Patients with CKD more likely to consume limited fruits, vegetables


Disclosures: Pourafshar reports no relevant financial disclosures.

We were unable to process your request. Please try again later. If you continue to have this issue please contact

Compared with patients without chronic kidney disease, patients with CKD are more likely to consume a limited number of fruits and vegetables, according to data published in the Journal of Renal Nutrition.

Investigators questioned if the low intake was a result or cause of CKD among these patients.

Fruit, vegetables, nuts
Source: Adobe Stock

“Available dietary guidelines for patients with CKD primarily focus on recommended nutrient intakes (eg, sodium, potassium, and phosphorus) with less emphasis on whole foods, such as fruits and vegetables,” Shirin Pourafshar, PhD, MSCR, RDN, from the department of medicine at the University of Virginia School of Medicine, and colleagues wrote. They added, “It is important to consider the interaction of nutrients in foods rather than isolating nutrients or restricting them in the diet. Understanding patterns of fruit and vegetable intake among CKD patients may provide a perspective different from traditional restrictive dietary guidelines.”

Researchers examined three cycles of data sets from the Third National Health and Nutrition Examination Survey (NHANES III) and Continuous NHANES to determine patterns of fruit and vegetable intake among US adults with and those without CKD.

Specifically, researchers evaluated 24-hour dietary recall data from the NHANES III cohort (1988 to 1994) and the Continuous NHANES cohorts (2003 to 2010 and 2011 to 2018).

Using the NOVA food classification system, researchers categorized foods into the following three groups: unprocessed; minimally processed and processed (minimally/processed); and ultra-processed fruits and vegetables. Foods in the analysis included fresh citrus fruit juice (100%), dried fruits, berries, other fruits, other fresh fruit juices (100%), potato and other starchy vegetables, different types of cabbage, dark green vegetables, deep-yellow vegetables , tomatoes and other vegetables.

Researchers conducted latent class analysis to compare intake patterns across cohorts. Additionally, researchers used weighted multinomial logistic regression to compare CKD status.

Analyses revealed a total of 13.6% (NHANES III) to 15.2% (Continuous NHANES 2011 to2018) of the population was estimated to have CKD. Researchers identified the following four similar patterns of fruits and vegetables in each cycle: overall low intake; high unprocessed; high ultra-processed; and moderate processed fruits and vegetables. However, the most prevalent pattern among all cohorts and CKD groups was overall low intake. Investigators observed dietary fiber was significantly lowest in the overall low intake pattern compared with other patterns.

Compared with patients without CKD, patients with CKD were more likely to be categorized as overall low intake in each cohort after adjusting for demographic variables and selected health conditions.

“This study is a first step to identify fruit and vegetable patterns that associate with CKD and supports the need for implementation studies to encourage higher consumption of fruits and vegetables in the overall population as well as patients with CKD,” Pourafshar and colleagues wrote. “Longitudinal follow-up studies are needed to examine the association of different patterns of fruit and vegetable intake with CKD outcomes.”

Leave a Comment