A new research study from Loma Linda University (LLU) demonstrates that naturally occurring antioxidants in pecans may help contribute to heart health and disease prevention; the results were published in the January 2011 issue of The Journal of Nutrition.
Pecans contain different forms of the antioxidant vitamin E — known as tocopherols, plus numerous phenolic substances, many of them with antioxidant abilities. The nuts are especially rich in one form of vitamin E called gamma-tocopherols. The findings illustrate that after eating pecans, gamma-tocopherol levels in the body doubled and unhealthy oxidation of LDL (bad) cholesterol in the blood decreased by as much as 33 percent. Oxidized LDLs may further contribute to inflammation in the arteries and place people at greater risk of cardiovascular problems. “Our tests show that eating pecans increases the amount of healthy antioxidants in the body,” says LLU researcher Ella Haddad, DrPH, associate professor in the School of Public Health department of nutrition. “This protective effect is important in helping to prevent development of various diseases such as cancer and heart disease.”
These findings are from a research project designed to further evaluate the health benefits of pecans, according to Dr. Haddad. She analyzed biomarkers in blood and urine samples from study participants (a total of 16 men and women between the ages 23 and 44) who ate a sequence of three diets composed of whole pecans, pecans blended with water, or a control meal of equivalent nutrient composition. The pecan meals contained about three ounces of the nut. Samples were taken prior to meals and at intervals up to 24 hours after eating. Following the test meals composed of whole pecans and blended pecans, researchers found that amounts of gamma-tocopherols (vitamin E) in the body doubled eight hours after both meals, and oxygen radical absorbance capabilities (ORAC — a scientific method for measuring antioxidant power in the blood) increased 12 and 10 percent respectively two hours after the meals. In addition, following the whole-pecan meal, oxidized LDL cholesterol decreased by 30 percent (after 2 hours), 33 percent (after 3 hours), and 26 percent (after 8 hours).
“This study is another piece of evidence that pecans are a healthy food,” says Dr. Haddad. “Previous research has shown that pecans contain antioxidant factors. Our study shows these antioxidants are indeed absorbed in the body and provide a protective effect against diseases.” Research from Loma Linda University published earlier in the Journal of Nutrition showed that a pecan-enriched diet lowered levels of LDL cholesterol by 16.5 percent — more than twice the American Heart Association’s Step I diet, which was used as the control diet in that study. Similarly, the pecan-enriched diet lowered total cholesterol levels by 11.3 percent (also twice as much as the Step I diet).
Drinking soft drinks is associated with higher blood pressure, according to a study of over 2,500 people reported this week in the journal Hypertension. High blood pressure is a major risk factor for heart disease, which is the leading cause of death worldwide. Someone with a blood pressure level in millimetres of mercury (mmHg) of 135 over 85 is twice as likely to have a heart attack or stroke as someone with a reading of 115 over 75.
The new research shows that for every extra can of soft drink consumed per day, participants on average had a higher systolic blood pressure by 1.6 mmHg and a higher diastolic blood pressure by 0.8 mmHg. This difference was statistically significant even after adjusting for factors such as weight and height. The study did not examine the mechanism that might link soft drinks with blood pressure. However, the researchers suggest that raised uric acid, which has been linked to soft drink consumption, might raise blood pressure by reducing the levels of nitric oxide, a chemical that relaxes the lining of the blood vessels.
The association between soft drinks and higher blood pressure was especially strong in people who consumed a lot of salt as well as sugar. Diet drinks were linked with lower blood pressure levels in some analyses, but the association was not consistent or strong. Professor Paul Elliott, senior author of the study, from the School of Public Health at Imperial College London, said: “It’s widely known that if you have too much salt in your diet, you’re more likely to develop high blood pressure. The results of this study suggest that people should be careful about how much sugar they consume as well.”
The researchers analysed data from 2,696 volunteers aged between 40 and 59, in eight areas of the US and two areas of the UK. On four separate occasions over a period of three weeks on average, the participants reported what they had eaten in the preceding 24 hours, as well as giving urine samples and having their blood pressure measured. The volunteers were taking part in INTERMAP, the International Study of Macronutrients, Micronutrients and Blood Pressure.
