Mariana Di Lorenzo

Background/Objectives: The global rise in obesity represents a major public health issue, extending its detrimental impact beyond metabolic complications to encompass renal dysfunction. A key element in this relationship lies in the interaction between visceral obesity and glomerular hyperfiltration—an early, often silent indicator of kidney injury that may precede the onset of chronic kidney disease (CKD). Methods: In this monocentric, retrospective study, we evaluated 43 adults with obesity attending the Outpatient Clinic for Diet Therapy in Transplantation, Renal Failure and Chronic Pathology at the University of Naples Federico II between March 2022 and March 2024. Clinical, anthropometric, biochemical, and 24 h urinary parameters were recorded, along with several validated visceral adiposity indices. Glomerular hyperfiltration was assessed through measured creatinine clearance (mClCr) tertiles, while associations with adiposity indices, proteinuria, and urinary sodium excretion were explored. Results: Higher creatinine clearance values were significantly associated with increased levels of adiposity indices—particularly Lipid Accumulation Product (LAP), New Visceral Adiposity Index (NVAI), and Metabolic Score for Visceral Fat (METS-VF)—as well as greater proteinuria, urinary sodium excretion, and daily salt intake. Subjects with proteinuria ≥ 150 mg/day exhibited higher NVAI values and elevated sodium and potassium urinary excretion compared with those without proteinuria. Significant correlations emerged between LAP and mClCr, sodium excretion, and proteinuria, even after adjustment for age and BMI. Conclusions: Higher visceral adiposity indices were associated with increased creatinine clearance, proteinuria, and urinary sodium excretion in adults with obesity. These findings suggest that visceral adiposity may represent a useful marker of early obesity-related renal alterations. Prospective studies are warranted to determine the causal relationships and mechanisms underlying these associations.

Background/Objectives: Chronic kidney disease (CKD) represents a major global public health challenge. Diet plays a central role in CKD management, with guidelines emphasizing individualized intake of energy, macronutrients, and micronutrients in combination with medical treatment. In recent years, increasing attention has been directed toward diet quality and the degree of food processing, particularly the consumption of ultra-processed foods (UPFs), which have been linked to adverse metabolic and renal outcomes. However, limited data are available on the real-life dietary patterns of individuals with CKD who have not yet received structured nutritional counseling. This study aims to describe the dietary habits of adults with CKD compared to healthy controls, in order to better understand nutritional challenges and identify potential targets for dietary intervention in CKD management. Methods: 73 subjects (46.6% M) were enrolled; they attended the Outpatients Clinic of the I.P. “Diet Therapy in transplantation, renal failure and chronic pathology”, University of Naples Federico II. Subjects were divided into two groups based on the presence/absence of CKD, established on the basis of a glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Each participant was evaluated for biochemical parameters, anthropometric measurements, body composition, and dietary assessment. Results: CKD group showed a lower caloric intake compared to Control Group. In particular, lipid intake was significantly higher in Control Group whereas carbohydrates intake was higher in CKD Group. No difference was found between the two groups regarding daily protein intake. Dietary sodium and salt intake was found to be lower in CKD Group compared to Control Group and the latter showed a lower omega-6/omega-3 ratio. Interestingly, the consumption of UPF was higher in Control Group compared to CKD Group. Conclusions: This study offers a snapshot of the dietary habits of a cohort from Southern Italy CKD stage 3–5 patients, showing that even in the absence of specific nutritional guidance, individuals were able to implement small lifestyle changes such as UPF and salt intake reduction. However, critical nutritional imbalances in CKD patients show the limits of self-managed diets, highlighting the need for structured nutritional support.

Background/Objectives: One of the main culprits of the obesity epidemic is the obesogenic food environment, which promotes the consumption of ultra-processed foods (UPFs) that are highly palatable, have low nutritional quality and a high caloric impact and are economical and ready to use. This monocentric retrospective study explored the association between UPFs, obesity and adiposity measurements among adults living with obesity in Southern Italy. Methods: According to their Body Mass Index (BMI) values, 175 participants (63M) were recruited and stratified into three groups. To evaluate their usual eating habits, PREDIMED and the Nova Food Frequency Questionnaire (NFFQ) were administered to investigate Mediterranean diet (MD) adherence and UPF consumption. Anthropometric and biochemical measurements, body composition, as well as visceral obesity indices were collected. Results: The data showed an increase in UPF consumption as the BMI increased, with a concomitant decrease in MD adherence. Soft drinks were the most representative UPF in all groups, and we observed a significant increase in such consumption as the BMI increased. In addition, in the highest tertile of UPF consumption, there was an increase in adiposity indices. Conclusions: Our data suggest that high UPF consumption correlates with an increased BMI and visceral adiposity, and it is a predictive risk factor for the occurrence of non-communicable diseases.