Association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and cardiovascular risk factors: A two-year follow-up study in kidney transplant recipients.

BACKGROUND & AIMS: Recent evidence suggests that moderate coffee intake is associated with multiple health benefits, including lower risk of obesity, sarcopenia and cardiovascular disease (CVD) in the general population. However, to date, no study has evaluated these associations in kidney transplant recipients (KTR). The aim of the present study was to evaluate the association of habitual coffee consumption with obesity, sarcopenia, bone mineral density and CVD risk factors in KTR. METHODS: This prospective 2 years-follow-up study included 170 KTR (59% men) aged 49.5 (42.0-57.0) years. At baseline participants were submitted to the following evaluations: clinical, laboratorial, dietary intake (including coffee), muscle strength, anthropometric and body composition by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). After two years 163 KTR were re-evaluated by anthropometry, BIA and muscle strength. Sarcopenia was defined according to EWGSOP2. Risk factors for CVD were hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and hyperhomcysteinemia. Participants were stratified according to coffee intake: 0 or 1 time/day (Gr0-1) and 2 or 3 times/day (Gr2-3). RESULTS: The median coffee consumption was 200 (150-250)mL/day and 112 (71-155)mL/1000 kcal/day. At baseline, Gr2-3 vs. Gr0-1 exhibited significantly higher values of waist circumference, waist-to-height ratio (WHtR) and presented a higher odds ratio for central obesity according to WHtR (2.68; 95%CI:1.19-6.02; p = 0.02) after adjustment for confounders. Coffee consumption (mL/1000 kcal/day) showed, even after adjustment for confounders, (1) a positive association with all parameters of body adiposity (anthropometry, BIA and DXA) and (2) a negative association with muscle quality index. After two years, coffee intake (mL/1000 kcal/day) at baseline presented a positive correlation with changes in fat mass (kg) by BIA (r = 0.22, p = 0.01) after adjustment for confounders. CONCLUSION: This study suggests that in KTR, higher coffee consumption is associated with increased adiposity, specially, central adiposity and lower muscle quality, but is not related with the other evaluated parameters.

Soaking to Reduce Potassium and Phosphorus Content of Foods.

OBJECTIVES: To achieve and maintain normal serum potassium and phosphorus levels reducing potassium and phosphorus intake is frequently recommended for adults living with chronic kidney disease. Exploring food preparation methods to reduce potassium and phosphorus content appears warranted. The study aim is to determine the impact of soaking foods in hot water on potassium and phosphorus content in a variety of plant- and animal-based foods. METHODS: Twenty foods were selected that are common staples in Brazilian diet patterns. Food was soaked for 5-10 minutes in deionized water that had been brought to a boil and then removed from heat using a 5-part water to 1-part sample ratio. The potassium content was determined by flame photometry. The phosphorus content was determined by visible ultraviolet spectrophotometry. RESULTS: Soaking foods resulted in a reduction in potassium and phosphorus. Potassium reduction in beef, green leafy vegetables, and grains was 40-49%; in chicken, fish, and nonleafy vegetables 30-39%; and tubers 10-20%. Phosphorus reduction in grains and beans was 30-39%; in nonleafy vegetables 20-29%; and beef, chicken, and fish 10-20%. CONCLUSIONS: Soaking foods in hot water for 5-10 minutes reduces potassium and phosphorus content. Using this technique to prepare foods may be a more acceptable alternative to longer demineralization periods making it easier for adults living with chronic kidney disease to follow diet recommendations.

Sarcopenia and sarcopenic obesity in chronic kidney disease: update on prevalence, outcomes, risk factors and nutrition treatment.

PURPOSE OF REVIEW: This review summarizes literature from the last 18 months reporting on sarcopenia (or its components) in chronic kidney disease (CKD). RECENT FINDINGS: The prevalence of sarcopenia in CKD is reported to be 5-62.5%, with higher rates observed later in the disease. Sarcopenic obesity rates are reported to be 2-23%. Sarcopenia in CKD is associated with increased risk of mortality, cardiovascular disease and vascular calcification. Risk factors include kidney disease itself and the impacts of CKD on lifestyle (reduced physical activity, diet changes). In earlier stages of CKD, if the risks from sarcopenia outweigh the risk of reaching end-stage renal disease, ensuring adequate energy intake combined with modest protein liberalization and physical activity may be indicated. Protein intakes above 1.3 g/kg of body weight per day should be avoided. For dialysis patients, interventions that provide a combination of carbohydrate, protein and fat appear more effective than those that provide protein alone, though it may take as long as 48 weeks for detectable changes in muscle mass. SUMMARY: Sarcopenia is prevalent in CKD as kidney disease significantly impacts muscle mass and function. Nutrition interventions can improve components of sarcopenia, with an emphasis on adequate energy and protein.