Poster Topical Area: Medical Nutrition
Location: Hall D
Poster Board Number: 639
Objective: To modify the hemodialysis eating index (m-HDEI) aligning with the Healthy Eating Index released by the US Department of Agriculture (USDA); and to investigate the associations of the m-HDEI with cardiovascular disease (CVD) risks in hemodialysis (HD) patients.
Methods: In the clinical cross-sectional study, we recruited 492 HD patients, aged ≥ 20 years, from 7 hospital-based dialysis centers in Taiwan, between 2013-2017. Dietitians assessed dietary intake using the 3-day dietary records. Traditional and non-traditional CVD risks were evaluated using patient chart reviews, and laboratory examinations. The m-HDEI scoring criteria was calculated from the diet quantity and quality recommended per energy requirement level, found in the Daily Food Guide in Taiwan, and the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines. We used regression models to examine the associations and conducted subgroup analysis for age and history of CVD.
Results: Out of sample, 61.8% patients aged < 65 years, 56.3% men, 66.1% without CVDs. The m-HDEI consisted of 5 diet quantity items (fruit, vegetable, grains, high protein food (HPF), oil), and 3 diet quality items (high biological value protein (HBV), fish, processed red meat). The score of components ranged from minimum of 0 to maximum of 10, 15 or 20, and m-HDEI score ranged from 0 to 100. Higher fruit score associated with reduced high SBP, and hypoalbuminemia; higher grain score associated with lower high LDL-C; higher oil score linked to lower hyperkalemia in patients without CVD. Higher vegetable score associated with lower hyperhomocysteinemia, inflammation in patients < 65 years old. Higher HPF score associated with lower hypercalcemia in patients < 65 years old; with lower hypophosphate and inflammation in both subgroups. Higher HBV score associated with lower low HDL-C in patients < 65 years old; with lower high intact parathyroid hormone (iPTH) in both subgroups. Higher seafood/fish score linked to lower prevalence of high LDL-C; higher score of (or less consumed) processed meat associated with reduced high DBP in both subgroups<./p>
Conclusions: The m-HDEI is valid and reliable. Dietary intake mainly associated with CVD risks in patients aged < 65 years, and without CVD. Early nutritional interventions might contribute to prevent CVD in HD patients.
Funding Source: The research was supported by Ministry of Science and Technology in Taiwan (NSC 102-2320-B-038-026, MOST 105-2320-B-038-033-MY3). The funder had no role in the decision to collect data, data analysis, or reporting of the results. The authors declare no competing financial interests.
Van Tuyen Duong
Postdotoral Research Fellow
Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)