膳食中添加树坚果和花生对肾移植受者的潜在健康益处——深入的叙述性综述及对未来研究的思考

Potential Health Benefits of Dietary Tree Nut and Peanut Enrichment in Kidney Transplant Recipients-An In-Depth Narrative Review and Considerations for Future Research.

作者信息

Kremer Daan, Vogelpohl Fabian A, van der Veen Yvonne, Doorenbos Caecilia S E, Yepes-Calderón Manuela, Knobbe Tim J, Post Adrian, Corpeleijn Eva, Navis Gerjan, Berger Stefan P, Bakker Stephan J L

机构信息

Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Post Box 30.001, 9700 RB Groningen, The Netherlands.

Division of Nursing Science, Department of Health Sciences, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.

出版信息

Nutrients. 2025 Jul 24;17(15):2419. doi: 10.3390/nu17152419.

Abstract

Kidney transplant recipients face a substantial burden of premature mortality and morbidity, primarily due to persistent inflammation, cardiovascular risk, and nutritional deficiencies. Traditional nutritional interventions in this population have either focused on supplementing individual nutrients-often with limited efficacy-or required comprehensive dietary overhauls that compromise patient adherence. In this narrative review, we explore the rationale for dietary nut enrichment as a feasible, multi-nutrient strategy tailored to the needs of kidney transplant recipients. Nuts, including peanuts and tree nuts with no added salt, sugar, or oil, are rich in beneficial fats, proteins, vitamins, minerals, and bioactive compounds. We summarize the multiple post-transplant challenges-including obesity, sarcopenia, dyslipidemia, hypertension, immunological dysfunction, and chronic inflammation-and discuss how nut consumption may mitigate these issues through mechanisms involving improved micro-nutrient intake (e.g., magnesium, potassium, selenium), lipid profile modulation, endothelial function, immune support, and gut microbiota health. Additionally, we highlight the scarcity of randomized controlled trials in high-risk populations such as kidney transplant recipients and make the case for studying this group as a model for investigating the clinical efficacy of nuts as a nutritional intervention. We also consider practical aspects for future clinical trials, including the choice of study population, intervention design, duration, nut type, dosage, and primary outcome measures such as systemic inflammation. Finally, potential risks such as nut allergies and oxalate or mycotoxin exposure are addressed. Altogether, this review proposes dietary nut enrichment as a promising, simple, and sustainable multi-nutrient approach to support cardiometabolic and immune health in kidney transplant recipients, warranting formal investigation in clinical trials.

摘要

肾移植受者面临着过早死亡和发病的沉重负担,主要原因是持续的炎症、心血管风险和营养缺乏。该人群传统的营养干预措施要么侧重于补充单一营养素——通常效果有限——要么需要全面的饮食调整,但这会影响患者的依从性。在这篇叙述性综述中,我们探讨了饮食中添加坚果作为一种针对肾移植受者需求的可行的多营养素策略的基本原理。坚果,包括未添加盐、糖或油的花生和树坚果,富含有益脂肪、蛋白质、维生素、矿物质和生物活性化合物。我们总结了肾移植后的多种挑战,包括肥胖、肌肉减少症、血脂异常、高血压、免疫功能障碍和慢性炎症,并讨论了食用坚果如何通过改善微量营养素摄入(如镁、钾、硒)、调节血脂、改善内皮功能、提供免疫支持和促进肠道微生物群健康等机制来缓解这些问题。此外,我们强调在肾移植受者等高风险人群中随机对照试验的稀缺性,并主张将该群体作为研究坚果作为营养干预措施临床疗效的模型进行研究。我们还考虑了未来临床试验的实际问题,包括研究人群的选择、干预设计、持续时间、坚果类型、剂量以及全身炎症等主要结局指标。最后,我们讨论了坚果过敏以及草酸盐或霉菌毒素暴露等潜在风险。总之,本综述提出饮食中添加坚果是一种有前景、简单且可持续的多营养素方法,可支持肾移植受者的心脏代谢和免疫健康,值得在临床试验中进行正式研究。

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