Associations between dietary patterns and nephrolithiasis risk in a large Chinese cohort: is a balanced or plant-based diet better?

Abstract

Purpose: Individual food items and nutrients are associated with the development of nephrolithiasis. Few studies have investigated the association between dietary patterns, particularly plant-based diets, and this disease. We aim to explore the associations between dietary patterns and incident nephrolithiasis risk. Materials and methods: This prospective cohort study included 26 490 participants. Factor analysis was applied to dietary information to identify three a posteriori dietary patterns, and six a priori plant-based dietary patterns (overall plant-based diet index [PDI], healthful plant-based diet index [hPDI], unhealthful plant-based diet index [uPDI], vegan diet, lacto-ovo-vegetarian diet, and fish-vegetarian diet) were defined. Nephrolithiasis was diagnosed using ultrasonography. Cox proportional hazard regression models were used to assess the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident nephrolithiasis related to dietary patterns. Results: After 101 094 person-years follow-up, we documented 806 incident nephrolithiasis cases. An a posteriori balanced dietary pattern characterized by a higher intake of vegetables, eggs, grains, legumes, legume products, and meat was associated with a lower risk of nephrolithiasis (P for trend = 0.02). Compared to the reference group in the lowest quartile of the balanced pattern, participants in the highest quartile had an adjusted HR (95% CI) of 0.72 (0.53-0.96) for incident nephrolithiasis. Adherence to the uPDI increased the risk of incident nephrolithiasis (P for trend < 0.01; adjusted HR4th quartile vs. 1st quartile, 1.46, 95% CI, 1.14-1.97). No significant association was found between other a posteriori or a priori dietary patterns and incident nephrolithiasis. Conclusions: Adherence to a balanced dietary pattern, but not a plant-based diet, was associated with a lower nephrolithiasis risk. Moreover, higher uPDI consumption increased incident nephrolithiasis risk.

• Authors: Song Bai, Yixiao Zhang, Chuanji Guo, Yashu Liu, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Tingjing Zhang, Yang Ding, Yuhong Zhao, Kaijun Niu, Yang Xia
• Journal: Food & function (Food Funct) Vol. 14 Issue 7 Pg. 3220-3229 (Apr 03 2023) ISSN: 2042-650X [Electronic] England
• PMID: 36920109 (Publication Type: Journal Article)

Topics

• Humans
• Diet
• Diet, Vegetarian
• East Asian People
• Kidney Calculi
• Prospective Studies