Effects of Italian Mediterranean organic diet vs. low-protein diet in nephropathic patients according to MTHFR genotypes.
BACKGROUND
Several reports associate an Italian-style Mediterranean diet (IMD) with lower risk of cardiovascular disease and morbidity. The present study aimed to explore the effects of an Italian Mediterranean organic diet (IMOD) versus low-protein diet (LPD) in chronic kidney disease (CKD) patients, according to patients' carrier status for the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism.


METHODS
A total of 40 male patients with CKD and stable renal function (Kidney Disease Outcomes Quality Initiative stages 2 and 3) were classified according to MTHFR polymorphism as carrier T(+) or non carrier T(-). At the time of enrolment (T0) patients' diet consisted of LPD; they were then administered IMD for 14 days (T1), thereupon IMOD for 14 days (T2). Patients underwent a complete medical history, body composition assessment and biochemical analysis.


RESULTS
Baseline homocysteine levels were on average 8.24 mol/l higher (95 % confidence interval 6.47, 10.00) among T(+) than T(-) and the difference was statistically significant (p < 0.001). We found a significant interaction between MTHFR status and the effect of both the IMD and IMOD on homocysteine levels compared to LPD (p for interaction <0.001). Both the IMD and IMOD resulted in significant variations of anthropometric and laboratory measurements.


CONCLUSIONS
IMD and IMOD diets could represent a viable alternative to LPD in CKD patients on conservative therapy. The effect of these diets seems to be influenced by MTHFR genotypes.
Department of Systems Medicine, Hypertension and Nephrology Unit, University of "Tor Vergata", 00133, Rome, Italy.
Nicola
N
Di Daniele
Laura
L
Di Renzo
Annalisa
A
Noce
Leonardo
L
Iacopino
Pietro Manuel
PM
Ferraro
Mariagiovanna
M
Rizzo
Francesca
F
Sarlo
Emidio
E
Domino
Antonino
A
De Lorenzo
D000328:Adult; D015415:Biomarkers / Q000097:blood; D038441:Diet, Mediterranean; D018753:Diet, Protein-Restricted; D058870:Food, Organic; D005838:Genotype; D006710:Homocysteine / Q000097:blood; D006801:Humans; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D010641:Phenotype; D011110:Polymorphism, Genetic; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000201:enzymology / Q000235:genetics*; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D006710:Homocysteine; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)