Carbohydrate ^, fiber vs chronic kidney disease?

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The below paper is pdf-availed. The prospective part of the paper was the only part I held to be more reliable, and glycemic index seemed not to matter, while chronic kidney disease risk of sugar intake seemed to be a no-no, although not significantly so.

Carbohydrate Nutrition Is Associated with the 5-Year Incidence of Chronic Kidney Disease.

Gopinath B, DC, Flood VM, Burlutsky G, Brand- J, P.

J Nutr. 2011 Jan 12. [Epub ahead of print]

PMID: 21228263

Abstract

It has been shown that dietary glycemic index (GI) and fiber could have a role in the development of chronic diseases; however, the link between carbohydrate nutrition and development of chronic kidney disease (CKD) is unclear.

We aimed to determine whether cross-sectional and longitudinal associations exist between carbohydrate nutrition (mean dietary GI, dietary intakes of carbohydrate, sugar, starch, and fiber) and CKD.

Data included 2600 Blue Mountains Eye Study (1997-1999) participants aged ≥50 y.

Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mLâ‹…min(-1)â‹…1.73 m(-2). Dietary data were collected in a semiquantitative FFQ.

Cross-sectionally, participants in the 4th quartile of mean dietary GI intake compared with those in the first quartile (reference) had a 55% increased likelihood of having eGFR < 60 mLâ‹…min(-1)â‹…1.73 m(-2) [multivariable-adjusted OR = 1.55 (95% CI = 1.07-2.26); P-trend = 0.01]. After multivariable adjustment, participants in the 4th quartile of dietary cereal fiber intake compared with those in the first quartile (reference) had a 50% reduced risk of incident moderate CKD (P-trend = 0.03). Higher baseline consumption of energy-dense, nutrient-poor sources of carbohydrate (e.g. cookies) yielded a 3-fold higher risk of incident CKD (P-trend = 0.01).

In summary, we observed a novel link between high cereal fiber intake and reduced incidence of moderate CKD and this was supported by the cross-sectional association with dietary GI. Conversely, our data suggest that higher intake of energy-dense, nutrient-poor sources of carbohydrate, potentially through acute hyperglycemia, could impair renal function.

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TABLE 4. Associations between mean dietary GI, sugar and cereal fiber intake and 5-y incidence of moderate CKD (eGFR , 60 mL×min21×1.73 m22) in participants in the BMES.----------------------------------------------------------Variable Mean (SD)^1 Cases/at risk, n/n OR (95% CI)^2 OR (95% CI)^3----------------------------------------------------------Dietary GI----------------------------------------------------------1st quartile 51.2 (2.2) 16/258 1.0 (reference) 1.0 (reference)2nd quartile 55.0 (0.8) 16/219 1.17 (0.56–2.42) 1.05 (0.50–2.19)3rd quartile 57.5 (0.7) 19/219 1.40 (0.69–2.84) 1.32 (0.64–2.72)4th quartile 61.6 (2.6) 16/234 1.09 (0.52–2.29) 0.84 (0.39–1.83)P-trend 0.72 0.81----------------------------------------------------------Sugar intake, g/d----------------------------------------------------------1st quartile 86.2 (16.3) 10/210 1.0 (reference) 1.0

(reference)2nd quartile 114 (5.8) 15/231 1.39 (0.60–3.21) 1.36 (0.58–3.17)3rd quartile 134 (6.3) 20/248 1.71 (0.77–3.81) 1.71 (0.76–3.85)4th quartile 169 (23.1) 22/241 1.96 (0.90–4.31) 2.07 (0.93–4.59)P-trend 0.08 0.06----------------------------------------------------------Cereal fiber intake, g/d----------------------------------------------------------1st quartile 2.9 (1.2) 23/223 1.0 (reference) 1.0 (reference)2nd quartile 5.5 (0.6) 18/210 0.78 (0.40–1.51) 0.79 (0.40–1.56)3rd quartile 7.8 (0.9) 12/247 0.39 (0.19–0.81) 0.43 (0.20–0.91)4th quartile 13.3 (4.6) 14/250 0.43 (0.21–0.88) 0.50 (0.24–1.03)P-trend 0.01 0.03---------------------------------------------------------- 1 The means for all variables were energy adjusted. 2 Adjusted for age and sex. 3 Additional adjustment for serum total homocysteine, hemoglobin, and

hematocrit.

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