Consumption of whole grains, fruit and vegetables is not associated with indices of renal function in the population-based longitudinal Doetinchem study.

Gerrie-Cor M Herber-Gast,Marijke Boersma,Stephan J L Bakker,Ron T Gansevoort,W M Monique Verschuren,Annemieke M W Spijkerman,Coen D A Stehouwer

doi:10.1017/s0007114517001726

Abstract

Emerging evidence suggests that diet and renal function are related. Little is known, however, about the association of consumption of whole grains, fruit and vegetables with urinary albumin:creatinine ratio (ACR) and changes in estimated glomerular filtration rate (eGFR). We investigated this in a population-based cohort aged 26-65 years. Data were from 3787 participants from the Doetinchem cohort study, who were examined ≥3 times, 5 years apart. Consumption of food groups was assessed at each round with a validated FFQ. GFR was estimated at each round from routinely measured cystatin C and creatinine using the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation. ACR was measured at the last round. Generalised estimated equation models were performed to examine associations with changes in eGFR. Linear regression was used to examine associations with ACR. Adjustments were made for covariates related to lifestyle, biological factors and diet. Mean baseline eGFR was 104·5 (sd 13·7) and mean annual decline was -0·95 (sd 0·67) ml/min per 1·73 m2 over a 15-year follow-up. A trend was observed towards slightly less annual decline in eGFR among those with higher consumption of whole grains (P=0·06). This association, however, was attenuated and no longer significant in multivariate models (P=0·29). Consumption of fruit and vegetables was not associated with changes in eGFR and urinary ACR. In conclusion, consumption of whole grains, fruit and vegetables is not associated with changes in eGFR and mean ACR. As this was the first longitudinal study into this association in the general population, and as results are only partially in line with related studies, further research is recommended.

Highlights

Chronic kidney disease (CKD) is increasingly recognised as a major global public health problem[1]
We recently found that coffee consumption was associated with a slightly higher estimated glomerular filtration rate[3]
A link between consumption of whole grains, fruit and vegetables, for instance, and renal function may be plausible too, as these food groups have earlier been associated with type 2 diabetes and CVD, which are related to renal dysfunction[5,6,7,8,9]

Summary

Introduction

Chronic kidney disease (CKD) is increasingly recognised as a major global public health problem[1]. Cross-sectional findings from the Multi-Ethnic Study of Atherosclerosis (MESA) showed that higher consumption of whole grains and fruit was associated with lower albumin:creatinine ratio (ACR; greater ACR may be a marker of renal damage)(10). These associations may partly be attributable to major components of these food groups, such as fibre, Mg, antioxidants and several B vitamins[11,12,13,14]. The Framingham Heart Study (FHS), found no associations between consumption of whole grains, fruit and vegetables and microalbuminuria (moderate increase of albumin excretion in the urine, which is a predictor of poor renal outcomes), incident low eGFR or risk of rapid eGFR decline (loss of >3 ml/min per 1·73 m2/year)(16). We will examine whether possible associations are mediated through increased fibre, Mg, antioxidant and/or B vitamins intake

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Results

Conclusion