Dietary Patterns and Physical Activity in Relation to Renal and Metabolic Outcomes among Older Adults with Type 2 Diabetes and Chronic Kidney Disease: A Systematic Review

Lifestyle modification is increasingly recognized as a critical component in the management of chronic kidney disease (CKD), particularly among elderly individuals with Type II diabetes, a population at high risk for disease progression and comorbidities. While pharmacological treatment remains central, growing evidence supports the role of healthy diet and physical activity in improving renal outcomes and overall health. However, the extent and consistency of these effects remain unclear, particularly in older diabetic populations. Therefore, this systematic review aims to investigate the effects of healthy diet and physical activity interventions on the management of chronic kidney disease among diabetic elderly. A comprehensive search was conducted across PubMed, EMBASE, Scopus, Web of Science and Cochrane databases, 30 eligible articles were included in the final analysis. Results show that healthier dietary patterns—particularly Mediterranean, plant-based, low-sodium, and moderated-protein approaches—were associated with improved renal and metabolic outcomes. Sodium restriction consistently reduced blood pressure and albuminuria, while protein moderation showed potential benefits with attention to malnutrition risk. Exercise interventions improved glycemic control, blood pressure, and functional capacity, with possible indirect renal benefits. Evidence for antioxidant supplementation and very low-carbohydrate diets remains preliminary. In conclusion, healthy diet and physical activity offer meaningful benefits in the management of CKD among Type II diabetic elderly populations, particularly in preserving renal function and improving metabolic parameters. These findings support the integration of lifestyle-based interventions into standard care frameworks. Further large-scale and long-term studies are needed to confirm these benefits and develop tailored intervention models for this vulnerable group.