Most consumed processed foods by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio

Watanabe, Marcela Tatiana; Araujo, Raphael M.; Vogt, Barbara; Barretti, Pasqual; Júnior, João Garcia Caramori

doi:10.1016/j.clnesp.2016.05.001

Cited by 33 publications

(25 citation statements)

References 19 publications

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“…Thus, the higher the consumption of foods rich in protein, the higher the serum urea. Another study that examined the phosphorus and protein content of the processed foods most consumed by HD individuals noted that the amount of protein consumed in these foods was greater than in the fresh food, due to the presence of food additives rich in nitrogen, such as nitrites and nitrates [4]. Our results suggest that the consumption of these foods can interfere with uremic control of HD individuals, which is crucial for life quality and retarding morbidity and mortality in these patients.…”

Section: Discussionmentioning

confidence: 65%

“…However, the nutritional transition has led to a reduction of the regular consumption of food rich in fiber, vitamins and minerals in contrast to the increased consumption of processed and ultra-processed food with high levels of saturated and trans fat, sugar and sodium [3]. These foods are also added to this inorganic phosphorus, which is more easily absorbed, increasing serum concentrations of this mineral in the bloodstream [4]. In addition, the nutritional composition of these could negatively modulate the lipid metabolism and other complications already prevalent in individuals with CKD Stage-5 [5].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…When we analyzed the eating habits, 25% of participants ate out three times or more per week instead of eating home‐cooked foods. Watanabe et al chemically analyzed the phosphorus and protein contents of both processed and fresh foods and revealed that the majority of processed foods contained phosphorus‐containing additives. Thus, patients who eat out are more frequently exposed to processed food and tend to show a higher consumption of non‐protein sources of phosphorus.…”

Section: Discussionmentioning

confidence: 99%

Daily dietary phosphorus intake variability and hemodialysis patient adherence to phosphate binder therapy

Tao

Hai-fen

Yang

et al. 2019

Hemodialysis International

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Introduction: Phosphate balance could be reached only by an optimized combination of dietary restriction and the careful use of phosphate binders for patients receiving standard hemodialysis treatment. Little is known about individual variability of phosphorus intake and phosphate binder use in hemodialysis patients. The purposes of this study were to quantify phosphorus intake and to describe individual phosphate‐binder use in hemodialysis patients. Methods: This was a cross‐sectional study. The dietary phosphorus intake was assessed using a 3‐day duplicate portion sampling method combined with chemical analysis. Patients' adherence to phosphate binders was evaluated by the Morisky Medication Adherence Scale, with a score of <6 being considered as an indicator of inadequate adherence. Findings: A total of 101 food samples from 36 patients were collected and analyzed. The mean daily phosphorus, protein, and energy intake was 15.1 mg/kg/d, 1.0 g/kg/d, and 28.9 kcal/kg/d, respectively. There was a higher consumption of phosphorus on dialysis days (DDs) than on non‐dialysis days (NDDs) (16.2 mg/kg/d vs. 14.0 mg/kg/d, P = 0.035); however, such a trend was not observed for dietary protein and energy intake (1.1 g/kg/d vs. 1.0 g/kg/d, P = 0.706; 30.3 kcal/kg/d vs. 27.6 kcal/kg/d, P = 0.225). A significantly higher percentage of patients on low phosphorus intake (<1000 mg/d) reported inadequate phosphate‐binding adherence than those on high phosphorus intake (60% vs. 18%, P = 0.031). Discussion: Patients receiving hemodialysis had a higher consumption of phosphorus on DDs than on NDDs; such a pattern was not obviously observed for protein and energy intake. For patients achieving phosphorus intake recommendation, medication nonadherence that possibly being attributed to the patient's necessity beliefs may pose extra hurdles for phosphate control.

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“…Despite these mentioned benefits, recently phosphate salts have begun to cause a negative impact due to their potential health risks (Itkonen et al, 2017;Watanabe, Araujo, Vogt, Barretti, & Caramori, 2016). From this viewpoint, an important strategy to eliminate the risks arise from phosphates in meat products is to find healthier ingredients that could compensate for the lack of them.…”

Section: Introductionmentioning

confidence: 99%

Powder/gelled inulin and sodium carbonate as novel phosphate replacers in restructured chicken steaks

Öztürk‐Kerimoğlu

Serdaroğlu

2019

J Food Process Preserv

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This study was performed to evaluate the characteristics of restructured chicken steaks with inulin and/or sodium carbonate as inorganic phosphate replacers. Six different treatments were formulated with 0.5% STPP (P), 0.2% sodium carbonate (C), 4.5% powder/gelled inulin (I, GI), and 4.5% powder/gelled inulin + 0.2% sodium carbonate (IC, GIC). P and C treatments had higher moisture content compared to I, GI, and GIC treatments. The samples containing inulin had lower total salt and sodium content compared to P and C samples. Incorporation of inulin and carbonate together was noted to increase protein solubility and provide equivalent pH and sensory characteristics to P samples. Use of gelled inulin decreased expressible moisture and improved juiciness. During frozen storage, inulin samples had similar oxidative and microbiological changes to phosphate samples, regardless of carbonate and/or inulin form. Consequently, utilization of inulin and sodium carbonate could compensate for the multi‐functional effects of phosphates in restructured poultry products. Practical applications In the last decades, there has been a rising demand to ready‐to‐eat poultry products depending on the progress in production techniques, the change in consumer behaviors, and modernization of everyday life. On the other hand, consumers have become more and more conscious about the foodstuff they eat, thus the tendency toward healthier, natural, and additive‐free meat products has been continuously increasing. Although phosphates are one of the widely used synthetic additives in meat product formulations, recently they have caused a negative impact due to their potential health risks. With this regard, phosphates are mentioned to be decreased or replaced in the content of reformulation strategies in meat products. Utilization of clean‐label ingredients is a growing trend representing one of the novel strategies for the development of healthier and additive‐free meat product formulations. Incorporation of inulin and sodium carbonate in phosphate‐free meat products could be an interesting approach for designing healthier formulations since they have a good potential to compensate for the multifunctional impacts of phosphates as clean‐label ingredients.

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Most consumed processed foods by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio

Cited by 33 publications

References 19 publications

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

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

Daily dietary phosphorus intake variability and hemodialysis patient adherence to phosphate binder therapy

Powder/gelled inulin and sodium carbonate as novel phosphate replacers in restructured chicken steaks

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