A Prospective Study on Nutritional Status and Nutrient Intake of Hemodialysis Patients Based on Coexistence of Diabetes

It is well known that malnutrition is a predictor of mortality in hemodialysis patients. The number of diabetic nephropathy patients is increasing rapidly. This study aimed to investigate nutritional status and nutrient intake according to the presence of diabetes among hemodialysis patients. The nutritional intake and general characteristics of outpatients at Ajou University Hospital (24 with diabetes and 30 without diabetes) were investigated between July and September 2015. Patients' general data were collected, and nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) was evaluated. Nutrient intakes were assessed according to 3-day food records. There was no significant difference regarding body weight between the two groups. However, the non-diabetic group showed a better nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) (5.2±4.4 vs. 8.0±4.3 score, non-diabetics vs. diabetics, P<0.05). There was no difference in daily calorie intake (1,473.9±370.5 vs. 1,503.8±397.5 kcal) and protein intake (60.3±19.7 vs. 65.6±20.5 g) in those with diabetes. Intakes of vegetables protein, sodium, potassium, vitamin C, folic acid and fiber were significantly higher in the diabetic group compared to those of the non-diabetic group. There was no difference in daily nutrient intake between the hemodialysis weekday and weekend groups. The non-diabetic group had higher calorie and sodium intakes per meal in the hemodialysis weekday group, but the difference was not significant. Based on these results, intervention should be performed to improve nutritional status in consideration of diabetes and dietary patterns.

Listas de alimentos relacionadas ao consumo alimentar de um grupo de idosos: análises e perspectivas / Food lists from the diet of a group of elderly individuals: analysis and perspectives

INTRODUÇÃO: A despeito do aumento expressivo da população idosa nos últimos anos, são escassos os estudos brasileiros relacionados ao consumo alimentar desses indivíduos. OBJETIVOS: Propor uma lista de alimentos mais consumidos por idosos residentes na Zona Leste de São Paulo e analisar os alimentos que contribuem para o consumo de nutrientes relevantes ao estado nutricional e, consequentemente, à saúde dos idosos. MÉTODOS: Foram avaliados 100 indivíduos acima de 60 anos, frequentadores de um centro de referência. Para caracterização do estado nutricional foi calculado o Índice de Massa Corporal (IMC). Para elaboração das listas de alimentos foram aplicados dois recordatórios alimentares de 24 horas (RA24h) em duas estações diferentes do ano, que foram analisados quanto à frequência de consumo de cada alimento e quanto à contribuição percentual de energia, macronutrientes, fibras, cálcio e vitamina D. RESULTADOS: Com relação ao estado nutricional, 52 por cento apresentaram o IMC < 28 kg/m²; 15 por cento entre 28 e 30 kg/m²; 26 por cento entre 30 e 35 kg/m² e 7 por cento com IMC > 35 kg/m². O aspecto positivo da dieta foi a preservação de hábitos saudáveis como o consumo de arroz e feijão, e também de vegetais verde-escuros. Como aspecto negativo observou-se que a dieta dos idosos é monótona, pois poucos alimentos contribuem para o consumo de vários nutrientes. Além disso, houve um elevado consumo de carboidratos refinados em detrimento do consumo de alimentos integrais. CONCLUSÕES: As listas de alimentos obtidas, além de permitirem a reflexão sobre intervenções educativas, permitem o desenvolvimento subsequente de um Questionário de Frequência Alimentar específico para esse grupo.

