Elderly patients on hemodialysis have worse dietary quality and higher consumption of ultraprocessed food than elderly without chronic kidney disease

摘要

Abstract Objectives The multiple dietary restrictions recommended to patients on hemodialysis (HD), coupled with conditions imposed by aging, may lead to poor dietary quality in these patients. The aim of this study was to investigate the dietary quality and consumption of ultraprocessed food by elderly patients on HD and those without chronic kidney disease (CKD). Additionally, diets on the day of dialysis and on nondialysis days were evaluated. Methods This was a cross-sectional study conducted with 153 noninstitutionalized elderly patients on HD (Elder-HD) and 47 non-CKD elderly (Elder-Healthy) aged ≥60?y. From a 3-d food record, the dietary quality was assessed using the Brazilian Healthy Eating Index Revised (BHEI-R) and the energy contribution of food-processing groups. Results Compared with the Elder-Healthy group, the Elder-HD group showed a lower total BHEI-R score ( P ??0.05). On the weekdays, the Elder-HD group showed lower scores ( P ??0.05) of whole fruit, dark green vegetables and legumes, meat, eggs, and legumes, whereas total cereals showed a higher score ( P ??0.05). When furthering the analysis on the Elder-HD group, although the total BHEI-R score did not differ among the days assessed, the components whole fruit, dark green vegetables, and legumes had lower scores ( P ??0.05) on the day of dialysis, and the opposite was observed for milk and dairy products. Moreover, the Elder-HD showed a higher ( P ??0.05) contribution of processed and ultraprocessed foods and lower ( P ??0.05) contribution of natural or minimally processed foods. Conclusion The Elder-HD group showed poorer dietary quality and higher consumption of processed and ultraprocessed foods than the Elder-Healthy group. Moreover, when compared with the nondialysis day, these patients exhibited worse dietary quality, on the day of dialysis. Highlights ? Elderly individuals on hemodialysis have worse dietary intake and higher consumption of ultraprocessed food that non-CKD elderly individuals. ? By futhering the analysis in the group comprised by elderly under chronic hemodialysis, the components whole fruit, dark green vegetables, and legumes had lower scores on the day of dialysis than in the non-dialysis days. ? On the dialysis days, a smaller proportion of patients reached the score minimum of the component of whole fruit from the Brazilian healthy eating index, suggesting a lower consumption of fruits on the dialysis day.