A Proinflammatory Diet Is Associated with Systemic Inflammation and Reduced Kidney Function in Elderly Adults. Issue 4 (28th January 2015)

• Record Type: Journal Article
• Authors: Xu, Hong; Sjögren, Per; Ärnlöv, Johan; Banerjee, Tanushree; Cederholm, Tommy; Risérus, Ulf; Lindholm, Bengt; Lind, Lars; Carrero, Juan Jesús
• Is Part Of: Journal of nutrition. Volume 145:Issue 4(2015)
• Page Start: 729
• Page End: 735
• Publication Date: 2015-01-28
• Subjects: diet -- ADII -- inflammation -- CRP -- kidney function -- eGFR; Nutrition -- Periodicals; Diet -- Periodicals; 613.205
• DOI: 10.3945/jn.114.205187
• Languages: English
• ISSNs: 0022-3166

Abstract

Abstract: Background: Diet can affect kidney health through its effects on inflammation. Objective: We tested whether the Adapted Dietary Inflammatory Index (ADII) is associated with kidney function and whether effects of diet on chronic low-grade inflammation explain this association. Methods: This was an observational analysis in 1942 elderly community-dwelling participants aged 70–71 y from 2 independent cohorts: the Uppsala Longitudinal Study of Adult Men ( n = 1097 men) and the Prospective Investigation of Vasculature in Uppsala Seniors ( n = 845 men and women). The ADII was calculated from 7-d food records, combining putatively proinflammatory and anti-inflammatory effects of nutrients, vitamins, and trace elements. The ADII was validated against serum C-reactive protein (CRP) concentrations. The estimated glomerular filtration rate (eGFR) was assessed from serum cystatin C (cys) and creatinine (crea). Associations between the ADII and eGFR were investigated, and CRP was considered to be a mediator. Results: In adjusted analysis, a 1-SD higher ADII was associated with higher CRP (β: 6%; 95% CI: 1%, 10%; P = 0.01) and lower eGFR [Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)cys : −2.1%; 95% CI: −3.2%, −1.1%; CKD-EPIcys+crea : −1.8%; 95% CI: −2.7%, −0.9%; both P < 0.001]. CRP was also inversely associated with eGFR. Mediation analyses showed that of the total effect of the ADII on kidney function, 15% and 17% (for CKD-EPIcys+crea and CKD-EPIcys equations, respectively) were explained/mediated by serum CRP. Findings were similar when each cohort was analyzed separately. Conclusions: A proinflammatory diet was associated with systemic inflammation as well as with reduced kidney function in a combined analysis of 2 community-based cohorts of elderly individuals. Our results also suggest systemic inflammation to be one potential pathway through which this dietary pattern is linked to kidney function.