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Abstract: TH-PO804

Effectiveness of Short-Term, Home-Delivered, Low Sodium Meals to Sustain Long-Term Changes in Dietary Behavior in Hemodialysis Patient

Session Information

Category: Health Maintenance‚ Nutrition‚ and Metabolism

  • 1400 Health Maintenance‚ Nutrition‚ and Metabolism

Authors

  • Kwan, Shu H., University of Illinois Urbana-Champaign College of Agricultural Consumer and Environmental Sciences, Urbana, Illinois, United States
  • King, Alexis, University of Illinois Urbana-Champaign, Urbana, Illinois, United States
  • Fang, Hsin-Yu, University of Illinois Urbana-Champaign, Urbana, Illinois, United States
  • Wilund, Kenneth Robert, University of Illinois Urbana-Champaign, Urbana, Illinois, United States
Background

Reducing dietary sodium intake (SI) in hemodialysis (HD) patients can reduce volume overload and risk of cardiovascular complications. However, previous studies indicated that dietary education alone is ineffective in reducing SI in HD patients. A 4-week-study in our lab found that short-term low-sodium home-delivered meals provision could reduce SI, interdialytic weight gain (IDWG), and blood pressure (BP) of HD patients. However, it is not known if changes from short-term meal feeding can be sustained long-term. The purpose of this study is to determine if short-term feeding of low-sodium meals can “prime” changes in long-term dietary behavior and lead to sustained reductions in IDWG and BP in HD patients.

Methods

To date, we have recruited 11 subjects (61+11 years, BMI 35.6+11.9 kg/m^2) from a HD clinic in central IL. Subjects were randomized into a control (CON) or intervention group (INT). CON subjects received standard care for the first 5 months, followed by 2 months of low-sodium meals (2 meals/day in Month 6 and 1 meal/day in Month 7) and dietary education. INT subjects received low-sodium meals (2 meals/day in Month 1 and 1 meal/day in Month 2) and dietary education for the first 2 months, followed by 3-month continued dietary education. We collected monthly IDWG, BP, and 3 days of dietary recalls at baseline (0M), 1 month (1M), 2 month (2M), and 5 month (5M).

Results

SI, IDWG, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were significantly reduced after 1 month of low-sodium meal feeding (p < 0.05), but these changes were not sustained long-term (Table). SI, IDWG, and DBP increased starting 2M.

Conclusion

Short-term low-sodium home-meal delivery can reduce SI, IDWG, and BP in HD patients. However, these changes are not sustained after patients’ resumption of meal responsibility. This suggests that extended meal feeding and/or more intensive low-sodium counseling strategies may be needed to sustain long-term behavior change.

Changes in Outcomes
Variable0M (Baseline)1M2 M5MP-value
 CONINTCONINTCONINTCONINT 
Dietary sodium, mg2663 ± 21482338 ± 12452738 ± 14111570 ± 632*2578 ± 12811800 ± 7362634 ± 14282125 ± 833* p < 0.05
IDWG, kg2.6 ± 1.42.5 ± 1.22.7 ± 1.32.3 ± 1.1*3.0 ± 1.32.5 ± 1.43.3 ± 1.42.6 ± 1.3* p < 0.05
SBP, mmHg155.0 ± 28.6154.0 ± 17.8164.1 ± 25.0149.7 ± 24.3*162.8 ± 23.7145.3 ± 24.1157.6 ± 24.4142.8 ± 24.4** p < 0.05
DBP, mmHg82.8 ± 12.781.3 ± 16.287.7 ± 12.478.5 ± 17.0*85.8 ± 16.277.6 ± 22.387.9 ± 16.478.3 ± 15.9* p < 0.05

Funding

  • Commercial Support –