Academic journal article Journal of Health Population and Nutrition

Comparison of Renal Function and Other Health Outcomes in Vegetarians versus Omnivores in Taiwan

Academic journal article Journal of Health Population and Nutrition

Comparison of Renal Function and Other Health Outcomes in Vegetarians versus Omnivores in Taiwan

Article excerpt

INTRODUCTION

In the last few years, renal disease has become one of the 10 leading causes of death in Taiwan. Results of an analysis of the United States Renal Data System (USRDS) showed that the incidence rates of reported end-stage renal disease (ESRD) in 2007 were the highest in Taiwan, at 415 per million population, followed by Mexico, the United States, Japan, and Turkey, at 372, 361, 285, and 229 per million population respectively (1). In 2009, the Department of Health, Taiwan, reported that mortality due to nephritis, nephrotic syndrome, and other kidney diseases was the 10th leading cause of death in Taiwan (2).

The diet of plant origin has become popular in Taiwan because many perceive it as a 'lighter' alternative and is, therefore, more healthful. Many studies focused on the impact of a diet of plant origin on nutrition and health (3). Hyperlipidaemia, persistent proteinuria, glomerular hyperfiltration, and hypertension may contribute to the deterioration of renal functions. In addition, excess protein may also exacerbate renal functions, especially with diabetic nephropathy. Results of some studies, using animal and human models, suggest that restrictions of dietary protein can significantly retard the progression of chronic renal insufficiency (4-6). Diet of vegetarians rich in plant proteins, especially soy-proteins, has positive effects on blood pressure and lipid profiles. These positive effects include an improvement in proteinuria, hyperfiltration and renal perfusion, and decreased renal injury. To prevent or delay further progression of kidney damage in diabetic nephropathy, results of studies suggest replacing animal protein with soy-protein (7-9). However, the impact of diet of the vegetarians on protecting renal function remains unclear. The aim of this study was to explore the effects of diets of the vegetarian and omnivorous consumers on renal functions.

MATERIALS AND METHODS

Study subjects

During March 2006-June 2007, we screened chronic diseases in Taichung City in central Taiwan. Initially, we recruited 105 Buddhist nuns, aged 20-78 years, from a temple. Of the 105 nuns, 102 were enrolled with complete data. The average history of practising diet of plant origin by the subjects was 17.8 years. Omnivorous female subjects were selected through a simple random-sampling method. The study used a 1:1 ratio of age, body mass index (BMI), and education level-matched vegetarian to omnivorous female subjects. The final number of the study subjects included 102 vegetarians and 102 omnivores. Subjects diagnosed with chronic renal diseases in both vegetarian and non-vegetarian groups were excluded.

Biochemical analysis

We collected fasting blood samples for studying both routine biochemical screening of renal disorders and lipid profile. The study used the Olympus AU-2700 (Olympus Japan Co. Ltd., Tokyo, Japan) and the SYSMEX XE-2100 (TOA Medical Electronics, Kobe, Japan) to measure the biochemical components. These measurements included blood urea nitrogen (BUN), serum creatinine, sodium, potassium, chloride, calcium, phosphorus, uric acid, albumin, fasting plasma glucose, triglycerides, and total cholesterol. The Medical Laboratory of the Chung Shan Medical University Hospital analyzed all the samples.

Definition of terms

We used serum creatinine, age, and gender to calculate the estimated glomerular filtration rate (eGFR) according to the equation of simplified modification of diet in renal disease (MDRD) (10). Table 1 classifies the renal functions into five stages. This aligns with the national DOQI (Disease Outcomes Quality Initiative) standards.

The Bureau of Health standards for Taiwan considers a BMI of >24 to be normal and BMI of <18 to be abnormal. Systolic blood pressure of >130 mmHg and/or diastolic blood pressure of >80 mmHg is defined as high blood pressure. Hyperglycaemia is defined as fasting plasma glucose of [greater than or equal to] 100 mg/dL while hypertriglyceridaemia is defined as serum triglycerides of >150 mg/dL. …

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