'Southern' Diet Increases CKD Patient Death Risk

Study reveals an association between mortality and high intake of items found in Southern diet.
Study reveals an association between mortality and high intake of items found in Southern diet.

A diet rich in processed and fried foods is independently associated with increased mortality among patients with chronic kidney disease (CKD), according to a new study.

Orlando M. Gutiérrez, MD, of the University of Alabama in Birmingham, and colleagues examined the relationship between dietary patterns and all-cause mortality and end-stage renal disease (ESRD) in 3,972 participants with CKD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, a prospective cohort study of 30,239 black and white adults aged 45 years or older.

Based on information provided by participants who filled out food frequency questionnaires, the researchers arrived at five dietary patterns: the “convenience” diet (high intake of Chinese and Mexican foods, pizza, and other mixed dishes); “plant-based” (high intake of fruits and vegetables); “sweets/fats” (high intake of sugary foods); “Southern” (high intake of fried foods, organ meats, sugar-sweetened beverages, and greens commonly found in the Southern diet); and “alcohol/salads (high intake of alcohol, green leafy vegetables, and salad dressing). The researchers calculated dietary pattern scores based on the participants' intake of various foods.

After a mean 6.5 years of follow-up, 816 participants died and 141 progressed to ESRD. Results showed no significant associations between convenience, sweets/fats, or alcohol/salads pattern scores and all-cause mortality after adjusting for multiple variables, Dr. Gutiérrez's team reported online ahead of print in the American Journal of Kidney Diseases.

Participants in the highest quartile of Southern pattern score had a 51% increased risk of all-cause mortality compared with those in the lowest quartile after adjusting for confounding factors. In contrast, participants in the highest quartile of plant-based pattern scores had a 23% decreased risk of all-cause mortality compared with those in the lowest quartile.

In addition, after a mean 6.4 years of follow-up, 141 participants initiated dialysis. In a fully adjusted model, none of the dietary patterns were associated with the risk of ESRD.

“These data emphasize the vital role of nutrition in optimizing CKD outcomes and provide novel insights into dietary factors that may contribute to geographic and racial disparities in kidney disease risk in the United States,” the authors concluded.

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