The researchers also found that people who drink more soft drinks tended to have more unhealthy diets in general. As well as consuming more sugar, those consuming more than one soft drink a day consumed more calories by 397 kilocalories per day on average, and less fibre and minerals. Those who did not consume soft drinks had a lower body mass index (BMI) on average than those who consumed more than one drink per day. “Individuals who drink a lot of sugar-sweetened beverages appear to have less healthy diets,” said Dr Ian Brown, the study’s first author, also from the School of Public Health at Imperial College London. “They are consuming empty calories without the nutritional benefits of real food. They consume less potassium, magnesium and calcium.” “This is a population study,” Dr Brown added. “It can’t say definitively that sugary drinks raise your blood pressure, but it’s one piece of the evidence in a jigsaw puzzle that needs to be completed. In the meantime, we would advise people who want to drink sugar-sweetened beverages should do so only in moderation.”
Scientists may have discovered a way of identifying dieters who are prone to piling the pounds back on after weight loss. A study at Maastricht University’s Department of Human Biology found a link between a gene involved in regulating blood pressure and post-diet weight gain in women. Women who regained weight after slimming had a high change in the concentration of a particular protein in their blood during dieting, research showed. Researchers now hope to develop a test to indicate how prone people are to yo-yo dieting.
Edwin Mariman, professor of functional genetics at Maastricht, said: “It was a surprising discovery, because until now there has been no clear link between this protein and obesity. “We do not yet have an explanation for the results, but it does appear that it should be possible within a few years to use this finding to develop a test to show who is at high risk of putting weight back on after a diet.”
Hospitals already conduct tests for the protein, known as the angiotensin I converting enzyme (ACE). But the test is currently carried out to check its activity in regulating blood pressure, rather than its concentration. Up 80% of dieters suffer from the yo-yo effect, returning to their original weight within a year.
The study looked at around 100 women aged 20 to 45, half of whom had maintained their post-diet weight and half of whom had put weight back on. The findings of the research have been published by Dr Ping Wang, a scientist in Professor Mariman’s research group, in the online scientific journal PloS ONE.
It's no secret that eating well is good for both body and mind, so it may not come as a surprise that a new study finds women who eat more olive oil and leafy vegetables such as salads and cooked spinach are significantly less likely to develop heart disease.A group of Italian researchers found that women who ate at least 1 serving of leafy vegetables per day were more than 40 percent less likely to develop heart disease over an average of eight years, relative to women who ate two or fewer portions of those vegetables each week. Women who downed at least 3 tablespoons of olive oil daily – such as in salad dressing – were also 40 percent less likely to be diagnosed with heart disease, compared to women who ate the least olive oil.
It's not exactly clear why specifically leafy vegetables and olive oil may protect the heart, said study author Dr. Domenico Palli of the Cancer Research and Prevention Institute in Florence. “Probably the mechanisms responsible for the protective effect of plant-origin foods on cardiovascular diseases involve micronutrients such as folate, antioxidant vitamins and potassium, all present in green leafy vegetables.” Folate reduces blood levels of homocysteine, Palli explained, which is thought to increase the risk of cardiovascular disease by damaging the inner lining of arteries. Other studies have shown people who eat more potassium have lower blood pressure, which can protect the cardiovascular system. Virgin olive oil may be particularly effective at lowering heart disease risk because of its high level of antioxidant plant compounds, he added.
This is not the first study to link olive oil or vegetables to good heart health. Most famously, the traditional Mediterranean diet — rich in vegetables and monounsaturated fats from olive oil and nuts, but low in saturated fat from meat and dairy — has been tied to a decreased risk of heart disease. Mediterranean-style eating has also been credited with lowering risk for some cancers, diabetes, and, more recently, with slowing brain aging. Cardiovascular disease is a major killer, responsible for 30 percent of all deaths worldwide and the leading cause of death for both men and women in the U.S.
To look more closely at the role of foods in protecting against heart disease, Palli and colleagues reviewed dietary information collected from nearly 30,000 Italian women participating in a large national health study. Researchers followed the women, whose mean age was 50 at the beginning of the study, for an average of 8 years, noting who developed heart disease. In that time, the women experienced 144 major heart disease-related events, such as heart attack or bypass surgery, the authors report in the American Journal of Clinical Nutrition. Women who ate at least one daily serving (about two ounces) of leafy vegetables – such as raw lettuce or endives, or cooked vegetables like spinach or chard — had a 46 percent lower risk of developing heart disease than women who ate at most two portions per week. Consuming at least an ounce of olive oil per day lowered their risk by 44 percent relative to women who consumed a half-ounce or less daily, the authors found.
