Diet sodas and end-stage renal disease
End-stage renal disease refers to kidney disease that has advanced such that either dialysis or a transplant is required to keep living. Soft drinks appear to be linked to kidney disease. Researchers at Johns Hopkins University examined whether higher consumption of artificially- or sugar-sweetened soft drinks predicted increased risk of end-stage renal disease. Data came from 15,368 participants with an average of 54 years in the Atherosclerosis Risk in Communities study.
After a median 23 years of follow-up and after accounting for sociodemographic factors and existing medical problems, compared to participants who reported drinking one or fewer 8-ounce diet sodas per week, participants who drank seven or more 8-ounce diet sodas per week had a significant 83 percent higher risk of developing end-stage renal disease. Results were similar for men and women and across different racial groups. Interestingly, participants who reported drinking seven or more 8-ounce sugar-sweetened sodas per week seemed to have lower risk of end-stage renal disease but the difference was not significant after accounting for confounding factors. Switching from sugary sodas to artificially sweetened sodas may help you lower your caloric intake but may also predispose you to kidney disease.
Regular sodas and chronic kidney disease
Chronic kidney disease (CKD) reflects damage to the kidneys such that they do not adequately filter blood. High consumption of sweetened drinks may increase risk of CKD. Researchers in South Korea used data from 127,830 participants with an average age of 55 years in the UK Biobank to test this idea. After adjusting for confounding factors, participants who reported consuming more than one sugar-sweetened drink per day had a significant 19 percent high risk of developing CDK after a median follow up of 10 years. For artificially sweetened drinks, the comparable increase was 26 percent. Interestingly, participants who drank more than one daily serving of natural fruit juice did not have higher risk of CKD. Substituting one serving per day of either sugar-sweetened or artificially sweetened drinks per day with water significantly reduced the risk of CKD by 7 and 9 percent, respectively. Do the results of this study motivate you to cut back on sweetened beverage consumption? I hope so, because you don’t want to end up with kidney dialysis in your later years.
Chronic kidney disease
Chronic kidney disease (CKD) affects about 10 percent of the world’s humans and predisposes patients to increased risks of cardiovascular disease and premature death. Health providers typically advise CKD patients to manage the disease through controlling blood pressure and blood glucose and taking medications. This approach requires self-management of diet, exercise, and medications, among other factors. Successful self-management can slow the progression of CKD and prevent complications. Alas, most patients engage in suboptimal self-management.
Researchers at the University of Pennsylvania interviewed 30 CKD patients to understand what factors related to CKD supported and thwarted successful self-management. Patients identified numerous facilitators and barriers to CKD self-management. Examples of facilitators include a positive attitude, filling out the blood pressure chart every day, taking the family dog for daily walks, my friends at church inquiring about my health, and the doctors explaining clearly what I need to do and why. Barriers include thinking that diabetes is more important than kidney concerns, thinking that the home blood pressure machine doesn’t work properly, medical providers not explaining what to do and why, the gym being too far from my home, everything that’s good to eat has sodium in it, and my husband doesn’t like medical stuff lying around the house. Interventions can be designed to help kidney disease patients promote facilitators and diminish barriers.
Chronic kidney disease promotes biological aging
Two researchers in Singapore make the case that chronic kidney disease accelerates biological aging through declining physical activity and cognitive capabilities, increased risks of falls and fractures, poor quality of life, loss of appetite and inflammation. Frailty and dementia signify the later stages, which predict increased risks of disability and death. Chronic kidney disease, dementia, and frailty form an interconnecting triangle in which these conditions reinforce each other through common risk factors. Eventually, kidney filtration rate declines to the point that requires a kidney transplant or dialysis. Older people and those with diabetes are especially prone to moving down this pathway of ill health. If reading this paragraph alarms you, remember that you can avoid this path by incorporating healthy choices, especially Keep Moving, and Eat Better, into your daily life.
Eating more dietary fiber reduces risk of kidney disease
Increased intake of dietary fiber predicts reduced risk of cardiovascular disease, type 2 diabetes, and cancer. Researchers in South Korea and elsewhere wondered if ramping up fiber intake would also reduce the risk of kidney disease. Data came from 110,412 participants with an average of 55 years in the UK Biobank study. Fiber intake data came from up to five 24-hour dietary food recall questionnaires over a median follow-up of 10 years. Fiber intake (soluble, insoluble, and total) was calculated as the number of grams of fiber eaten daily per 1,000 calories of food energy.
Compared to participants in the lowest category of total daily fiber intake (less than 6.9 grams/1,000 calories), participants in the highest category (more than 10.4 grams/1,000 calories) had a significant 34 percent lower risk of developing kidney disease. For soluble fiber (as in rolled oats) and insoluble fiber (as in wheat bran) fiber, the risk of developing kidney disease declined by 38 and 13 percent, respectively. Each additional gram of total daily fiber intake predicted a significant 5 percent drop in kidney diseases risk. By way of comparison, the USDA’s recommended amount of daily total fiber intake, 14 grams per 1,000 calories of food energy, exceeds the average of the highest category of fiber intake. Thus, the highest category in this study isn’t that high. Nevertheless, the additional benefit of increased total fiber intake ceased above in intake of 10 grams per 1,000 calories per day. This study provides one more reason to increase your daily intake of fiber.
What to do
Adopt the healthy lifestyle choice of Eat Better and limit your consumption of sodas and ramp up your intake of fiber, meaning more fruits, vegetables, beans, lentils, and whole-grain cereals.
