title: Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study.
abstract: BACKGROUND
  Modifiable lifestyle-related factors are associated with risk of coronary heart disease and may also influence kidney disease risk.
  
  
  METHODS
  Community-based prospective cohort study.
  
  
  METHODS
  2,354 African American and white participants aged 28-40 years without baseline microalbuminuria or estimated glomerular filtration rate <60 mL/min/1.73 m² recruited from 4 US centers: Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA.
  
  
  METHODS
  Current smoking, physical activity, fast food habits, obesity, and diet quality, which was based on 8 fundamental components of the Dietary Approaches to Stop Hypertension (DASH) diet, including increased intake of fruits, vegetables, low-fat dairy products, whole grains, and nuts and legumes and reduced intake of sodium, sugar-sweetened beverages, and red and processed meats.
  
  
  METHODS
  Spot urine albumin-creatinine ratios were obtained at baseline (1995-1996) and three 5-year follow-up examinations (5, 10, and 15 years' follow-up). Incident microalbuminuria was defined as the presence of age- and sex-adjusted albumin-creatinine ratio ≥25 mg/g at 2 or more of the successive follow-up examinations.
  
  
  RESULTS
  During the 15-year follow-up, 77 (3.3%) individuals developed incident microalbuminuria. After multivariable adjustment, poor diet quality (OR, 2.0; 95% CI, 1.1-3.4) and obesity (OR, 1.9; 95% CI, 1.1-3.3) were associated significantly with microalbuminuria; current smoking (OR, 1.6; 95% CI, 0.9-2.8) was associated with microalbuminuria, although the CI crossed 1.0. Neither low physical activity (OR, 1.0; 95% CI, 0.5-1.8) nor fast food consumption (OR, 1.2; 95% CI, 0.7-2.3) was associated with microalbuminuria. Compared with individuals with no unhealthy lifestyle-related factors (poor diet quality, current smoking, and obesity), adjusted odds of incident microalbuminuria were 131%, 273%, and 634% higher for the presence of 1 (OR, 2.3; 95% CI, 1.3-4.3), 2 (OR, 3.7; 95% CI, 1.8-7.7), and 3 (OR, 7.3; 95% CI, 2.1-26.1) unhealthy lifestyle-related factors.
  
  
  CONCLUSIONS
  Self-reported dietary history and physical activity, low number of outcomes.
  
  
  CONCLUSIONS
  Consuming an unhealthy diet and obesity are associated with incident microalbuminuria.
authors.affiliation: Division of Nephrology, Johns Hopkins University, Baltimore, MD 21205, USA. achang43@jhmi.edu
authors.forename: Alex
authors.initials: A
authors.lastname: Chang
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Britt
authors.initials: B
authors.lastname: Newsome
authors.forename: David A
authors.initials: DA
authors.lastname: Shoham
authors.forename: Ramon
authors.initials: R
authors.lastname: Durazo-Arvizu
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bibbins-Domingo
authors.forename: Jared
authors.initials: J
authors.lastname: Reis
authors.forename: Holly
authors.initials: H
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000419:Albuminuria / Q000209:etiology* / Q000517:prevention & control*; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D018570:Risk Assessment; D044465:White People; D055815:Young Adult
keywords: DASH diet; kidney disease; lifestyle factors; microalbuminuria; obesity