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Higher consumption of ultra-processed foods is independently associated with a higher risk of developing chronic kidney disease in the general population.

“Ultra-processed foods are industrially processed foods and drinks that are virtually free of intact foods and artificial additives and substances. Recently, there has been an increase in the consumption of ultra-processed foods around the world, which is associated with adverse health effects.” Shutong Du, MHS, from the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins University in Maryland and colleagues wrote. “In this study, we sought to expand the evidence by examining the relationship between consumption of ultra-processed foods and the risk of CKD.”


Ultra-Processed Foods
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In a prospective cohort study, investigators examined 14,679 adults (mean age 54.1 years) without CKD at baseline (1987–1989) as part of the Atherosclerosis Risk in Community Study.

Participants responded to a modified 66-item Willett semi-quantitative meal frequency questionnaire at baseline and at the third visit. The researchers used the NOVA classification (1 for unprocessed or minimally processed foods, 2 for processed cooking ingredients, 3 for processed foods, and 4 for ultra-processed foods) to calculate the participants’ daily food intake.

The last follow-up was on December 31, 2018, until which time the investigators considered the primary outcomes to be CKD, hospitalization for CKD, death, or end-stage kidney disease.

Using Cox proportional hazards models adjusted for several variables, the researchers measured the correlation between consumption of ultra-processed foods and CKD. The researchers used constrained cubic splines to estimate the shape of the association.

Overall, the investigators identified a total of 4859 cases of CKD during a mean follow-up of 24 years. The analyzes showed that the incidence rate for the highest quartile of consumption of ultra-processed foods was 16.5 per 1000 person-years and 14.7 per 1000 person-years for the lowest consumption quartile.

Participants in the highest quartile of consumption of ultra-processed foods had a 24% higher risk of developing CKD after adjusting for confounding factors compared to those in the lowest quartile. The researchers noted that replacing one serving of highly processed foods with minimally processed foods reduced the risk of CKD by 6%. Ultimately, consumption of ultra-processed foods was independently correlated with risk of developing CKD.

“This association was independent of CKD risk factors, was not fully explained by potential mediated health conditions and dietary quality, and was consistent across study population subgroups across sex, race, BMI, diabetes status, and hypertension status,” Du and colleagues wrote. . “Given the rise of ultra-processed foods in the global food supply, our study provides additional support to avoid ultra-processed foods and replace ultra-processed foods with minimally processed or unprocessed foods.”

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