The women's intake of other types of vegetables, such as roots and cabbages, and their consumption of tomatoes or fruit did not seem to be linked to their risk for major heart events. Both fruits and vegetables have been associated with heart benefits in past studies conducted elsewhere in Europe and in North America. The authors caution that the apparent lack of positive effect from high fruit consumption in their results may have something to do with a different attitude toward fruit in Italy. It is cheap, varied and easily available, so eating a lot of fruit is a widespread habit but it does not necessarily signal that the rest of someone's diet is as healthy, the authors wrote. Another issue with the study, Palli noted, is that women had to report how much they ate of various items, and some may not have remembered their diets accurately, or may have changed their eating habits during the study period. In addition, people sometimes over-estimate their healthy behaviors, believing they eat healthier than they really do.
SOURCE: American Journal of Clinical Nutrition, published online December 22, 2010.
Women consuming too much red meat may have a higher risk of stroke than women eating less, says a new study. Red meat is high in saturated fat and cholesterol; both are risk factors for cardiovascular disease, heart attack, and stroke. The United States Centers for Disease Control and Prevention suggests lowering saturated fat intake and eating more fresh fruits and vegetables to help reduce your risk of stroke. Writing in the journal Stroke, researchers examined nearly 35,000 Swedish women, ages 39 to 73. None of the women had heart disease prior to the start of the study in 1997.
After ten years, results showed 4% of the study participants, 1,680 women, had a stroke. Those consuming the most red meat had the highest risk of stroke. Women in the top tenth of red meat intake, consuming at least 3.6 ounces each day, were 42% more likely to have a stroke, compared to women who ate just under one ounce of red meat daily.
Eating processed meat also increased stroke risk. Women eating 1.5 ounces of processed meat each day were 24% more likely to suffer a cerebral infarction, compared to woman consuming less than half an ounce of processed meat each day. Processed meat was not linked to any other form of stroke. Cerebral infarction is a type of stroke caused by a disturbance in the blood vessels supplying blood to the brain. Other types of stroke involve a rupturing of a blood vessel, called hemorrhagic strokes.
The scientists blame red meat and processed meat’s effect on raising blood pressure for the increased stroke risk. According to the World Health Organization (WHO), every year an estimated 17 million people die due to cardiovascular diseases, most notably stroke and heart attack. The WHO lists physical inactivity and unhealthy diet as the main risk factors for heart disease and major cardiac events.
People who weigh more have lower circulating levels of Vitamin D according to recent research conducted at the Rikshospitalet-Radiumhospitalet Medical Center in Oslo, Norway and published in the Journal of Nutrition. Lead researcher, Zoya Lagunova, MD and her colleagues measured the serum levels of Vitamin D and 1,25(OH)2D in 1,779 patients at a Medical and Metabolic Lifestyle Management Clinic in Oslo, Norway. The associations among 1,25(OH)(2)D, serum 25-hydroxyvitamin D [25(OH)D], and body composition were analyzed. Lagunova noted that generally people with higher BMI had lower levels of Vitamin D. Age, season, and gender were also found to influence serum 1,25(OH)(2)D.
Vitamin D is not a true vitamin, but rather a vitamin-steroid thought to play a key role in the prevention of cancer, cardiovascular disease, diabetes, multiple sclerosis and other diseases. It is likely not coincidental that obesity is also a risk factor for many of these diseases. Vitamin D is vital to the regulation of calcium. Studies have shown that calcium deficiency increases the production of synthase, an enzyme that converts calories into fat. It has been shown that calcium deficiency can increase synthase production by up to 500 percent. Vitamin D has also been shown to play a role in the regulation of blood sugar levels; proper blood sugar regulation is vital to the maintenance of a healthy weight. Vitamin D is produced from sunlight and converted into various metabolites. It is stored in fat tissue. According to Lagunova, obese people may take in as much Vitamin D as other people; however, because it is stored in fat it may be less available. This may result in lower circulating levels of Vitamin D.
A previous study conducted by Shalamar Sibley, MD, MPH, an assistant professor of medicine at the University of Minnesota, showed that subjects who have higher levels of Vitamin D at the start of a weight loss diet lose more weight than those with lower levels. The study measured Vitamin D levels of 38 overweight men and women both before and after following an 11-week calorie-restricted diet. Vitamin D levels at the start of diet was an accurate predictor of weight loss…those with higher levels of Vitamin D lost more weight. It was found that for every nanogram increase in Vitamin D precursor, there was an 1/2 pound increase in weight loss.
