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Sodium Intake in Inner-City Patients with Diabetes and Chronic Kidney Disease (CKD): Relationship to Age, Depression/Anxiety, and Diet Quality (P04-112-19)

Leong, Jonathan, Yang, Georgiana, Lembrikova, Katerina, Moy, Matthew, Leventer, Sarah, Fazli, Jessamine, Wilson, Clara, Markell, Mariana
Current developments in nutrition 2019 v.3 no.Supplement_1
added sugars, anxiety, ascorbic acid, body mass index, computer software, cured meats, diabetes, dialysis, diet counseling, diet recall, educational status, eggs, fat soluble vitamins, folic acid, food security, gender, grains, healthy eating habits, income, kidney diseases, low sodium diet, marital status, meat, medicine, men, niacin, nutrition education, nutrition knowledge, nutritional adequacy, patients, sodium, vegetable consumption, vegetables, women, United States
We examined factors associated with adherence to 2.3 g/d sodium intake in a population of inner-City patients from specialty clinics where sodium restriction is advised. A random sample of 109 patients from an inner-city CKD (37), dialysis (23), medicine/diabetes (18) and transplant clinic (31) were studied. Dietary intake was assessed by 24-hour food recall, analyzed using ASA24 software and used to calculate Healthy Eating Index (HEI). Nutritional literacy was assessed via the Newest Vital Signs toolkit. Depression and anxiety were assessed using PHQ-9 and PSS scales. There were 41 (38%) men and 67 (62%) women with 89 black, 5 white, 3 Hispanic and 14 other. 71 (65%) pts were foreign born (time in the US 35.9 ± 15.3 yrs). 43/81 (53%) pts made <$20 K/yr. Mean BMI was 29.2 ± 6.4. Mean sodium intake was 2.53 ± 0.99 g/d (range 0.95 to 6.67 g). 14 pts (14%) restricted sodium to <1.5 g/d. 45 (41%) pts ate 2.3 g or less sodium/day (LoNa). LoNa pts were older than pts who ate > 2.3 g/d (HiNa) (69.1 ± 11.4 vs 58.4 ± 15.9, P < 0.001), but did not differ for BMI, gender, education, nutritional literacy, exposure to nutrition counseling, income or marital status. LoNa had lower scores for depression (2.33 ± 4.3 vs 4.22 ± 4.3, P = 0.016) and anxiety (7.83 ± 7.4 vs 11.7 ± 6.6, P = 0.019). LoNa pts ate fewer calories overall (1093 ± 258.9 vs 1594 ± 401.5, P < 0.0001), less B1, B2, Niacin, B6 and folate but did not differ for vitamins C, E , D or K. They ate less cured meat and total grains, but similar total fat and vegetable intake, eggs, dairy, or added sugars. They ate a higher % of calories from carbohydrates (50.4 ± 13.4 vs 44.4 ± 10.9, P = 0.012), but did not differ for fat or protein. LoNa pts scored lower for food insecurity than HiNa (3.67 ± 0.69 vs 3.17 ± 1.1, P = 0.012, 4 = food secure, < 4 = food insecure) and had higher HEI (61.0 ± 12.9 vs 54.3 ± 11.5, P = 0.009). In our population of inner-City pts: 1. Most patients ate >2.3 g sodium/day. 2. Pts who ate low sodium were older, ate fewer calories overall, and scored lower for depression, anxiety, and food insecurity. 3. Pts who ate low sodium ate a higher percentage of calories from carbohydrates and less B vitamins, cured meat and grains but did not differ for fat, fat soluble vitamins, vit C, vegetables, eggs, dairy or added sugar. 3. The contribution of depression/anxiety, stress and food insecurity to higher sodium intake is unclear, but warrants further study. none.