Higher ultra-processed food consumption correlates with higher risk for incident CKD


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A higher consumption of ultra-processed foods is independently associated with a higher risk for incident chronic kidney disease among the general population.

“Ultra-processed foods are industrially processed foods and drinks that contain little to no intact foods and artificial additives and substances. The consumption of ultra-processed foods has been increasing around the world recently and has been linked with adverse health outcomes,” Shutong Du, MHS, from Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins University in Maryland, and colleagues wrote. “In this study, we aim to expand the evidence by investigating the relationship between ultra-processed food consumption and risk of CKD.”

Ultra-processed foods

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In a prospective cohort study, researchers examined 14,679 adults (mean age, 54.1 years) without CKD at baseline (1987-1989) in the Atherosclerosis Risk in Communities study.

Participants answered a 66-item modified semiquantitative Willett food frequency questionnaire at baseline and visit three. Researchers used NOVA classification (1 — unprocessed or minimally processed foods, 2 — processed culinary ingredients, 3 — processed foods and 4 — ultra-processed foods) to calculate daily food consumption among participants.

The final follow-up occurred on Dec. 31, 2018, until which point researchers considered incident CKD, CKD-related hospitalization, death or end-stage kidney disease as the primary outcomes.

Using multivariable-adjusted Cox proportional hazards models, researchers measured the correlation between ultra-processed food consumption and CKD. Researchers used restricted cubic splines to evaluate the shape of association.

Overall, researchers identified a total of 4,859 cases of incident CKD during a median follow-up of 24 years. Analyses revealed the incidence rate for the highest quartile of ultra-processed food consumption was 16.5 per 1,000 person-years and 14.7 per 1,000 person-years for the lowest quartile of consumption.

Participants in the highest quartile of ultra-processed foods consumption had a 24% higher risk of developing CKD after adjusting for confounders compared with those in the lowest quartile. Researchers did note that substituting one serving of ultra-processed foods with minimally processed foods reduced the risk for CKD by 6%. Ultimately, ultra-processed food intake independently correlated with risk for CKD.

“This association was independent of CKD risk factors, was not entirely explained by potential mediating health conditions and diet quality, and was consistent across subgroups of the study population by 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 further support to avoid ultra-processed foods and to replace ultra-processed foods with minimally processed or unprocessed foods.”