(Press-News.org) Fitness and Staving Off Weight Gain May Be More Important than Weight Loss for Preventing Kidney Disease in Obese Adults, Drexel Study Says
As obesity is a contributing factor to chronic kidney disease, weight loss can help mitigate a patient’s risk. But new research suggests that fitness and preventing weight gain could actually play a more important role in reducing risk than weight loss. The findings were published today in the journal Obesity from researchers at Drexel University’s College of Medicine and Dornsife School of Public Health.
The researchers followed 1,208 overweight and obese adults (BMI equal to or over 25 kg/m2) from six cities nationwide who were participants in the NIH-sponsored Multi-Ethnic Study of Atherosclerosis (MESA). The participants were recruited from July 2000 to August 2002 and followed over a median of 9 years, during follow-up exams at 18 months, 3 years, 5 years, and 10 years. In contrast with most previous research on physical activity and chronic kidney disease risk, adults in this study did not have diabetes, heart disease, or reduced kidney function at baseline.
The Drexel team found that weight gain was associated with a higher risk of chronic kidney disease; specifically each 5 kg of weight gain from baseline was associated with a 1.34 times higher rate of developing chronic kidney disease. This increase was measured by blood tests of estimated glomerular filtration rate, or eGFR, using a formula that factors in both cystatin C – a protein produced by cells — and serum creatinine, which kidneys filter out of blood through production of urine. High levels of cystatin C and serum creatinine signal poor kidney function.
The group also looked at how physical fitness, as indicated by walking pace, was linked to kidney function. They found that a slow walking pace (under 2 miles per hour) – as self-reported in surveys at each visit — was associated with more rapid kidney function decline and a individuals with a slower pace are at higher risk for developing chronic kidney disease than faster-walking patients. Their findings were similar whether or not patients had high blood pressure at baseline.
“We found that for adults with obesity, low physical fitness, assessed by usual walking pace, and weight gain increase risks of developing kidney disease, but we did not see an association between weight loss and lower CKD risk,” said Harhay. “There are still likely to be kidney-related health benefits from weight loss in this population, such as improvements in glycemic and blood pressure control.”
Harhay said the lack of an association between weight loss and chronic kidney disease risk speaks to the field’s limited knowledge of the specific mechanisms that link weight loss and kidney health.
“We already know that obesity raises risks of Type 2 diabetes, a condition that is the main driver of chronic kidney disease in our country. But when we focused on adults with obesity who did not have diabetes or kidney disease at baseline, we found that it was weight gain and low physical fitness that were risk factors for CKD, whereas weight loss was not necessarily protective. These findings certainly warrant more study.” said Harhay. “The improved glycemic and blood pressure control, that we typically see with weight loss, might be more consequential in a population that already has chronic kidney disease, or in adults with severe obesity — adults could not qualify for MESA if they weighed more than 300 pounds.”
Previous studies have also found an association between weight gain and higher chronic kidney disease risk, but the current study is among the first to look at the role of physical fitness and chronic kidney disease risk in an obese population without diabetes.
More than 1 in seven U.S. adults -- thirty-seven million -- suffer from chronic kidney disease. Estimates suggest that nine out of 10 of these individuals do not know that they have the disease. Deaths from the disease are on the rise nationally, from 91.7 per 1,000 in 2019 to 100.6 per 1,000 in 2020 — with higher increases among Black and Hispanic populations. Treating patients is also taxing for the nation’s health care system, with more than $85 billion spent by Medicare alone in 2020. As of February 2023, 88,658 people were on the waiting list for a life-saving kidney transplant in the United States.
Although the researchers point out that slow walking speed may also result from other diseases and ailments that influence chronic kidney disease risk, such as arthritis, they also note that the association between walking pace and eGFR decline was significant using Cystatin C, which is less affected by muscle mass, to determine eGFR.
“Our study shows that physical fitness may be as important as body weight when assessing chronic kidney disease risk among adults with obesity, but future studies are needed to determine whether these results are also produced while testing interventions to help patients in this population prevent weight gain and improve their overall fitness,” said Harhay.
Funding for the study came from the National Institutes of Health’s National Institutes of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the National Center for Advancing Translational Sciences. Harhay consults for Nephria Bio, but the company had no involvement in decision-making in the study and the authors declare no conflict of interest.
In addition to Harhay, authors on the study include Yuna Kim and Kari Moore from Drexel, Michael O Harhay from the University of Pennsylvania, Ronit Katz of the University of Washington, Michael G Shlipak from the University of California, and Kramer H from Loyola University Chicago.
