Dietary intake in hemodialysis patients does not reflect a heart healthy diet

Abstract

Objective: Cardiovascular disease is highly prevalent and has a major effect on morbidity and mortality in patients undergoing maintenance hemodialysis (MHD). Dietary factors that may contribute to cardiovascular disease have not been well studied in this population. We hypothesize that dietary intake in this population does not meet the guidelines for cardiovascular risk reduction.

Design: A cross-sectional study was completed using the validated "Block Dialysis 1 Food Frequency Questionnaire" to assess dietary intake of MHD patients.

Setting and patients: A total of 70 patients undergoing MHD at our outpatient dialysis center completed the questionnaire under the supervision of a trained dietitian. The population consisted of 38 men and 32 women.

Main outcome measure: Dietary intake was the main outcome measure, with a focus on calories, soluble fiber, saturated fatty acid (SFA), unsaturated fatty acid intake (UFA), and protein.

Results: The mean fiber intake was 10.77 (±5.87) g/day, and only 2 of 71 (2.9%) were in compliance with the recommended daily intake of >25 g/day. As percentage of total calories, of the 70 patients, 5 (7.1%) had a fat intake of <30%, 22 (31.4%) had SFA intake of <10%, 64 (91.4%) had a UFA of ≤30%, 22 (31.4%) had a protein-based diet of ≥15%, and 66 (94.3%) had a carbohydrate diet of <60%.

Conclusions: Most patients did not meet the dietary guidelines for reducing the risk of cardiovascular disease. Substituting UFA or soluble fiber for SFA improves low density lipoprotein (LDL) cholesterol levels without negative effects on other lipid parameters.