Skip to main content
SpringerLink
Log in

Impact of dietary habits on renal function in Saku, a rural Japanese town: a cohort study

  • Original article
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

High protein intake leads to a decline in renal function in the advanced stages of chronic kidney disease (CKD). An effective diet for maintaining renal function in healthy individuals or patients in the early stages of CKD has not been established. This cohort study was conducted in Saku, Nagano Prefecture, Japan, to investigate the impact of dietary habits on renal function.

Methods

In this cross-sectional cohort study, we used the Saku Control Obesity Program (UMIN000016892), including 4,446 participants who submitted a brief-type self-administered diet history questionnaire and underwent routine physical examination. The amount of food intake was divided into quartiles. After adjusting for age and sex, multivariate logistic regression analysis was used to calculate the odds ratio (OR) for the risk of developing CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2).

Results

In total, 3,899 participants were analyzed. The overall prevalence of patients with eGFR < 60 mL/min/1.73 m2 was 11% (n = 434, male; 7.1%, female; 4.1%). The groups with a high intake of chicken (approximately 63.4 g/day, adjusted OR: 0.632, P = 0.003), natto (fermented bean; approximately 21.7 g/day, adjusted OR: 0.679, P = 0.01), and plant protein (approximately 0.8 g/ideal body weight/day, adjusted OR: 0.695, P = 0.042) showed a low risk of developing CKD compared to the group with the lowest intake.

Conclusions

Our cross-sectional study showed that the intake of chicken meat, natto, and plant protein was associated with high eGFR levels. This information can be of value for preventing CKD incidence in healthy Japanese individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Data availability

The data are available from the corresponding author upon reasonable request.

References

  1. Chan AY, Cheng ML, Keil LC, Myers BD. Functional response of healthy and diseased glomeruli to a large, protein-rich meal. J Clin Invest. 1988;81:245–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Addis T. Glomerular nephritis: diagnosis and treatment. NY: MacMillan; 1948.

    Google Scholar 

  3. Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med. 1982;307:652–9.

    Article  CAS  PubMed  Google Scholar 

  4. Eckardt KU, Kasiske BL. Foreword. Kidney Int. 2009;76113:S1–2.

    Article  PubMed  Google Scholar 

  5. Rughooputh MS, Zeng R, Yao Y. Protein diet restriction slows chronic kidney disease progression in non-diabetic and in type 1 diabetic patients, but not in type 2 diabetic patients: a meta-analysis of randomized controlled trials using glomerular filtration rate as a surrogate. PLoS ONE. 2015;10: e0145505.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Watanabe S, Tsugane S, Sobue T, Konishi M, Baba S. Study design and organization of the JPHC study. J Epidemiol. 2001;11(6sup):3–7. https://doi.org/10.2188/jea.11.6sup_3.

    Article  Google Scholar 

  7. Sasaki S, Yanagibori R, Amano K. Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol. 1998;8:203–15.

    Article  CAS  PubMed  Google Scholar 

  8. Scheer FA, Hilton MF, Mantzoros CS, Shea SA. Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci USA. 2009;106:4453–8.

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  9. Imai S, Fukui M, Kajiyama S. Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes. J Clin Biochem Nutr. 2014;54:7–11.

    Article  CAS  PubMed  Google Scholar 

  10. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018;378: e34.

    Article  CAS  PubMed  Google Scholar 

  11. Yamori Y, Miura A, Taira K. Implications from and for food cultures for cardiovascular diseases: Japanese food, particularly Okinawan diets. Asia Pac J Clin Nutr. 2001;10:144–5.

    Article  CAS  PubMed  Google Scholar 

  12. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses. Nutrients. 2019;11:338.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Matsuo S, Imai E, Horio M, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.

    Article  CAS  PubMed  Google Scholar 

  14. Kobayashi S, Murakami K, Sasaki S, et al. Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults. Public Health Nutr. 2011;14:1200–11.

    Article  PubMed  Google Scholar 

  15. Kobayashi S, Honda S, Murakami K, et al. Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. J Epidemiol. 2012;22:151–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Murakami K, Sasaki S, Takahashi Y, et al. Reproducibility and relative validity of dietary glycaemic index and load assessed with a self-administered diet-history questionnaire in Japanese adults. Br J Nutr. 2008;99:639–48.

    Article  CAS  PubMed  Google Scholar 

  17. Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr. 1997;65(4):1220S-1228S. https://doi.org/10.1093/ajcn/65.4.1220S.

    Article  CAS  PubMed  Google Scholar 

  18. Motokawa M, Fukuda M, Muramatsu W, et al. Regional differences in end-stage renal disease and amount of protein intake in Japan. J Ren Nutr. 2007;17:118–25.

    Article  PubMed  Google Scholar 

  19. Haring B, Selvin E, Liang M, et al. Dietary protein sources and risk for incident chronic kidney disease: results from the Atherosclerosis Risk in Communities (ARIC) study. J Ren Nutr. 2017;27:233–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Lew QJ, Jafar TH, Koh HW, et al. Red meat intake and risk of ESRD. J Am Soc Nephrol. 2017;28:304–12.

