Ultra-processed foods and risk of all-cause mortality in renal transplant recipients
Osté MCJ, Duan MJ, Gomes-Neto AW, Vinke PC, Carrero JJ, Avesani C, Cai Q, Dekker LH, Navis GJ, Bakker SJL, Corpeleijn E
The American journal of clinical nutrition · 34 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Food frequency questionnaire
Who paid for it
- Funding
- Independent funding
- Government
- European Commission
- Industry group
- Dutch Top Institute Food and Nutrition
- Government
- European Union
- Grants
- European Commission (A-1003); European Commission (HORIZON2020); European Commission (754425)
Based on 3 listed funder(s).
Publication
- Published
- 2022-02-26 · Am J Clin Nutr · vol. 115 · issue 6 · pp. 1646–1657
- Publisher
- Elsevier BV
- Cited
- 43 citations · more than 98% of similar papers · 7.4× the field average
- Impact
- Top 10% most cited in its field
- References
- 57 works
- Access
- Open access (hybrid journal) · CC-BY-NC
- Research areas
- Consumer Attitudes and Food Labeling · Dietary Effects on Health · Nutritional Studies and Diet
- Keywords
- Medicine, Cohort, Confounding, Food group, Proportional hazards model, Renal transplant, Food consumption, Internal medicine, Prospective cohort study, Transplantation, Environmental health
- MeSH
- kidney, humans, kidney transplantation, diet, prospective studies, energy intake, food handling, adult, aged, middle aged, female, male, fast foods
11 authors
From NL, SE
- Maryse C.J. Osté · correspondingUniversity Medical Center Groningen; University of Groningen
- Ming-Jie DuanUniversity Medical Center Groningen; University of Groningen
- Antonio W. Gomes NetoUniversity Medical Center Groningen; University of Groningen
- Petra Corianne VinkeUniversity Medical Center Groningen; University of Groningen
- Juan Jesús CarreroUniversity Medical Center Groningen; University of Groningen; Karolinska Institutet
- Carla María AvesaniUniversity Medical Center Groningen; University of Groningen; Karolinska Institutet
Abstract
Background
Renal transplant recipients (RTRs) have a 6-fold higher risk of mortality than age- and sex-matched controls. Whether high consumption of ultra-processed foods is associated with survival in RTRs is unknown.
Objectives
We aimed to study the association between high consumption of ultra-processed foods and all-cause mortality in stable RTRs.
Methods
We conducted a prospective cohort study in adult RTRs with a stable graft. Dietary intake was assessed using a validated 177-item FFQ. Food items were categorized according to the NOVA classification system and the proportion ultra-processed foods comprised of total food weight per day was calculated.
Results
We included 632 stable RTRs (mean ± SD age: 53.0 ± 12.7 y, 57% men). Mean ± SD consumption of ultra-processed foods was 721 ± 341 g/d (28% of total weight of food intake), whereas the intake of unprocessed and minimally processed foods, processed culinary ingredients, and processed foods accounted for 57%, 1%, and 14%, respectively. During median follow-up of 5.4 y [IQR: 4.9-6.0 y], 129 (20%) RTRs died. In Cox regression analyses, ultra-processed foods were associated with all-cause mortality (HR per doubling of percentage of total weight: 2.13; 95% CI: 1.46, 3.10; P < 0.001), independently of potential confounders. This association was independent from the quality of the overall dietary pattern, expressed by the Mediterranean Diet Score (MDS) or Dietary Approaches to Stop Hypertension (DASH) score. When analyzing ultra-processed foods by groups, only sugar-sweetened beverages (HR: 1.21; 95% CI: 1.05, 1.39; P = 0.007), desserts (HR: 1.24; 95% CI: 1.02, 1.49; P = 0.03), and processed meats (HR: 1.87; 95% CI: 1.22, 2.86; P = 0.004) were associated with all-cause mortality.
Conclusions
Consumption of ultra-processed foods, in particular sugar-sweetened beverages, desserts, and processed meats, is associated with a higher risk of all-cause mortality after renal transplantation, independently of low adherence to high-quality dietary patterns, such as the Mediterranean diet and the DASH diet.This trial was registered at clinicaltrials.gov as NCT02811835.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC).
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