Relative validities of 3-day food records and the food frequency questionnaire

The food frequency questionnaire (FFQ) has been used as an important dietary assessment tool in epidemiologic studies, but the usefulness of the FFQ has been debated in recent years. This study was performed to evaluate the relative validities of 3-day food records and the semi-quantitative FFQ. A total of 124 subjects finished 3-day food records (FRs) during each of the four seasons, as well as the FFQ from December 2002 to May 2004. The FFQ was a food based semi-quantitative FFQ including 103 items. Three-day FRs from each season and a randomly selected season were compared with the remaining 9-day FRs. The remaining 9-day FRs, as a reference measurement, were also compared with the FFQ. Pearson's correlation coefficients between the 3-day FRs and the 9-day FRs were between 0.14 and 0.56. Pearson's correlation coefficients between the FFQ and the 9-day FRs ranged between 0.07 and 0.41. Average proportions of classification into the same quartiles, adjacent quartiles, and distant quartiles between the 3-day FRs and the 9-day FRs were 35.8%, 40.5%, and 5.2%, respectively. On average, the proportions of classification into the same quartiles, adjacent quartiles, and distant quartiles between the FFQ and the 9-day FRs were 31.1%, 39.4%, and 6.9%, respectively. Three-day FRs showed higher correlations and higher agreement proportions of quartile classification with the 9-day FRs than did the FFQ, but both relative validities of 3-day FRs and the FFQ appear to be acceptable as dietary assessment tools. Further studies for validating food intake by reliable biomarkers are necessary.

Assessment of energy and macronutrient intake in young men: a comparison of 4-day food record and 24-hour dietary recall

OBJECTIVE: The objective was to assess the quantitative agreement between a 4-day food record and a 24-hour dietary recall in young men. METHODS: Thirty-four healthy men aged 18-25 years had their food intake estimated by 4-day food record within one week following 24-hour dietary recall in a cross-sectional study. Resting metabolic rate was assessed by indirect calorimetry and Energy Expenditure was estimated by physical activity records completed simultaneously with food intake records. The validity of food records was determined by direct comparison of Energy Intake and Energy Expenditure (95 percent confidence interval for Energy Intake/Energy Expenditure). RESULTS: There were good agreements between the measurements of energy and macronutrient intakes by 24-hour dietary recall and 4-day food record at the group level, but not at the individual level. Compared to energy expenditure, about 20 percent and 9 percent of participants underreported their Energy Intake by 4-day food record and 24-hour dietary recall, respectively. Over 30 percent of underreporters of Energy Intake estimated by 24-hour dietary recall underreported Energy Intake estimated by 4-day food record. CONCLUSION: Both diet methods, 24-hour dietary recall and 4-day food record, may be used to collect data at the group level, but not at the individual level. Both methods, however, appear to underestimate Energy Intake. Underreporting may be subject-specific and appears that is more difficult to retrieve valid dietary data from some people than others.

OBJETIVO: Medir a concordância qualitativa entre registros alimentares, obtidos durante 4 dias, e recordatório alimentar de 24 horas em homens jovens. MÉTODOS: Em um estudo com delineamento transversal, o consumo alimentar de 34 homens saudáveis com idades entre 18 e 25 anos foi medido por meio do recordatório alimentar de 24 horas e uma semana depois, por meio de 4 dias de registros alimentares. O gasto energético em repouso foi medido por calorimetria indireta e o gasto energético total foi medido por meio de registros de atividade física. A validade dos registros alimentares foi determinada por comparação direta do consumo energético com o gasto energético total (intervalo de confiança de 95 por cento para consumo energético/gasto energético total). RESULTADOS: A concordância entre medidas de consumo energético e de consumo de macronutrientes, obtida por meio de registros alimentares de 4 dias e por recordatório de 24 horas, foi boa para grupos, mas não para indivíduos. Comparado com o gasto energético total, um baixo consumo energético foi observado em 20 por cento e em 9 por cento dos participantes, quando o consumo alimentar foi obtido por meio de registros alimentares de 4 dias e por recordatório de 24 horas, respectivamente. Mais de 30 por cento dos participantes que tiveram baixo consumo energético, obtido com a utilização de recordatório de 24 horas, também tiveram baixo consumo energético a partir do exame dos registros alimentares de 4 dias. CONCLUSÃO: O recordatório de 24 horas é uma opção para registros alimentares de 4 dias na coleta de dados para grupos, mas não para indivíduos. Entretanto, baixo consumo alimentar, em alguns participantes, foi observado quando ambos os métodos foram utilizados na coleta de dados de consumo alimentar. É possível que a determinação de baixo consumo alimentar em alguns participantes seja específica do participante, sugerindo que pode ser mais difícil obter dados precisos de umas pessoas do...