    Article  PubMed  Google Scholar 

  21. Willett WC, Sacks F, Trichopoulou A, et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61(Supplement):1402S-S1406.

    Article  CAS  PubMed  Google Scholar 

  22. Santin F, Canella D, Borges C, Lindholm B, Avesani C. Dietary patterns of patients with chronic kidney disease: the influence of treatment modality. Nutrients. 2019;11(8):1920. https://doi.org/10.3390/nu11081920.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Jing Z, Wei-Jie Y. Effects of soy protein containing isoflavones in patients with chronic kidney disease: a systematic review and meta-analysis. Clin Nutr. 2016;35:117–24.

    Article  CAS  PubMed  Google Scholar 

  24. Lin YC, Chen EH, Chen RP, Dunny GM, Hu WS, Lee KT. Probiotic bacillus affects Enterococcus faecalis antibiotic resistance transfer by interfering with pheromone signaling cascades. Appl Environ Microbiol. 2021;87: e0044221.

    Article  PubMed  Google Scholar 

  25. Piewngam P, Zheng Y, Nguyen TH, et al. Pathogen elimination by probiotic bacillus via signalling interference. Nature. 2018;562:532–7.

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  26. Fujiwara K, Miyaguchi Y, Toyoda A, et al. Effect of fermented soybean “Natto” supplement on egg production and qualities. Asian-Australas J Anim Sci. 2008;21:1610–5.

    Article  CAS  Google Scholar 

  27. Gupta J, Mitra N, Kanetsky PA, et al. Association between albuminuria, kidney function, and inflammatory biomarker profile in CKD in CRIC. Clin J Am Soc Nephrol. 2012;7:1938–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Anders HJ, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney Int. 2013;83:1010–6.

    Article  CAS  PubMed  Google Scholar 

  29. Shi K, Wang F, Jiang H, et al. Gut bacterial translocation may aggravate microinflammation in hemodialysis patients. Dig Dis Sci. 2014;59:2109–17.

    Article  CAS  PubMed  Google Scholar 

  30. Natarajan R, Pechenyak B, Vyas U, et al. Randomized controlled trial of strain-specific probiotic formulation (Renadyl) in dialysis patients. BioMed Res Int. 2014;2014: 568571.

    Article  PubMed  PubMed Central  Google Scholar 

  31. He LX, Abdolmaleky HM, Yin S, Wang Y, Zhou JR. Dietary fermented soy extract and oligo-lactic acid alleviate chronic kidney disease in mice via inhibition of inflammation and modulation of gut microbiota. Nutrients. 2020;12:2376.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Horie M, Koike T, Sugino S, Umeno A, Yoshida Y. Evaluation of probiotic and prebiotic-like effects of Bacillus subtilis BN on growth of lactobacilli. J Gen Appl Microbiol. 2018;64:26–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all the participants for their dedication to this research project. We sincerely thank all researchers and co-medical staff of Saku Central Hospital for their excellent medical examinations and follow-up surveys. There is no conflict of interest in all the authors listed.

Funding

This study was partly supported by a fund from a Research-in-Aid Grant for Cardiovascular Diseases from the Ministry of Health, Labor and Welfare.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, Japan

    Keika Adachi, Marie Yasuda, Makiko Ida, Takeshi Kanda & Hiroshi Itoh

  2. Department of Public Health and Occupational Medicine, Mie University, 1577 Kurimamachiya-Cho, Tsu City, Tsu, Japan

    Akemi Morita

  3. Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-5 Kuramoto-Cho, Tokushima City, Tokushima, Japan

    Shu Wakino

  4. Department of Nutritional Science, Faculty of Applied Biosciences, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-Ku, Tokyo, Japan

    Shaw Watanabe

Authors
  1. Keika Adachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Makiko Ida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Kanda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akemi Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shu Wakino
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shaw Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Itoh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Shaw Watanabe and Shu Wakino conceived the idea of the study. The authors wish to acknowledge AM, MI, and MY for valuable technical assistance. KA developed the statistical analysis plan and conducted the statistical analyses. HI contributed to the interpretation of the results. KA drafted the original manuscript. TK supervised the conduct of this study. All authors reviewed the manuscript draft and revised it critically on intellectual content. All authors approved the final version of the manuscript to be published.

Corresponding author

Correspondence to Shu Wakino.

Ethics declarations

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

The study protocol was reviewed and approved by the ethics committee of Saku Central Hospital and adhered to the principles of the Declaration of Helsinki. Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 20 kb)

Supplementary file2 (PDF 160 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adachi, K., Yasuda, M., Ida, M. et al. Impact of dietary habits on renal function in Saku, a rural Japanese town: a cohort study. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02479-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10157-024-02479-6

Keywords

Search

Navigation