###
END
Previous research shows that conversational turns (interactive conversations) between parents and children are important for a child’s long-term language development and academic achievement and that these conversations can be enhanced via parent-coaching language interventions. The neural networks responsible for language develop rapidly even before a child can talk, making these interactive conversations especially important during infancy.
Music is an engaging and social experience between parents and children that is often part of daily routines during infancy. Emerging literature also documents links between music experiences and child language outcomes. Researchers ...
Two of the best predictors of life-long health and well-being are early childhood self-control skills and healthy eating habits. A new program that teaches parents how to cook with their 2-year-olds is helping toddlers excel on both fronts. Doing things like stirring ingredients together without spilling and singing a song while something is in the microwave helps toddlers learn multiple important self-control skills, like paying attention, controlling their bodies, waiting patiently, and cooperating with their parents. Toddlers also get excited about being involved in the “grown-up” activity and are more likely to try the new foods they help make. Previous research has shown that ...
A new study has found that Canadian adults with cannabis use disorder appear to have an approximately 60% higher risk of experiencing their first heart attack, stroke, or other major cardiovascular event than those without cannabis use disorder.
The study, published in Addiction, measured the association between problematic marijuana use and the first-time occurrence of adverse cardiovascular disease events such as heart attack, stroke, cardiac dysrhythmias, and peripheral vascular disease.
Researchers used five Canadian health databases to create a cohort of nearly 60,000 participants, half with a cannabis use disorder ...
Some substances in medicines, household items and the environment are known to affect prenatal child development. In a study published in Toxicological Sciences, researchers tested the effects of five drugs (including caffeine and the blood thinner warfarin) on the growth of zebrafish embryos. They found that all five had the same effect, impairing the migration of bone-forming cells which resulted in the onset of facial malformation. Zebrafish embryos grow quickly, are transparent and develop outside of the parent’s body, ...
Sushi has become everyday fare in Norway and elsewhere around the globe, and many people opt for sashimi and other raw fish when they want to treat themselves to something tasty.
It is important to emphasise here that, as a general rule, it is completely safe to eat this type of food in Norway. However, despite the fact that sushi can be delicious, it also carries a health hazard, both for individuals and for society at large.
“Bacteria in sushi, sashimi and cold-smoked fish products can pose a risk to people who eat such foods frequently, especially people with weak immune systems, children and the elderly,” says Hyejeong Lee.
She recently completed her PhD at the Department ...
Researchers have found a link between a pregnant woman or her partner losing their job and an increased risk of miscarriage or stillbirth.
The study, which is published today (Thursday) in Human Reproduction [1], one of the world’s leading reproductive medicine journals, found a doubling in the chances of a pregnancy miscarrying or resulting in a stillbirth following a job loss.
The researchers, led by Dr Selin Köksal from the Institute for Social and Economic Research at the University of Essex, UK, ...
Researchers have established the protein p53 as critical for regulating sociability, repetitive behavior, and hippocampus-related learning and memory in mice, illuminating the relationship between the protein-coding gene TP53 and neurodevelopmental and psychiatric disorders like autism spectrum disorder.
“This study shows for the first time that p53 is linked directly to autism-like behavior,” said Nien-Pei Tsai, an associate professor of molecular and integrative biology at the University of Illinois Urbana-Champaign and a researcher at the Beckman Institute for Advanced Science and Technology.
In living systems, ...
Accessing stable employment with fair pay and predictable hours is harder for workers in the North and Midlands, which can severely affect their living standards, health, and future job prospects.
A new report published by the Work Foundation at Lancaster University reveals the regions with the highest and lowest levels of ‘severely insecure’ work (employment that is involuntarily temporary or part-time, or when multiple forms of insecurity come together, such as casual or zero-hours contracts, or low or unpredictable ...
Increased consumption of carbohydrate from refined grains, starchy vegetables, and sugary drinks is associated with greater weight gain throughout midlife, while increased fibre and carbohydrate from whole grains, fruit, and non-starchy vegetables is linked to less weight gain, finds a large US study published by The BMJ today.
Most of these associations were stronger for people with excessive body weight, highlighting the potential importance of carbohydrate quality and source for long term weight management, say the researchers.
The role of carbohydrates in weight gain and obesity remains controversial, and few studies have evaluated ...
Patients in some of the most deprived areas of England, where respiratory conditions including chronic lung disease (COPD) and asthma are most prevalent, have limited or no access to vital diagnostic tests to confirm their diagnosis, reveals a survey by The BMJ today.
Despite NHS England’s promise of access via Community Diagnostic Centres (CDCs), journalist Sally Howard speaks to GPs in some of the worst affected areas who say having no means of referring patients for lung function tests is “troubling” and “a silent scandal.”
And last month, a report by the charity Asthma + Lung UK ...