Abstract：
OBJECTIVE: Dietary patterns are rapidly becoming a major focus of medical nutrition therapy in chronic kidney disease (CKD) and the analysis of dietary patterns has emerged as a practical approach to evaluate qualitative as well as quantitative aspects of overall diet. In an a-posteriori data-driven approach, dietary patterns are based on the actual food intake of the population evaluated. Investigation of dietary patterns in CKD is not well-described, and to our knowledge, has not been conducted in a UK-based cohort.
METHODS: Adult participants with a diagnosed kidney condition (CKD 1-5 not requiring dialysis) were recruited into a multicenter observational cross-sectional study. Dietary intake was assessed using the European Prospective Investigation of Cancer in Norfolk Food Frequency Questionnaire. Logistic Principal Component Analysis was used to identify food group clusters. Differences between groups were assessed using univariate general linear modeling.
RESULTS: In total, 696 patients were included. The mean age was 64.7 (±14.0) years, 61% of the cohort were male. Most participants were White British (89%). The mean estimated glomerular filtration rate was 36.6 (±20.9) mL/minute/1.732. We found differences in food group intake across stages (e.g., greater intake of nuts and seeds intake in CKD 1-2 versus CKD 4) and across sex (e.g., females had a higher intake of fruit and vegetables versus males). Comparison with the reference cohort revealed that, overall, the CKD cohort had reduced intakes of food stuffs such as cereals and cereal products, but higher intakes of groups such as meat and meat products. There were limited differences in micronutrients, although vitamin B2 and calcium were higher in earlier stages.
CONCLUSIONS: Overall, the findings from a novel a-posteriori approach underline the complex diversity of food patterns in CKD. The findings from our study may inform dieticians and other health-care providers about the need to consider treatment modalities and stages when giving dietary recommendations.
METHODS: Adult participants with a diagnosed kidney condition (CKD 1-5 not requiring dialysis) were recruited into a multicenter observational cross-sectional study. Dietary intake was assessed using the European Prospective Investigation of Cancer in Norfolk Food Frequency Questionnaire. Logistic Principal Component Analysis was used to identify food group clusters. Differences between groups were assessed using univariate general linear modeling.
RESULTS: In total, 696 patients were included. The mean age was 64.7 (±14.0) years, 61% of the cohort were male. Most participants were White British (89%). The mean estimated glomerular filtration rate was 36.6 (±20.9) mL/minute/1.732. We found differences in food group intake across stages (e.g., greater intake of nuts and seeds intake in CKD 1-2 versus CKD 4) and across sex (e.g., females had a higher intake of fruit and vegetables versus males). Comparison with the reference cohort revealed that, overall, the CKD cohort had reduced intakes of food stuffs such as cereals and cereal products, but higher intakes of groups such as meat and meat products. There were limited differences in micronutrients, although vitamin B2 and calcium were higher in earlier stages.
CONCLUSIONS: Overall, the findings from a novel a-posteriori approach underline the complex diversity of food patterns in CKD. The findings from our study may inform dieticians and other health-care providers about the need to consider treatment modalities and stages when giving dietary recommendations.
摘要：
目的：饮食模式正迅速成为CKD医学营养治疗的主要焦点，对饮食模式的分析已成为评估总体饮食的定性和定量方面的实用方法。在后验数据驱动的方法中，膳食模式是基于评估人群的实际食物摄入量。CKD饮食模式的调查没有得到很好的描述，and,根据我们的知识，尚未在英国队列中进行。
方法：将诊断为肾脏疾病（CKD1-5不需要透析）的成年参与者纳入多中心观察性横断面研究。使用诺福克食物频率问卷中的欧洲癌症前瞻性调查评估饮食摄入量。Logistic主成分分析用于识别食物类群。使用单变量一般线性模型评估组间差异。
结果：总计，纳入696例患者。平均年龄64.7(±14.0)岁,61%的队列是男性。大多数参与者是英国白人（89%）。平均eGFR为36.6(±20.9)ml/min/1.732。我们发现不同阶段的食物组摄入量存在差异(例如，CKD1-2中坚果和种子的摄入量高于CKD4)和跨性别(例如，女性的水果和蔬菜摄入量高于男性）。与参考队列的比较显示，总的来说,CKD队列减少了谷物和谷物产品等食物的摄入量，但肉类和肉制品等群体的摄入量较高。微量营养素的差异有限，虽然维生素B2和钙在早期阶段较高。
结论：总体而言，新的后验方法的发现强调了CKD中食物模式的复杂多样性。我们的研究结果可能会告知营养学家和其他医疗保健提供者在提供饮食建议时需要考虑治疗方式和阶段。
方法：将诊断为肾脏疾病（CKD1-5不需要透析）的成年参与者纳入多中心观察性横断面研究。使用诺福克食物频率问卷中的欧洲癌症前瞻性调查评估饮食摄入量。Logistic主成分分析用于识别食物类群。使用单变量一般线性模型评估组间差异。
结果：总计，纳入696例患者。平均年龄64.7(±14.0)岁,61%的队列是男性。大多数参与者是英国白人（89%）。平均eGFR为36.6(±20.9)ml/min/1.732。我们发现不同阶段的食物组摄入量存在差异(例如，CKD1-2中坚果和种子的摄入量高于CKD4)和跨性别(例如，女性的水果和蔬菜摄入量高于男性）。与参考队列的比较显示，总的来说,CKD队列减少了谷物和谷物产品等食物的摄入量，但肉类和肉制品等群体的摄入量较高。微量营养素的差异有限，虽然维生素B2和钙在早期阶段较高。
结论：总体而言，新的后验方法的发现强调了CKD中食物模式的复杂多样性。我们的研究结果可能会告知营养学家和其他医疗保健提供者在提供饮食建议时需要考虑治疗方式和阶段。
