BOWDEN K1, GRAY N1,2,3, SWANEPOEL L1, WRIGHT H1,3
1School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, Australia, 2Department of Nephrology, Sunshine Coast Hospital and Health Service, Birtinya, Australia, 3Sunshine Coast Health Institute, Birtinya, Australia
Background. People with chronic kidney disease (CKD) often present with one or more comorbidities. Diet quality is a known non-pharmacological strategy to slow CKD progression and improve management of underlying comorbidities.
Aim. This study aimed to describe diet quality and adherence to healthful dietary patterns in 99 people, aged 73.2±10.5 years with non-dialysis dependent CKD (NDD-CKD, stage 3-5).
Methods. This mixed-method sequential explanatory study assessed diet quality using a priori dietary index scores, the revised Dietary Guidelines Index (DGI-2013) and Mediterranean lifestyle (MEDLIFE) index. Dietary intake was assessed using a self-reported semi-quantifiable food frequency questionnaire. Adherence was stratified using quartiles as cut-offs for each dietary index score. Semi-structured qualitative telephone interviews were conducted to explore factors influencing adherence.
Results. Most participants (67.7%) presented with two or more comorbidities, 32.6% were overweight, and 50.0% obese. Moderate adherence to a Mediterranean diet (89.7%) and the Australian Dietary Guidelines (81.5%) was concluded. Average DGI-2013 score was 87.4±12.9 (n=92) and MEDLIFE index score was 11.3±3.3 (n=97). Legume intake was protective to advanced CKD (stage 4/5) in adjusted models (OR:0.69, CI 0.47-0.97, p=0.04). Food choice was influenced by what is believed to be good for health (68.0%), what is believed to manage kidney disease (50.5%), food availability (36.2%) and healthcare provider advice (29.2%). Interview participants (n=15) felt that adherence was influenced by the six major determinants of food choice, including biological, social and physical factors. Lack of awareness between diet and CKD and desire for support was highlighted as an important factor influencing adherence.
Conclusion. Moderate adherence to healthful dietary patterns and resounding desire for dietary support highlights the need for dietetic services in this group of people with NDD-CKD.
Katelyn Bowden is an Accredited Practising Dietitian and graduated from the University of the Sunshine Coast in 2021 with a Bachelor of Dietetics and first-class honours. She published one manuscript in the Journal of Nutritional Sciences (IF: 3.35) and has submitted another from her honours study findings. She is passionate about sports nutrition and drivers of eating behaviour.