDAS score: low adherence: 0-5 points; moderate: 6-8 points; high: 9-14 points); (ii) An Mediterranean-like dietary pattern, based on 36 food groups, which was generated using factor analysis. Renal function decline was calculated as an estimated glomerular filtration rate (eGFR) decrease ≥1 mL/min/1.73 m per year of follow-up.
A total of 104 cases of renal function decline occurred. Compared with participants with a low MEDAS adherence, the multivariable-adjusted odds ratios (95% confident interval) for renal function decline risk were 0.63 (0.38-1.03) for moderate adherence, and 0.52 (0.29-0.95) for high adherence (-trend: 0.015). Multivariable-adjusted odds ratios (95% confidence interval) for renal function decline risk according to increasing quartiles of the adherence to the Mediterranean-like dietary pattern were 1.00, 0.67 (0.38-1.20), 0.65 (0.35-1.19), and 0.47 (0.23-0.96) (-trend: 0.042).
A higher adherence to a Mediterranean diet was associated with a lower risk of renal function decline in older adults, suggesting benefits to health of this dietary pattern in Mediterranean countries.
随着人口老龄化，慢性肾脏病的疾病负担逐渐加重。然而，关于地中海饮食对肾功能影响的证据有限，特别是在地中海国家的老年人中。
这是一项前瞻性队列研究，于 2008 年至 2010 年在西班牙招募了 975 名年龄≥60 岁的社区居民，并随访至 2015 年。在基线时，使用经过验证的饮食史获取食物消耗情况。使用了两种地中海饮食模式：（i）一种预先定义的模式，地中海饮食依从性筛查器（MEDAS 评分：低依从性：0-5 分；中等：6-8 分；高：9-14 分）；（ii）一种基于 36 种食物组的类似地中海的饮食模式，使用因子分析生成。肾功能下降的计算方法是估计肾小球滤过率（eGFR）每年下降≥1ml/min/1.73m。
共发生 104 例肾功能下降。与 MEDAS 低依从性的参与者相比，肾功能下降风险的多变量调整比值比（95%置信区间）分别为中等依从性 0.63（0.38-1.03）和高依从性 0.52（0.29-0.95）（趋势：0.015）。根据地中海类似饮食模式依从性递增四分位数，肾功能下降风险的多变量调整比值比（95%置信区间）分别为 1.00、0.67（0.38-1.20）、0.65（0.35-1.19）和 0.47（0.23-0.96）（趋势：0.042）。
较高的地中海饮食依从性与老年人肾功能下降风险降低相关，表明这种饮食模式在地中海国家对健康有益。
