DASH important again!!

[Guest guest]

Lifestyle decisions made before age 30 appear to determine a person's risk

of developing chronic kidney disease many years down the road, researchers

here suggested.

Individuals who neglected to eat a quality diet -- defined as the National

Heart, Lung and Blood Institute's DASH (Dietary Approaches to Stop

Hypertension) diet -- had a 63% increased risk of chronic kidney disease 20

years later than did participants in the study who ate a diet rich in fruits

and vegetables and low in fat (*P*<0.05).

" Unhealthy lifestyle behaviors such as eating a poor-quality diet, smoking,

and being obese may increase the risk of early kidney disease, " said

Chang, MD, a fellow in nephrology at the Loyola University Medical

Center in Maywood, Ill., at his poster presentation at the National Kidney

Foundation Spring Clinical Meetings.

In the study, Chang and colleagues reviewed the health records of 5,112

participants in the Coronary Artery Risk Development in Young Adults

(CARDIA) study.

The researchers identified 97 participants who developed microalbuminuria

during the 20-year follow-up.

The development of hypertension by year 15 resulted in a fourfold risk of

kidney disease by year 20 (*P*<0.001); the development of diabetes by year

15 resulted in a nine-fold risk of kidney disease by year 20 (*P*<0.001).

Because the development of diabetes and hypertension likely occurred due to

obesity, by year 20, obesity was not a statistically significant cause of

kidney disease in the multivariate analysis, Chang told *MedPage Today*.

Smoking, while associated with an increased risk, also did not reach

statistical significance for kidney disease in the multivariate analysis.

" For the kidney doctor community, by the time we are seeing patients it is

already too late, " he said. " They already have diabetes or hypertension or

both, and a lot of them happen to be very obese. "

Chang said the cohort was somewhat unique: the subjects were recruited when

they were 18 to 30 years of age and before they had diabetes, high blood

pressure, or other diseases.

The researchers stratified the group on the basis of a diet score based on

the DASH diet. " What we found is that the risk of kidney disease among

people who eat what doesn't look at all like a DASH diet is about twice the

risk as someone who eats a diet that resembles a DASH diet. Smoking gives

you a 50% increase in risk; if you look at obesity, you have a nearly

threefold increase in risk, " Chang said.

" If you look at the number of lifestyle factors – smoking, little activity,

poor diet, and obesity, the risk of kidney disease increases with every

unhealthy lifestyle habit you have. "

He demonstrated that one risk factor doubles the risk of kidney

disease (*P*<0.05),

two risk factors triple the risk (*P*<0.01), and three to four risk factors

increase the likelihood more than fourfold (*P*<0.01).

" The thing about lifestyle factors is that they can affect other disease

processes that affect kidney disease, " said J. Choi, associate

professor of nephrology at s Hopkins School of Medicine, and scientific

program chairman for the meeting.

" In the DASH diet, we really try to have a push on fruits, vegetables. There

is some thought that there is potassium in fruits and vegetables. There is

citrate which is a base that may help fight acid loads. We can see how diet

can be very helpful, " he told *MedPage Today.*

" Obesity is bad for everything -- heart disease, hypertension, metabolic

syndrome, cholesterol, " he said in commenting on the study. " All those

things could exacerbate any predisposition you have for kidney disease --

and probably is an additive factor as well. "

" Although these factors have been shown to increase cardiovascular and other

disease risks, this study is the first to show that [they] also increase the

risk of kidney disease, " Chang said.

" To me this is really important because when I am seeing patients in clinic,

usually the number one question I am asked is 'Doctor, what can I do to

improve my health without taking medications?' " he said.

" Everything your mom told you that [is] good for you [is] probably good for

you. That's kind of the gist of it, " Chang said. " If you want to make

changes to impact kidney disease, it should be done early in life. "

LINK

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--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

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