Association between an Antioxidant-Rich Japanese Diet and Chronic Kidney Disease: The Ohasama Study

• Published in: Journal of Atherosclerosis and Thrombosis 2024/04/01, Vol.31(4), pp.461-477
• Main Authors: Tsubota-Utsugi, Megumi, Satoh, Michihiro, Watanabe, Jun, Takebayashi, Jun, Oki, Tomoyuki, Tatsumi, Yukako, Asayama, Kei, Kikuya, Masahiro, Murakami, Takahisa, Hirose, Takuo, Metoki, Hirohito, Hara, Azusa, Nomura, Kyoko, Hozawa, Atsushi, Tsubono, Yoshitaka, Imai, Yutaka, Ohkubo, Takayoshi
• Format: Article
• Language: English
• Subjects: Antioxidant capacity; Antioxidants; Chronic kidney disease; Diet - adverse effects; Female; General population; Glomerular Filtration Rate; Humans; Incidence; Japan - epidemiology; Male; Middle Aged; Original; Oxygen radical absorbance capacity; Proteinuria - epidemiology; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - prevention & control; Risk Factors; Typical Japanese diet
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.64423

Aims: Although physiological effects of hydrophilic- (H-) and lipophilic- (L-) antioxidant capacities (AOCs) are suggested to differ, the association of an antioxidant-rich diet and chronic kidney disease (CKD) incidence has not been examined. We therefore explored the association between the H- or L-AOC of a whole Japanese diet and CKD risk in a general population.Methods: A total of 922 individuals without CKD (69.2% women; mean age, 59.5 years old) from Ohasama Town, Japan, were examined. CKD incidence was defined as the presence of proteinuria and/or an estimated glomerular filtration rate (eGFR) of ＜60 ml/min/1.73 m2. Consumption of H-/L-AOC was determined based on the oxygen radical absorbance capacity in a specially developed Japanese food AOC database. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for new-onset CKD using a Cox proportional hazards model.Results: During the median follow-up of 9.7 years, 137 CKD incidents were recorded. After adjusting for potential confounding variables, the highest quartile of L-AOC was significantly associated with a 51% reduced CKD risk among only women. An increased L-AOC intake was more effective in preventing eGFR reduction than in preventing proteinuria in women. These associations were not seen for H-AOC intake in both sexes and L-AOC intake in men.Conclusions: A high intake of lipophilic antioxidants may be associated with a reduced CKD risk. The balance between dietary antioxidant intake and pro-oxidants induced by unhealthy lifestyles may be crucial for preventing future kidney deterioration.