Article The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

Background and objectives Various dietary strategies have been investigated to slow kidney function decline. However, it is unknownwhether aMediterranean diet, which has been associatedwith improved cardiovascular risk, is associated with change in kidney function. Design, setting, participants, & measurements This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcomewas incident eGFR,60 ml/min per 1.73 m2using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline ($2.5 ml/min per 1.73 m2 per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors. ResultsMean baseline age was 64 years, with 59%women and 65%Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m2. Incident eGFR,60 ml/min per 1.73 m2 developed in 14 %. In adjusted models, every 1-point increase in theMeDi score, indicating increasing adherence to aMediterranean diet, was associated with decreased odds of incident eGFR,60 ml/min per 1.73 m2 (odds ratio, 0.83; 95 % confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95 % confidence interval, 0.79 to 0.98). ConclusionsAMediterranean diet was associatedwith a reduced incidence of eGFR,60ml/min per 1.73m2 and upper quartile of eGFR decline in a multiethnic cohort