You are what you eat…and so are your grandkids? Study links poor diet to multi-generational health issues

Study finds how the effects of famine can be passed from one generation to the next
Study finds how the effects of famine can be passed from one generation to the next.

You are what you eat, as the adage goes. However, a new study from Tulane University found that what’s missing from your diet may also impact the health of your descendants across multiple generations.

Recent research supports the idea that famine in one generation can lead to harmful genetic outcomes in the next. However, questions about how many generations could be affected when an ancestor endures a nutritional crisis have persisted.

In a study published in Heliyon, Tulane researchers found that when paired mice were fed a low-protein diet, their offspring had lower birthweights and smaller kidneys over the next four generations, leading risk factors for chronic kidney disease and hypertension.

Researchers found that correcting the diets in offspring had no impact, and subsequent generations continued to be born with low nephron counts, the vital filtration units that help kidneys remove waste from the bloodstream. Though further work remains to determine if the findings translate to humans, the outcomes underscore the potential for food scarcity or malnutrition to result in decades of adverse health outcomes.

“It’s like an avalanche,” said lead author Giovane Tortelote, assistant professor of pediatric nephrology at Tulane University School of Medicine. “You would think that you can fix the diet in the first generation so the problem stops there, but even if they have a good diet, the next generations – grandchildren, great-grandchildren, great-great-grandchildren – they may still be born with lower birth weight and low nephron count despite never facing starvation or a low-protein diet.”

Correcting the diet in any of the generations failed to return kidney development in offspring to normal levels.

While maternal nutrition is crucial to an infant’s development, the study found that first-generation offspring were negatively impacted regardless of whether the mother or the father ate a protein-deficient diet.

This novel finding of how diet can have a transgenerational impact on kidney development is one of the latest in the field of epigenetics, the study of how environmental factors can impact gene expression without changing the DNA sequence.

The researchers studied four generations of offspring with nephron counts beginning to show signs of normalizing by the third and fourth generations. Tortelote said further research is needed to determine which generation returns to proper kidney development – and why the trait is passed on in the first place. 

“The mother’s diet is absolutely very important, but it appears there’s also something epigenetically from the father that governs proper kidney development,” Tortelote said.

The study also illuminates further understanding of the underlying causes of chronic kidney disease, the eighth leading cause of death in the U.S.

“If you’re born with fewer nephrons, you are more prone to hypertension, but the more hypertension you have, the more you damage the kidney, so it’s a horrible cycle and a public health crisis that could affect people across 50 to 60 years if we apply this to humans’ lifespans,” Tortelote said. “There are two main questions now: Can we fix it, and how do we fix it?”

The enzyme that could help 700 million people worldwide

3D illustration of kidney disease which now affects 10 per cent of the world’s population due to a spike in obesity, leading to diabetes CREDIT University of South Australia

University of South Australia researchers have identified an enzyme that may help to curb chronic kidney disease, which affects approximately 700 million people worldwide.

This enzyme, NEDD4-2, is critical for kidney health, says UniSA Centre for Cancer Biology scientist Dr Jantina Manning in a new paper published this month in Cell Death & Disease.

The early career researcher and her colleagues, including 2020 SA Scientist of the Year Professor Sharad Kumar, have shown in an animal study the correlation between a high salt diet, low levels of NEDD4-2 and advanced kidney disease.

While a high salt diet can exacerbate some forms of kidney disease, until now, researchers did not realise that NEDD4-2 plays a role in promoting this salt-induced kidney damage.

“We now know that both a high sodium diet and low NEDD4-2 levels promote renal disease progression, even in the absence of high blood pressure, which normally goes hand in hand with increased sodium,” says Dr Manning.

NEDD4-2 regulates the pathway required for sodium reabsorption in the kidneys to ensure correct levels of salt are maintained. If the NEDD4-2 protein is reduced or inhibited, increased salt absorption can result in kidney damage.

Even people on a low salt diet can get kidney damage if they have low levels of NEDD4-2 due to genetic variations or mutations in the gene.

Prof Kumar says the long-term goal is to develop a drug that can increase NEDD4-2 levels in people with chronic kidney disease (CKD).

“We are now testing different strategies to make sure this protein is maintained at a normal level all the time for overall kidney health,” Prof Kumar says.

“In diabetic nephropathy – a common cause of kidney disease – levels of NEDD4-2 are severely reduced. This is the case even when salt is not a factor.”

The study also revealed a surprising finding: that the high salt diet induced kidney disease is not always due to high blood pressure.

“In a lot of cases, kidney disease is exacerbated by hypertension, so we wanted to investigate that link in our study. In fact, we found the complete opposite – that a high salt diet caused excessive water loss and low blood pressure. This is significant because it means that kidney disease can also happen in people who don’t have high blood pressure,” Dr Manning says.

