Ultra-processed food consumption and the prevalence of malnutrition and clinical weakness among hemodialysis patients: a single-center cross-sectional study.

BACKGROUND

The consumption of ultra-processed foods (UPFs) is increasing worldwide. However, there is limited information about the relationship between UPFs and kidney health. The study objective was to investigate the relationship between UPF consumption and the odds of malnutrition and clinical weakness in hemodialysis (HD) patients.

METHODS

This is a cross-sectional study evaluating 90 patients. Sociodemographic, anthropometric, and laboratory data were collected. UPF consumption was evaluated by a validated food frequency questionnaire according to the NOVA classification system and patients divided into two groups as lower (M1) and higher (M2) based on the median of UPF consumption. Malnutrition and clinical weakness status of the patients were assessed using Nutritional Risk Index (NRI) and Hand Grip Strength (HGS) Index. Binary and multivariate logistic regression analyses (enter methods) were used to analyze UPFs associated with the odds of clinical weakness and malnutrition. The significance level was set at p < 0.05.

RESULTS

The median UPF consumption of patients was 105.5 g. The M1 group had significantly higher pre-postdialysis creatinine, total iron binding capacity (TIBC), total cholesterol and lower pre-postdialysis potassium than the M2 group. Although there was no statistically significant difference in NRI values between the two groups, the HGS index was statistically higher in the M1 group than the M2 group (89.6 ± 24.1, 77.7 ± 23.9, respectively). No significant relationship was found between UPF consumption and the odds of malnutrition in both unadjusted and adjusted models. According to the crude Model, the odds of clinical weakness was 3.70-fold higher in the M2 group (Model 1, 95%CI: 1.41–9.70, p = 0.008). This relationship was also significant in the adjusted models (Model 2, 95%CI: 1.30;11.77, p = 0.015 and Model 3, 95%CI: 1.28;12.08, p = 0.017).

CONCLUSION

The increased UPF consumption was significantly associated with a higher likelihood for clinical weakness, but not malnutrition in HD patients. CLINICAL TRIAL NUMBER: Not applicable.