Rationale & Objective

Ultraprocessed foods have become readily available in the global food supply in the past few decades. Several adverse health outcomes have been linked with higher consumption of ultraprocessed foods. However, the impact of ultraprocessed foods on chronic kidney disease (CKD) risk remains unknown.

Study Design

Prospective cohort study.

Setting & Participants

14,679 middle-aged adults without CKD at baseline in the Atherosclerosis Risk in Communities (ARIC) study.

Exposure

Ultraprocessed foods consumption (servings per day) calculated using dietary data collected via a food frequency questionnaire at visit 1 and visit 3.

Outcome

Incident CKD defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² accompanied by ≥25% eGFR decline, CKD-related hospitalization or death, or kidney failure with kidney replacement therapy.

Analytical Approach

Multivariable-adjusted Cox proportional hazards models were used to assess the association between ultraprocessed foods consumption and CKD. Restricted cubic splines were used to examine the shape of the association.

Results

During a median follow-up period of 24 years, there were 4,859 cases of incident CKD. The incidence rate for the highest quartile of ultraprocessed foods consumption was 16.5 (95% CI, 15.6-17.4) per 1,000 person-years and 14.7 (95% CI, 13.9-15.5) per 1,000 person-years for the lowest quartile of consumption. After adjusting for a range of confounders including lifestyle factors, demographic characteristics, and health behaviors, participants in the highest quartile of ultraprocessed foods consumption had a 24% higher risk (HR, 1.24 [95% CI, 1.15-1.35]) of developing CKD compared with those in the lowest quartile. There was an approximately linear relationship observed between ultraprocessed food intake and risk of CKD. By substituting 1 serving of ultraprocessed foods with minimally processed foods, there was a 6% lower risk of CKD observed (HR, 0.94 [95% CI, 0.93-0.96]; P < 0.001).

Limitations

Self-reported data and residual confounding.

Conclusions

Higher ultraprocessed foods consumption was independently associated with a higher risk of incident CKD in a general population.

中文翻译：

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超加工食品消费与 CKD 事件风险之间的关联：一项前瞻性队列研究

理由和目标

在过去的几十年里，超加工食品在全球食品供应中变得随处可见。一些不良的健康结果与超加工食品的高消费量有关。然而，超加工食品对慢性肾脏病 (CKD) 风险的影响仍然未知。

学习规划

前瞻性队列研究。

设置和参与者

社区动脉粥样硬化风险 (ARIC) 研究中有 14,679 名基线时没有 CKD 的中年成年人。

接触

使用访问 1 和访问 3 时通过食物频率问卷收集的膳食数据计算超加工食品消费量（每天份量）。

结果

CKD 事件定义为估计的肾小球滤过率 (eGFR) < 60 mL/min/1.73 m ²伴有 ≥25% eGFR 下降、CKD 相关住院或死亡，或肾替代疗法导致的肾衰竭。

分析方法

多变量调整的 Cox 比例风险模型用于评估超加工食品消费与 CKD 之间的关联。受限三次样条用于检查关联的形状。

结果

在 24 年的中位随访期间，有 4,859 例 CKD 事件发生。消费超加工食品最高四分位数的发病率为每千人年 16.5（95% CI，15.6-17.4），消费最低四分位数的发病率为每千人年 14.7（95% CI，13.9-15.5）。在调整了一系列混杂因素（包括生活方式因素、人口特征和健康行为）后，食用超加工食品最高四分位数的参与者患 CKD 的风险高 24%（HR，1.24 [95% CI，1.15-1.35]）与最低四分位数的人相比。在超加工食品摄入量与 CKD 风险之间观察到近似线性关系。通过用最少加工食品代替 1 份超加工食品，观察到 CKD 风险降低 6%（HR，0.P  < 0.001）。

限制

自我报告的数据和残余混杂。

结论

在一般人群中，较高的超加工食品消费量与较高的 CKD 事件风险独立相关。