A 2020 Lancet paper estimated that about 700 million people – or 10 per cent of the world’s population – suffer from chronic kidney disease, which represents a 29 per cent increase in the past 30 years.

The huge spike in CKD is mainly attributed to a global obesity epidemic in recent decades, leading to diabetes, one of the leading causes of chronic kidney disease along with high blood pressure.

World Health Organization statistics reveal a 300 per cent increase in diabetes between 1980 and 2014, making it one of the top 10 causes of death worldwide and showing the gravity of the problem facing scientists trying to tackle kidney disease.

“Obesity and lifestyle are two main factors driving chronic kidney disease but there are other things at play as well,” says Dr Manning. “Acute kidney injuries, drugs taken for other conditions, high blood pressure and a genetic predisposition can also cause it.”

Weightlifting shows benefits for kidney disease patients

Weightlifting shows benefits for kidney disease patients

Weightlifting shows benefits for kidney disease patients

A new study conducted at Leicester’s Hospitals by University of Leicester researchers, led by Dr Emma Watson, Dr Tom Wilkinson, and Professor Alice Smith, has shown that non-dialysis  chronic kidney disease (CKD) patients who conducted both aerobic exercise and combined exercise for 12 weeks, three times a week experienced significant increases in strength, leg muscle size and cardiorespiratory fitness.

While positive changes were seen in patients just doing aerobic exercise – such as treadmill walking, cycling and rowing – the addition of resistance exercise, such as weightlifting, led to greater increases in muscle mass (nine percent compared to five percent) and strength (49 percent compared to 17 percent) than aerobic exercise alone.

“There is limited research on the effects of exercise in CKD patients, and a lack of knowledge on what exercise is most beneficial in this group” says Dr Tom Wilkinson from the University of Leicester’s Department of Infection, Immunity and Inflammation. “Our study shows that both aerobic exercises and strength exercises are important in CKD patients in keeping muscles strong and healthy and can be combined successfully and safely.”

“For time and logistical reasons, combining both modes of exercise – aerobic and strength – in the same session would be optimal,” added Dr Emma Watson.

Patients, who were recruited from outpatient clinics at Leicester’s Hospitals, had a six week run in control period before starting the exercise programme. The researchers observed any ‘natural’ changes in strength, fitness, and muscle. No changes were seen, which meant that any changes seen after the intervention were a result of the exercise.

Patients then underwent 12 weeks of supervised aerobic based exercise (treadmill, rowing or cycling exercise) for 30 minutes, or combined training (aerobic exercise plus leg extension and leg press exercise) performed three times week. The researchers then analysed the potential health benefits.

The sessions took place at the exercise gym in the Leicester Diabetes Centre.

One female patient, aged 80, said: “I went for my first session and I was absolutely over the moon. I loved it because it was just exercise and I thought fancy me at my age and I can do all this. I thought when I tell my grandchildren they will be absolutely delighted. I used to really like the exercise and the staff there were so supportive and explained everything to me. I was just a very happy lady.”

“I have certainly noticed that my general level of fitness changed after the extra CKD and I discovered muscles that I hadn’t had for a little while,” added a male patient, 62 years old, who took part in the study.

The study was conducted by the Leicester Kidney Lifestyle Team and supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC). The Leicester BRC is a partnership between Leicester’s Hospitals, the University of Leicester and Loughborough University.

The paper, titled ‘12-weeks combined resistance and aerobic training confers greater benefits than aerobic alone in non-dialysis CKD’, is published here: http://www.physiology.org/doi/abs/10.1152/ajprenal.00012.2018

World Kidney Day – Celebrate by giving a glass of water! #glassofwater #isupportwkd.


World Kidney Day

World Kidney Day

Tomorrow 12th March sees the 10th Anniversary of World Kidney Day (WKD).

This year’s objective is to encourage people to drink more water as part of the overall kidney health. In fact we are being asked to give a glass of water to family, friends and co-workers as part of the day.

World Kidney Day’s Dr. Philip Li told us “Sharing a glass of water on March 12 is a good way to remind us that kidneys are vital organs and that they should be taken care of, wherever you live and whether you’re at risk or not. Taking steps to live a healthy lifestyle clearly helps to reduce risk, and early detection and treatment can slow or prevent the progression of kidney disease.”

Participants can send WKD messages and their pictures, using the #glassofwater and #isupportwkd.

Indeed with up to 10% of the population worldwide having some form of kidney damage, there is still a long road ahead to raise awareness of kidney disease. Chronic Kidney Disease (CKD), which is predicted to increase by 17% over the next decade, is now recognized b as a global public health issue.

Check out our previous blog on World Kidney Day for a few tips on improving your kidney health here.

You may also want to check out World Kidney Day own site which is available here.