Prospective cohort study observes increased chronic kidney disease risk with high ultra-processed food intake in older adults, suggesting food processing negates plant-based benefits.
Key Points
To determine whether consumption of plant- and animal-sourced ultra-processed foods is associated with incident chronic kidney disease risk and long-term kidney function decline.
Analyzed 2,661 older adults (≥65 years) from the prospective Cardiovascular Health Study with dietary intake categorized using the Nova framework from food frequency questionnaires.
Tracked incident chronic kidney disease (eGFR <60 mL/min/1.73 m²) and absolute eGFR change over a median 6.8 years of follow-up (up to 18 years) using time-dependent Cox and linear models.
Participants in the highest tertiles of total and animal-sourced ultra-processed food intake had higher risks of incident chronic kidney disease compared to the lowest tertile (HR 1.26; 95% CI, 1.08–1.47; p-trend=0.003 and HR 1.37; 95% CI, 1.17–1.60; p-trend<0.001, respectively).
Per standard deviation increase in plant-sourced ultra-processed food was associated with increased chronic kidney disease risk (HR 1.07; 95% CI, 1.01–1.13), while highest intake of minimally processed foods was protective (HR 0.80; 95% CI, 0.69–0.95; p-trend=0.008).
Replacing three daily servings of minimally processed food with ultra-processed food was weakly associated with elevated kidney disease risk, whereas no significant associations were observed for absolute eGFR change.