Seventy-five percent or more of Americans, teenage and older, are Vitamin D deficient according to a recent study published in the Archives of Internal Medicine. According to the Gallup-Healthways Well-Being Index, 26.5% of American are obese. More research needs to be conducted into the exact role Vitamin D plays in obesity and weight loss and the possibility of increased Vitamin D consumption (through the form of supplementation and/or increased sun exposure) being a key factor to achieving a healthy weight.
If you want to wage battle against cholesterol and other lipids (fat) that can contribute to vascular disease, then make tomatoes a big part of your diet. Scientists say this popular fruit contains a nutrient that can fight vascular disease such as stroke and arteriosclerosis.
Tomatoes fight more than cholesterol and fat
Excessive levels of lipids, such as cholesterol and triglycerides in the bloodstream, a condition known as dyslipidemia, can lead to potentially deadly diseases such as arteriosclerosis, cirrhosis, and stroke. Scientists from Kyoto University and New Bio-industry Initiatives, Japan, report that a compound called 9-oxo-octadecadienoic extracted from tomatoes can boost oxidation of fatty acids and contribute to the regulation of lipid metabolism by the liver. These qualities indicate that 9-oxo-octadecadienoic acid can fight cholesterol and other lipids and therefore help prevent vascular diseases.
Vascular disease is a general term used to describe diseases that affect the blood vessels. The Vascular Disease Foundation offers information on nearly two dozen different conditions that fit this category, including abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, lymphedema, peripheral artery disease, and stroke.
Tomatoes are also valued for other health benefits. Much research has been dedicated to a potent antioxidant in tomatoes, lycopene, and its potential in the fight against various types of cancer, and especially prostate cancer. Tomatoes also contain excellent levels of other nutrients, including niacin, which helps lower cholesterol; and potassium, which reduces blood pressure and the risk of heart disease.
Dr. Teruo Kawada, who is from Kyoto University and who led the study, noted that “Finding a compound which helps the prevention of obesity-related chronic diseases in foodstuffs is a great advantage to tackling these diseases. It means that the tomato allows people to easily manage the onset of dyslipidemia through their daily diet.” To help the fight against cholesterol and other fats that contribute to vascular disease, enjoy more tomatoes.
Kim YI et al. Molecular Nutrition & Food Research doi:10.1002/mnfr.201000264
Women who eat more than three servings of fish per week are less likely to experience a stroke, a new study suggests. Specifically, fish-lovers in Sweden were 16 percent less likely to experience a stroke over a 10-year-period, relative to women who ate fish less than once a week. “Fish consumption in many countries, including the U.S., is far too low, and increased fish consumption would likely result in substantial benefits in the population,” said Dr. Dariush Mozaffarian of the Harvard School of Public Health. When choosing fish to eat, it’s best to opt for fish that are rich in omega-3 fatty acids, found most abundantly in fatty fish like salmon, mackerel and albacore tuna. “But any fish is better than none,” Mozaffarian noted.
“Indeed, these fatty acids likely underlie the benefits of fish on stroke risk”, said study author Dr. Susanna Larsson of the Karolinska Institute in Stockholm. “These fatty acids may reduce the risk of stroke by reducing blood pressure and blood (fat) concentrations.”
This is not the first study to suggest that people who eat more fish have a lower risk of stroke, and experts already recommend a fishy diet to reduce the risk of cardiovascular problems, Mozaffarian added. “This study supports current recommendations.” Earlier this year, for instance, a study showed that middle-aged and older men who eat fish every day are less likely than infrequent fish eaters to develop a suite of risk factors for heart disease, diabetes and stroke.
In the current study, published in the American Journal of Clinical Nutrition, Larsson and her colleagues looked at 34,670 women 49 to 83 years old. All were free of cardiovascular disease and cancer at the beginning of the study, in 1997. During 10 years of follow-up, 1,680 of the women (4 percent) had a stroke. Stroke caused by blockage of an artery that supplies blood to the brain — also known as a “cerebral infarction” or “ischemic stroke” — was the most common event, representing 78 percent of all strokes in the study. Other types of strokes were due to bleeding in the brain, or unspecified causes.
