Low Mediterranean Diet scores are associated with reduced kidney function and health related quality of life but not other markers of cardiovascular risk in adults with diabetes and chronic kidney disease.

Affiliation

Picard K(1), Senior PA(2), Adame Perez S(1), Jindal K(3), Richard C(1), Mager DR(4).
Author information:
(1)Department of Agricultural, Food & Nutritional Sciences, Li Ka Shing Centre for Health Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada.
(2)Department of Medicine, Division of Endocrinology, 9-114F Clinical Sciences Building, University of Alberta, Edmonton, Alberta T6E 2E1, Canada.
(3)Department of Medicine, Division of Nephrology, 11-107 Clinical Sciences Building, University of Alberta, Edmonton, Alberta T6E 2E1, Canada.
(4)Department of Agricultural, Food & Nutritional Sciences, Li Ka Shing Centre for Health Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada. Electronic address: [Email]

Abstract

BACKGROUND AND AIMS: How Mediterranean-style diets impact cardiovascular and health outcomes in patients with diabetes and chronic kidney disease (CKD) is not well known. Our aim was to investigate the association between diet quality, using Mediterranean Diet Scores (MDS) and health outcomes. METHODS AND RESULTS: This is a post-hoc analysis of an RCT and longitudinal study investigating patients with diabetes and CKD. MDS was calculated annually. Scores were analyzed for correlation with lipids, HbA1c, serum potassium, health-related quality of life (HRQOL) and depression. 178 diet records from 50 patients who attended two or more visits were included. Mean MDS was moderate (4.1 ± 1.6) and stable over time. Stage 1-2 vs 3-5 CKD had lower raw MDS (3.8 ± 1.5 vs 4.6 ± 1.5, p < 0.001). Having hyperkalemia was associated with a lower raw MDS scores (3.6 ± 1.6 vs 4.2 ± 1.5, p = 0.03) but not energy adjusted MDS. MDS was not associated with HbA1c or lipids. High vs low MDS was associated with improved HRQOL (mental health 84.4 ± 14.3 vs 80.3 ± 17.1, p < 0.05; general health 62.6 ± 21.0 vs 56.3 ± 19.8, p < 0.001) and fewer depressive symptoms (9.1 ± 7.4 vs 11.7 ± 10.6, p = 0.01). CONCLUSIONS: Low MDS was associated with reduced kidney function and health related quality of life, but not other markers of cardiovascular risk. Further studies are needed to understand the nature and direction of the association between diet quality and disease outcomes in this population.