Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease

Hong Xu; Megan Rossi; Katrina L. Campbell; Gloria Lissete Sencion; Johan Ärnlöv; Tommy Cederholm; Per Sjögren; Ulf Risérus; Bengt Lindholm; Juan Jesús Carrero

doi:10.1016/j.numecd.2016.02.016

Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease

Hong Xu, Megan Rossi, Katrina L. Campbell, Gloria Lissete Sencion, Johan Ärnlöv, Tommy Cederholm, Per Sjögren, Ulf Risérus, Bengt Lindholm, Juan Jesús Carrero

Nutritional Sciences

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

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Abstract

AbstractBackground and Aims The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber. Methods and Results Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70–71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) grams/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1,000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events. Conclusions An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD.

Original language	English
Journal	NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
Early online date	8 Mar 2016
DOIs	https://doi.org/10.1016/j.numecd.2016.02.016
Publication status	E-pub ahead of print - 8 Mar 2016

Keywords

protein intake
fiber intake
protein-fiber intake ratio
CVD
CKD

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.numecd.2016.02.016

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Xu, H., Rossi, M., Campbell, K. L., Sencion, G. L., Ärnlöv, J., Cederholm, T., Sjögren, P., Risérus, U., Lindholm, B., & Carrero, J. J. (2016). Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES. Advance online publication. https://doi.org/10.1016/j.numecd.2016.02.016

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title = "Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease",

abstract = "AbstractBackground and Aims The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber. Methods and Results Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70–71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) grams/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1,000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events. Conclusions An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD.",

keywords = "protein intake, fiber intake, protein-fiber intake ratio, CVD, CKD",

author = "Hong Xu and Megan Rossi and Campbell, {Katrina L.} and Sencion, {Gloria Lissete} and Johan {\"A}rnl{\"o}v and Tommy Cederholm and Per Sj{\"o}gren and Ulf Ris{\'e}rus and Bengt Lindholm and Carrero, {Juan Jes{\'u}s}",

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doi = "10.1016/j.numecd.2016.02.016",

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T1 - Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease

AU - Xu, Hong

AU - Rossi, Megan

AU - Campbell, Katrina L.

AU - Sencion, Gloria Lissete

AU - Ärnlöv, Johan

AU - Cederholm, Tommy

AU - Sjögren, Per

AU - Risérus, Ulf

AU - Lindholm, Bengt

AU - Carrero, Juan Jesús

PY - 2016/3/8

Y1 - 2016/3/8

N2 - AbstractBackground and Aims The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber. Methods and Results Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70–71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) grams/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1,000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events. Conclusions An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD.

AB - AbstractBackground and Aims The elevated cardiovascular (CVD) risk observed in chronic kidney disease (CKD) may be partially alleviated through diet. While protein intake may link to CVD events in this patient population, dietary fiber has shown cardioprotective associations. Nutrients are not consumed in isolation; we hypothesize that CVD events in CKD may be associated with dietary patterns aligned with an excess of dietary protein relative to fiber. Methods and Results Prospective cohort study from the Uppsala Longitudinal Study of Adult Men. Included were 390 elderly men aged 70–71 years with CKD and without clinical history of CVD. Protein and fiber intake, as well as its ratio, were calculated from 7-day dietary records. Cardiovascular events were registered prospectively during a median follow-up of 9.1 (inter-quartile range, 4.5-10.7) years. The median dietary intake of protein and fiber was 66.7 (60.7-71.1) and 16.6 (14.5-19.1) grams/day respectively and the protein-to-fiber intake ratio was 4.0 (3.5-4.7). Protein-to-fiber intake ratio was directly associated with serum C-reactive protein levels. During follow-up, 164 first-time CVD events occurred (incidence rate 54.5/1,000 per year). Protein-fiber intake ratio was an independent risk factor for CVD events [adjusted hazard ratio, HR per standard deviation increase (95% confidence interval, CI) 1.33 (1.08, 1.64)]. Although in opposing directions, dietary protein [1.18 (0.97, 1.44)], dietary fiber alone [0.81 (0.64, 1.02)], were not significantly associated with CVD events. Conclusions An excess of dietary protein relative to fiber intake was associated with the incidence of cardiovascular events in a homogeneous population of older men with CKD.

KW - protein intake

KW - fiber intake

KW - protein-fiber intake ratio

KW - CVD

KW - CKD

U2 - 10.1016/j.numecd.2016.02.016

DO - 10.1016/j.numecd.2016.02.016

M3 - Article

SN - 0939-4753

JO - NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES

JF - NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES

ER -

Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease

Abstract

Keywords

UN SDGs

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