Association Between Ultraprocessed Food Consumption and Risk of Incident CKD: A Prospective Cohort Study
Abstract
Rationale & Objective – Ultra-processed foods (UPF) 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 UPF. However, the impact of UPF 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 – UPF consumption (servings/d) calculated using dietary data collected via a food frequency questionnaire at visit 1 and visit 3. Outcome – Incident CKD defined as eGFR <60 mL/min/1.73 m2 accompanied by ≥25% eGFR decline, CKD-related hospitalization or death, or end-stage renal disease. Analytical Approach – Multivariable-adjusted Cox proportional hazards models were used to assess the association between UPF consumption and CKD. Restricted cubic splines were used to examine the shape of the association. Results – During a median follow-up of 24 years, there were 4,859 cases of incident CKD. The incidence rate for the highest quartile of UPF consumption was 16.5 per 1000 person-years (95% CI, 15.6–17.4) and 14.7 per 1000 person-years (95% CI, 13.9–15.5) 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 UPF consumption had a 24% higher risk (HR, 1.24; 95%…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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