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High dietary fiber intake reduces the risk of premature death among people with chronic kidney disease.

Chronic kidney disease, an umbrella term for a variety of conditions that impair kidney function, affects as many as 700 million people worldwide. The primary causes of chronic kidney disease are diabetes and hypertension32977-0/fulltext). Findings from a recent study suggest that high dietary fiber intake reduces the risk of premature death among people with chronic kidney disease.

Dietary fiber refers to the indigestible components of plant-based foods. A growing body of evidence indicates that eating a fiber-rich diet decreases the risks of many chronic diseases, such as coronary heart disease, stroke, hypertension, diabetes, and some types of cancer, including breast cancer and colon cancer. Public health recommendations for fiber intake vary based on a person’s age and sex. For example, adult females need between 22 and 28 grams of fiber per day, and adult males need between 28 and 34 grams per day. Most people living in the United States only get about half of the recommended amounts of fiber daily.

The study involved nearly 3,900 adults (average age, 63 years) who had chronic kidney disease and were enrolled in the Korean Genome and Epidemiology Study. The investigators collected information regarding the participants' diets (including fiber intake), lifestyle habits (such as smoking or exercising), alcohol intake, and overall health. They tracked the participants for about ten years and noted whether the participants died and, if so, their cause of death.

During the ten-year period, 602 of the participants died; of these, 149 died from cardiovascular diseases. The participants' average daily fiber intake was approximately 5 grams per day. The participants who consumed the most fiber were 37 percent less likely to die from all causes of premature death than those who consumed the least, even when considering age, sex, body mass index, smoking, exercise, hypertension, diabetes, and abnormal blood lipids. When the investigators looked at specific causes of death, they found that participants who consumed the most fiber were 44 percent less likely to die from cardiovascular diseases than those who consumed the least.

These findings suggest that dietary fiber markedly reduces the risk of premature death in people with chronic kidney disease. Interestingly, people with chronic kidney disease are often advised to reduce their intake of fiber-rich vegetables, fruits, nuts, legumes, and whole grains because these foods also contain phosphates and potassium, which carry risks in the setting of poor kidney function. However, dietary counseling regarding which foods to avoid can offset some of these risks and encourage healthy consumption of dietary fiber.

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