Tags

Type your tag names separated by a space and hit enter

Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease.
Nutr Metab Cardiovasc Dis. 2016 07; 26(7):597-602.NM

Abstract

BACKGROUND AND AIMS

The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber.

METHODS AND RESULTS

Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70-71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) g/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events.

CONCLUSIONS

An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Xu H
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Rossi M
Centre for Kidney Disease Research, Princess Alexandra Hospital, Brisbane, Australia; Division of Diabetes and Nutritional Sciences, King's College, London, United Kingdom.
Campbell KL
Centre for Kidney Disease Research, Princess Alexandra Hospital, Brisbane, Australia; Bond University, Faculty of Health Sciences and Medicine, Robina, Australia.
Sencion GL
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Ärnlöv J
Department of Medical Sciences, Molecular epidemiology, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
Cederholm T
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
Sjögren P
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
Risérus U
Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
Lindholm B
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Carrero JJ
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Division of Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden. Electronic address: juan.jesus.carrero@ki.se.

MeSH

AgedBiomarkersC-Reactive ProteinCardiovascular DiseasesDiet RecordsDietary FiberDietary ProteinsFeeding BehaviorGeriatric AssessmentHumansIncidenceLongitudinal StudiesMaleNutrition AssessmentNutritional StatusProportional Hazards ModelsProspective StudiesProtective FactorsRecommended Dietary AllowancesRenal Insufficiency, ChronicRisk AssessmentRisk FactorsSwedenTime Factors

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27089977

Citation

Xu, H, et al. "Excess Protein Intake Relative to Fiber and Cardiovascular Events in Elderly Men With Chronic Kidney Disease." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 26, no. 7, 2016, pp. 597-602.
Xu H, Rossi M, Campbell KL, et al. Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease. Nutr Metab Cardiovasc Dis. 2016;26(7):597-602.
Xu, H., Rossi, M., Campbell, K. L., Sencion, G. L., Ärnlöv, J., Cederholm, T., Sjögren, P., Risérus, U., Lindholm, B., & Carrero, J. J. (2016). Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 26(7), 597-602. https://doi.org/10.1016/j.numecd.2016.02.016
Xu H, et al. Excess Protein Intake Relative to Fiber and Cardiovascular Events in Elderly Men With Chronic Kidney Disease. Nutr Metab Cardiovasc Dis. 2016;26(7):597-602. PubMed PMID: 27089977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease. AU - Xu,H, AU - Rossi,M, AU - Campbell,K L, AU - Sencion,G L, AU - Ärnlöv,J, AU - Cederholm,T, AU - Sjögren,P, AU - Risérus,U, AU - Lindholm,B, AU - Carrero,J J, Y1 - 2016/03/08/ PY - 2015/11/16/received PY - 2016/02/23/revised PY - 2016/02/29/accepted PY - 2016/4/20/entrez PY - 2016/4/20/pubmed PY - 2017/8/9/medline KW - CKD KW - CVD KW - Fiber intake KW - Protein intake KW - Protein–fiber intake ratio SP - 597 EP - 602 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 26 IS - 7 N2 - BACKGROUND AND AIMS: The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber. METHODS AND RESULTS: Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70-71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) g/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events. CONCLUSIONS: An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/27089977/Excess_protein_intake_relative_to_fiber_and_cardiovascular_events_in_elderly_men_with_chronic_kidney_disease_ DB - PRIME DP - Unbound Medicine ER -