Women who ate more than three servings of fish per week had a 16 percent lower risk of stroke than women who ate less than one serving a week. “Not a small effect,” Mozaffarian said, noting that it was roughly equivalent to the effect of statin drugs on stroke risk. Furthermore, the researchers asked women about their diets only once, using a questionnaire, which might have caused errors that would underestimate the link between a fishy diet and stroke risk, he explained. “So, the true risk reduction may be larger.”
Interestingly, women appeared to benefit most from eating lean fish, when other research shows fatty fish is better for health. This finding may stem from the fact that most fatty fish, such as herring and salmon, is eaten salted in Sweden, Larsson explained. “A high intake of salt increases blood pressure and thus may increase the risk of stroke,” she said. “So the protective effects of fatty acids in fatty fish may be attenuated because of the salt.”
Indeed, when it comes to fish, not all have equal benefits, Mozaffarian noted – for instance, he said, research has not shown any cardiovascular benefits from eating fast food fish burgers or fish sticks. In addition, women of childbearing age should avoid certain types of fish known to carry relatively high levels of pollutants, such as shark and swordfish, Mozaffarian cautioned. “This is a very, very short list of fish to avoid or minimize — there are many, many other types of fish to consume,” he said. “Women at risk of stroke are generally beyond their child-bearing years, and so for these women, all types of fish can be consumed.”
Larsson and her team speculate that certain nutrients in fish, such as fatty acids and vitamin D, might explain its apparent benefits. The Swedish study cannot prove cause and effect for high fish consumption and lowered stroke risk, however. For instance, fish consumption could be a sign of a generally healthier lifestyle or some other mechanism at work. Last December, Larsson and colleagues published data from the same group of women in the journal Stroke showing that those who eat a lot of red meat may also be putting themselves at increased risk of stroke.
SOURCE: bit.ly/dKunk8 American Journal of Clinical Nutrition, online December 29, 2010.
The vitamin D levels of newborn babies appear to predict their risk of respiratory infections during infancy and the occurrence of wheezing during early childhood, but not the risk of developing asthma. Results of a study in the January 2011 issue of Pediatrics support the theory that widespread vitamin D deficiency contributes to risk of infections.
“Our data suggest that the association between vitamin D and wheezing, which can be a symptom of many respiratory diseases and not just asthma, is largely due to respiratory infections,” says Carlos Camargo, MD, DrPH, of the Massachusetts General Hospital (MGH), who led the study. “Acute respiratory infections are a major health problem in children. For example, bronchiolitis – a viral illness that affects small airway passages in the lungs – is the leading cause of hospitalization in U.S. infants.”
Although vitamin D is commonly associated with its role in developing and maintaining strong bones, recent evidence suggests that it is also critical to the immune system. Vitamin D is produced by the body in response to sunlight, and achieving adequate levels in winter can be challenging, especially in regions with significant seasonal variation in sunlight. Previous studies by Camargo's team found that children of women who took vitamin D supplements during pregnancy were less likely to develop wheezing during childhood. The current study was designed to examine the relationship between the actual blood levels of vitamin D of newborns and the risk of respiratory infection, wheezing and asthma.
The researchers analyzed data from the New Zealand Asthma and Allergy Cohort Study, which followed more than 1,000 children in the cities of Wellington and Christchurch. Midwives or study nurses gathered a range of measures, including samples of umbilical cord blood, from newborns whose mothers enrolled them in the study. The mothers subsequently answered questionnaires – which among other items asked about respiratory and other infectious diseases, the incidence of wheezing, and any diagnosis of asthma – 3 and 15 months later and then annually until the children were 5 years old. The cord blood samples were analyzed for levels of 25-hydroxyvitamin D (25OHD) – considered to be the best measure of vitamin D status.
Cord blood samples were available from 922 newborns in the study cohort, and more than 20 percent of them had 25OHD levels less than 25 nmol/L, which is considered very low. The average level of 44 nmol/L would still be considered deficient – some believe that the target level for most individuals should be as high as 100 nmol/L – and lower levels were more common among children born in winter, of lower socioeconomic status and with familial histories of asthma and smoking. By the age of 3 month, infants with 25OHD levels below 25 nmol/L were twice as like to have developed respiratory infections as those with levels of 75 nmol/L or higher.
