Dietary adherence in Hispanic patients receiving hemodialysis.

OBJECTIVES: The study objective was to identify the factors that influence dietary adherence in Hispanic patients receiving maintenance hemodialysis and to determine the differences in dietary adherence between Hispanic and non-Hispanic patients. DESIGN: We performed a cross-sectional study using a descriptive-comparative design. SETTING: The study took place at hemodialysis centers at Winthrop-University Hospital, New York. PARTICIPANTS: The participants were adult patients of Hispanic descent receiving maintenance hemodialysis three times per week for 3 months or more and an equal number of age- and sex-matched non-Hispanic patients. INTERVENTION: Information was obtained by a questionnaire about knowledge of the diet, preferred language for education, consumption of potassium- (K(+)) and phosphorus- (PO(4)) containing foods, and adherence attitudes and behaviors. Serum albumin (SAlb), K(+), and PO(4) for the past 3 months were obtained from medical records and evaluated to assess dietary adherence. MAIN OUTCOME MEASURE: The main outcome measure was a mean SAlb of 3.2g/dL or greater, K(+) of 5.5 mEq/L or less, and PO(4) of 5.5 mg/dL or less. RESULTS: A total of 17 Hispanic and 17 comparison patients were included. Both groups were adherent to the diet because their mean levels of SAlb, K(+), and PO(4) were within acceptable limits. Dietary adherence was observed in 76% of the Hispanic patients for SAlb, 88% for K(+), and 65% for PO(4), whereas the rate of adherence was 59%, 88%, and 76%, respectively, for the comparison group. CONCLUSION: Both groups were adherent to the restrictions of the renal diet. More patients from both groups were adherent to K(+) than to PO(4) restrictions. Among the factors that probably influenced dietary adherence to the renal diet in this dialysis facility are knowledge of the renal diet, language, food frequency consumption, socioeconomic status, family support, and attitudes toward the renal diet. Patient education provided in Spanish with family involvement is an important element for promoting adherence among Hispanic patients receiving dialysis.

Food selections of Roux-en-Y gastric bypass patients up to 2.5 years postsurgery.

Bariatric surgery forces participants to undergo a volatile dietary adjustment. The purpose of this cross-sectional research was to chronicle food selection during the period from when solid food is reintroduced through 2.5 years. Forty-eight postsurgery Roux-en-Y gastric bypass patients participated in the research. Each food item selection was recorded from a list of foods that consisted of 236 individual foods. Food item selection was then categorized into one of nine conventional US Department of Agriculture-based food-groupings (eg, Dairy). No food selection differences were detected between the men and women in the study. Mean weight loss since surgery was 53.6+/-20.6 kg. Mean time since surgery was 11.1+/-7.0 months for the 35 female and 13 male patients. The food selection categories ranged from 63.2% for Condiments to 28.3% for Sweets. Next, food selections were reclassified into 31 more specific bariatric subgroups (eg, Cheeses, Milks, Yogurts). Bariatric subgroup intake ranged from 84.2% for Bottled/Tap Water to 4% for Sugared Beverages. Several group homogeneity differences existed between conventional and bariatric subgroups. Subgroup means were statistically different for the conventional categories of Dairy, Sweets, and Beverages (P>0.05). These differences demonstrate that the standard benchmarks of conventional food groupings sometimes fail to represent accurately food selection in this population. This type of more specific classification information improves eating recommendations provided by dietetics practitioners. Just as exchange food groups are of great value to patients with diabetes, these more specific bariatric food subgroups represent a needed increase in accuracy in dietary recommendations for patients after Roux-en-Y gastric bypass.

Prevalent use of dietary supplements among people who exercise at a commercial gym.

Supplement use was surveyed in a convenience sample of persons who exercised regularly at a Long Island, NY gym. Participants, age at least 18 y, completed anonymous questionnaires. A majority (84.7 %) took supplements. Many consumed multivitamin/minerals (MVM; 45 %), protein shakes/bars (PRO; 42.3 %), vitamin C (34.7 %), and vitamin E (VE; 23.4 %) at least 5 times per wk. Other dietary supplements were used less frequently or by fewer participants. Ephedra was consumed by 28 % at least once per wk. Choices and reasons for dietary supplement use varied with age of the participant. More of the oldest consumed MVM or VE, while those 45 y or younger chose PRO. Those younger than 30 consumed creatine more frequently. The oldest participants took supplements to prevent future illness, while others took supplements to build muscle. The reason for committing to an exercise program influenced supplement use. Bodybuilders more frequently consumed PRO, creatine, and ephedra compared to those exercising for health reasons.