A planetary health diet is associated with a lower risk of developing chronic kidney disease

1. Adherence to the EAT-Lancet planetary health diet is associated with a lower risk of developing chronic kidney disease (CKD), which is partly mediated by specific metabolic and proteomic pathways. 

Evidence Rating Level: 1 (Excellent) 

Chronic kidney disease (CKD) is widespread, affecting 10% of adults globally, with diet playing a key role in reducing the disease’s burden. The EAT-Lancet planetary health diet, constructed to promote health and sustainability, has been unexplored in terms of CKD effects. The diet has aspects shown to reduce CKD risk in previous studies, but its specific relationship has not been studied. This study aimed to explore the impact of the EAT-Lancet diet on the incidence of CKD, the associations of proteomic and metabolomic signatures with CKD risk and the potential mediating effects of the diet on CKD. The study was based on data from the UK Biobank, consisting of 500,000 participants aged 40 to 69 in Britain, of whom 179,508 were enrolled. During follow-up, 4819 (2.7%) developed CKD. In the models used for evaluating EAT-Lancet diet, higher adherence showed lower risk of CKD development (Yi-Xiang (adjusted HR 0.94, 95% CI 0.91 to 0.97), Knuppel (adjusted HR 0.94, 95% CI 0.92 to 0.97), Stubbendorff (adjusted HR 0.91, 95% CI 0.88 to 0.94), and Kesse-Guyot (adjusted HR 0.92, 95% CI 0.90 to 0.95)). Linear regression helped identify 146 metabolites with higher prevalence from the EAT-Lancet diet, further refined to 122 key metabolites with significant correlation (r = 0.2,p < 0.001). Similarly, 420 proteins were initially identified to be significantly associated with the diet, refining to 143 key associated proteins (0.3, p < 0.001). Both the metabolic and proteomic signature scores showed inverse linear relationships with CKD risk, with each standard deviation increase in signature lowering CKD risk by 11% (adjusted HR 0.89, 95% CI 0.85 to 0.93) and 20% (adjusted HR 0.80, 95% CI 0.73 to 0.89), respectively. Overall, the EAT-Lancet diet was shown to reduce CKD risk, emphasizing the importance of diet in CKD prevention and mitigation.

Click here to read the study in CMAJ

Image: PD

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