Eating a healthy diet and drinking a moderate amount of alcohol may be associated with decreased risk or progression of chronic kidney disease in patients with type 2 diabetes mellitus, according to a study.
Type 2 diabetes and associated chronic kidney disease have become major public health problems, according to background information in the study, which was published Aug. 12 on the website of JAMA Internal Medicine. However, little is known about the long-term effect of diet on the incidence and progression of early-stage diabetic CKD.
Daniela Dunkler, PhD, of McMaster University in Ontario, Canada, and colleagues examined the association of a healthy diet, alcohol, protein and sodium intake with incidence or progression of CKD among patients with type 2 diabetes. All 6,213 patients with type 2 diabetes in a clinical trial were included in the observational study.
The results indicated 31.7% of patients developed CKD and 8.3% of patients died after 5.5 years of follow-up. Compared with patients in the least healthy scoring group on an index that assessed diet quality, patients in the healthiest group had a lower risk of CKD and lower risk of mortality. Patients who ate more than three servings of fruits per week had a lower risk of CKD compared with patients who ate fruit less frequently.
Patients in the lowest group of total and animal protein intake had an increased risk of CKD compared with patients in the highest group. Sodium intake was not associated with CKD, while moderate alcohol intake reduced the risk of CKD and mortality.
“A healthy diet and moderate intake of alcohol may decrease the incidence or progression of CKD among individuals with type 2 diabetes,” the authors concluded. “Sodium intake, within a wide range, and normal protein intake are not associated with CKD.”
In a related commentary, Holly Kramer, MD, MPH, of Loyola University Chicago in Maywood, Ill., and Alex Chang, MD, MS, of Johns Hopkins University in Baltimore, wrote: “Patients with both type 2 diabetes and kidney disease may be frustrated by the numerous dietary restrictions that are recommended by their healthcare team.
“Patients may even ask, ‘What can I eat? Perhaps the best dietary advice we can give to patients with type 2 diabetes and kidney disease is the same as the advice for those who want to avoid chronic kidney disease, and the same advice for preventing and treating hypertension, and the same dietary advice for everyone: Eat a diet rich in fruits and vegetables, low-fat dairy products and whole grains while minimizing saturated and total fat.”
Study abstract: http://archinte.jamanetwork.com/article.aspx?articleid=1726997.