Processed and ultra-processed food consumption are related to metabolic markers in hemodialysis subjects

Abstract

Objective To investigate the consumption of processed and ultra-processed foods and evaluate its relationship with the nutritional and metabolic status of hemodialysis patients in a single center in Brazil. Methods This cross-sectional study enrolled 73 individuals in hemodialysis (50 men and 23 women, 21-87 years-old). Clinical and lifestyle variables were assessed by a semi-structured questionnaire and dietary data by food frequency questionnaire. Anthropometric and metabolic data are collected from medical records. Results Processed and ultra-processed foods represented 11.0% of daily caloric intake, 53.0% of trans fatty acid, and 12.5% of salt consumed in the study sample. Individuals who had high intake of this food group (≥128.4g/day, median intake) had higher serum phosphorus and pre-dialysis urea values (p=0.038; p=0.013, respectively). Also, individual with higher consumption of processed meat, sausages and ready prepared food had higher pre-dialysis serum urea (p=0.021), while serum potassium was higher among the subjects who consumed more sauces and salt-based seasonings (p=0.002). Conclusion Higher consumption of processed and ultra-processed foods was associated with important biomarkers of metabolic control for hemodialysis subjects, probably due to non-health dietary composition. Nutritional guidelines and intervention strategies must be promoted to reduce consumption of these food-group in thisspecific population.

Relative validity and reproducibility of food frequency questionnaire for individuals on hemodialysis (NUGE‐HD study)

“…As strengths of our study, we highlight the originality of our FFQ‐HD, which can have great epidemiological utility to assess specific foods and/or dietary and nutritional patterns in the clinical outcomes of Brazilians on HD. In addition, our instrument did not overestimate the reference method (as most studies have shown), 27–29,47 possibly due to factors related to dialysis treatment and to CKD itself, such as lack of appetite for uremia 11,48 . Moreover, the use of various appropriate and robust statistical tests, including correlation coefficients, tertile classification, and Bland–Altman plots, increases the accuracy of our validation.…”

“…Recently, our research group reported the FFQ-HD was useful to capture the intake of restrictive nutrients such as potassium and phosphorus, preventing poor prognosis outcomes. 11 Another useful application of the FFQ-HD would be to assess the protein intake, macronutrient with low consumption of proteins among HD subjects. In this sense, FFQ-HD may detect the inefficient intake of essential food sources for the maintenance of lean mass and prevention of sarcopenia.…”

“…In addition, our instrument did not overestimate the reference method (as most studies have shown), [27][28][29]47 possibly due to factors related to dialysis treatment and to CKD itself, such as lack of appetite for uremia. 11,48 Moreover, the use of various appropriate and robust statistical tests, including correlation coefficients, tertile classification, and Bland-Altman plots, increases the accuracy of our validation. Sample size is also adequate and sufficient to perform the type of study.…”

“…3,8,9 In this context, the 24-h food recall (24hR) and the food record are tools that can be used to assess current and individual intake; however the wide; within-subject variability of these individuals implies the need for several days of application of these methods, making them unviable for epidemiological studies. 10 In turn, food frequency questionnaires (FFQ) assess intake over time (usual) and allow the establishment of associations between nutrients and clinical outcomes, being a more useful tool among HD subjects who suffer from chronic diseases 6,10,11 However, an FFQ to assess the usual food intake of Brazilian individuals on HD has not been reported, and researches with relative validation and reproducibility in HD are scarce in the literature. Thus, the aim of the study was to evaluate the relative validity and reproducibility of a specific FFQ for HD individuals (FFQ-HD).…”

Bioimpedanciometria em avaliações nutricionais e de hidratação em um único centro de diálise

“…Status socioeconômico, desemprego e menor educação formal também contribuem para a não adesão às orientações alimentares 26,27 . Os alimentos ultraprocessados, ricos em sal e aditivos representam uma parcela significativa da ingestão diária dos pacientes 28 . Embora não tenhamos realizado um questionário socioeconômico, reconhecemos que a maioria dos pacientes em nossa unidade tem baixa renda, baixa escolaridade, depende do sistema público de saúde e recebe benefícios da previdência social.…”