Association Between Mediterranean Lifestyle and Lower Risk of Chronic Kidney Disease: A Population-Based Prospective Study

Abstract

Objective: To investigate the association between the Mediterranean lifestyle and incident chronic kidney disease (CKD). Patients and Methods: This population-based, prospective, observational study used data from the UK Biobank cohort, collected from March 13, 2006, through July 31, 2010, and included 158,080 participants without CKD who completed a dietary assessment. The main predictor was the Mediterranean Lifestyle (MEDLIFE) index, comprising 3 blocks: (1) Mediterranean food consumption, (2) Mediterranean dietary habits, and (3) physical activity, rest, social habits, and conviviality. A Cox proportional hazards model was used to investigate the association between the MEDLIFE index and incident CKD. Further analysis was conducted to examine the associations between the individual blocks and items of the MEDLIFE index and the incidence of CKD. Results: At baseline, individuals with a higher MEDLIFE index score had lower blood pressure and body mass index and were less likely to have diabetes, hypertension, or cardiovascular disease. During median follow-up of 11.2 years, CKD occurred in 4354 participants (2.75%). The adjusted hazard ratio per 1-point increase in the MEDLIFE index for incident CKD was 0.94 (95% CI, 0.93 to 0.96). Compared with quartile 1 of the MEDLIFE index, the adjusted hazard ratios (95% CIs) for quartiles 2 to 4 were 0.80 (0.74 to 0.87), 0.76 (0.70 to 0.82), and 0.65 (0.59 to 0.72), respectively. This favorable association was consistently observed for all 3 blocks of the MEDLIFE index. Conclusion: These results suggest that a higher MEDLIFE index is associated with a lower risk of incident CKD.