Adherence to a healthful plant-based diet and risk of mortality among individuals with chronic kidney disease: A prospective cohort study
Author Identifier
Nicola P. Bondonno: https://orcid.org/0000-0001-5905-444X
Document Type
Journal Article
Publication Title
Clinical Nutrition
Volume
43
Issue
10
First Page
2448
Last Page
2457
PubMed ID
39305755
Publisher
Elsevier
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
RAS ID
75806
Funders
Scottish Government / Department for the Economy / Co-Centre for Sustainable Food Systems / Medical Research Council / Welsh Assembly Government / Department for Employment and Learning, Northern Ireland / British Heart Foundation , and Diabetes United Kingdom , Northwest Regional Development Agency / Wellcome Trust / Arkansas Department of Health / Pennsylvania Department of Health / British Heart Foundation, and Diabetes United Kingdom, Northwest Regional Development Agency
Abstract
Background: Plant-rich dietary patterns may protect against negative health outcomes among individuals with chronic kidney disease (CKD), although aspects of plant-based diet quality have not been studied. This study aimed to examine associations between healthful and unhealthful plant-based dietary patterns with risk of all-cause mortality among CKD patients for the first time. Methods: This prospective analysis included 4807 UK Biobank participants with CKD at baseline. We examined associations of adherence to both the healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI), calculated from repeated 24-h dietary assessments, with risk of all-cause mortality using multivariable Cox proportional hazard regression models. Results: Over a 10-year follow-up, 675 deaths were recorded. Participants with the highest hPDI scores showed a 34% lower risk of mortality [HRQ4vsQ1 (95% CI): 0.66 (0.52–0.83), ptrend <0.001]. Those with the highest uPDI scores had a 52% [1.52 (1.20–1.93), ptrend = 0.002] higher risk of mortality compared to participants with the lowest respective scores. In food group-specific analyses, higher wholegrain intakes were associated with a 29% lower mortality risk, while intakes of refined grains, and sugar-sweetened beverages were associated a 30% and 34% higher risk, respectively. Conclusions: In CKD patients, a higher intake of healthy plant-based foods was associated with a lower risk of mortality, while a higher intake of less healthy plant-based foods was associated with a higher risk of mortality. These results underscore the importance of plant food quality and support the potential role of healthy plant food consumption in the treatment and management of CKD to mitigate unfavourable outcomes.
DOI
10.1016/j.clnu.2024.09.021
Access Rights
subscriptin content
Comments
Thompson, A. S., Gaggl, M., Bondonno, N. P., Jennings, A., O’Neill, J. K., Hill, C., Karavasiloglou, N., Rohrmann, S., Cassidy, A., & Kühn, T. (2024). Adherence to a healthful plant-based diet and risk of mortality among individuals with chronic kidney disease: A prospective cohort study. Clinical Nutrition, 43(10), 2448-2457. https://doi.org/10.1016/j.clnu.2024.09.021