Survey results covering the first five years of the participants' lives showed that, the lower the neonatal 25OHD level, the higher the cumulative risk of wheezing during that period. But no significant association was seen between 25OHD levels and a physician diagnosis of asthma at age 5 years. Some previous studies had suggested that particularly high levels of vitamin D might increase the risk for allergies, but no such association was seen among study participants with the highest 25OHD levels. Camargo notes that very few children in this study took supplements; their vitamin D status was determined primarily by exposure to sunlight.
An associate professor of Medicine at Harvard Medical School, Camargo notes that the study results do not mean that vitamin D levels are unimportant for people with asthma. “There's a likely difference here between what causes asthma and what causes existing asthma to get worse. Since respiratory infections are the most common cause of asthma exacerbations, vitamin D supplements may help to prevent those events, particularly during the fall and winter when vitamin D levels decline and exacerbations are more common. That idea needs to be tested in a randomized clinical trial, which we hope to do next year.”
Co-authors of the Pediatrics paper are Ravi Thadhani, MD, and Janice Espinola, MPH, from MGH; Tristram Ingham, MBChB, Kristin Wickens, PhD, and Julian Crane, FRACP, from University of Otaga, Wellington, New Zealand; Karen Silvers, PhD, Michael Epton, PhD, FRACP, and Philip Pattemore, MD, FRACP, from University of Otago, Christchurch, NZ; and Ian Town, DM, from University of Canterbury, Christchurch, NZ. The study was supported by grants from the Health Research Council of New Zealand, the David and Cassie Anderson Bequest and the MGH Center for D-receptor Activation Research.
Cystatin C, a blood marker of kidney function, proved significantly more accurate than the standard blood marker, creatinine, in predicting serious complications of kidney disease, in a study by researchers at the San Francisco VA Medical Center and the University of California, San Francisco. Among adults who were identified as having chronic kidney disease by high creatinine levels, the researchers found that only patients who also had abnormally high levels of cystatin C were at high risk for death, cardiovascular disease, heart failure, or kidney failure. People with high creatinine but normal cystatin C levels had risks similar to those with normal creatinine levels.
The researchers also found that a small but important segment of the study population was missed by creatinine but identified by cystatin C as being at significant risk of serious complications, according to lead author Carmen A. Peralta, MD, MAS, an SFVAMC researcher and an assistant professor of medicine in residence in the division of nephrology at UCSF.
The study of 11,909 participants appears online on December 16, 2010, in the JASN Express section of the Journal of the American Society of Nephrology. The authors analyzed patient data from two prospective studies: the Multi-Ethnic Study of Atherosclerosis and the Cardiovascular Health Study, both sponsored by the National Heart, Lung, and Blood Institute.
Principal investigator Michael G. Shlipak, MD, MPH, chief of general internal medicine at SFVAMC, said that the current study highlights a potential clinical use for cystatin C as a method for confirming a diagnosis of chronic kidney disease. Shlipak has been a leader among physicians in identifying cystatin C as an alternative, accurate, and reliable marker of kidney function.
Both cystatin C and creatinine are substances made in the body and filtered by the kidneys. High levels of the substances in the blood indicate that the kidneys are losing the ability to filter them, and thus are losing function. However, explained Peralta, creatinine is a byproduct made in muscles, so it is affected by what you eat and especially by how much muscle you have. Thus, a bodybuilder with healthy kidneys might have an elevated creatinine level because of high muscle mass, whereas a frail elderly person might have normal or even low levels of creatinine, but in fact this persons kidneys are not working well – its just that theres not much creatinine because theres not much muscle.
In contrast, cystatin C is a protein made in cells throughout the body. In studies so far, it does not seem to be that affected by age or muscle mass or diet, said Shlipak, who is also a professor in residence of medicine and epidemiology and biostatistics at UCSF.
Shlipak proposes that cystatin C, which can cost as little as $17 per test, be added as a method for confirming or staging chronic kidney disease in guidelines that are currently being formulated by nephrologists. Its vital that we have an accurate diagnostic test, because kidney disease does not show symptoms until its too late, when your kidneys have almost failed completely, he said. Being missed by creatinine is an important limitation in our current method of diagnosing kidney disease, said Peralta. Yet, she adds, being falsely identified with kidney disease through inaccurate test results can be disastrous as well. There is fear and psychological stress, particularly in communities of color, where people have a lot of friends and family members who are on dialysis, she noted. You can also be subjected to unnecessary and expensive tests and medications.