Comparison of diet quality tools to assess nutritional adequacy for adults living with kidney disease

• Published in: Canadian journal of dietetic practice and research Vol. 83; no. 4; pp. 180 - 185
• Main Authors: Picard, RD BSc, Kelly, Senior, MBBS PhD FRCP(E) FRCP, Peter A, Wilmott, BSc, Ashley, Jindal, MD FRCPC, Kailash, Richard, RD PhD, Caroline, Mager, RD PhD, Diana R
• Format: Journal Article
• Language: English
• Published: Canada Dietitians of Canada 01.12.2022
• Subjects: Adequacy; Adult; Adults; Care and treatment; Chronic kidney failure; Comparative analysis; Correlation; Correlation analysis; Diabetes; Diabetes mellitus; Diet; Diet, Mediterranean; Dietitians; Eating; Fatty acids; Food; Food intake; Health status indicators; Humans; Kidney diseases; Kidneys; Longitudinal Studies; Nutrients; Nutrition; Nutrition research; Phosphorus; Potassium; Product/Service Evaluations; Quality assessment; Quality control; Renal Insufficiency, Chronic; Canada; diversité des aliments santé; indice de saine alimentation; journal alimentaire sur 3 jours; Healthy Food Diversity; Healthy Eating Index; Chronic kidney disease; indices du régime méditerranéen; maladie du rein chronique; 3-day food records; Mediterranean Diet Scores
• ISSN: 1486-3847; 2292-9592
• DOI: 10.3148/cjdpr-2022-009

There is no specific diet quality tool recommended for adults living with chronic kidney disease (CKD). Identifying how diet quality tools assess nutritional adequacy and correlate with potassium and phosphorus (nutrients of interest in CKD) is warranted. Our aim was to compare Mediterranean Diet Scores (MDS), Healthy Eating Index (HEI), and Healthy Food Diversity (HFD) to determine their correlation with nutrient intake in adults living with diabetes and CKD. Using data from a longitudinal study of 50 participants with diabetes and CKD, diet quality was assessed at baseline and 1 or more times at annual visits up to 5 years (complete diet records n = 178). Diet quality was investigated for correlation with nutrient intake. Compared with HEI and HFD, MDS was poorly correlated with nutrient intake (all values <0.40). HFD and HEI were moderately correlated with potassium (  = 0.66,  < 0.01 and  = 0.57,  < 0.01, respectively). HEI was weakly correlated with phosphorus (  = 0.365,  < 0.01). MDS recommends moderation of dairy and meat, this may have specific benefits for CKD as these are both sources of phosphorus, as such high MDS were associated with lower phosphorus intake. This study suggests that development of a renal specific diet quality assessment tool may be useful; however, further studies are needed.