Effects of a 6-Month Lifestyle Intervention on Dietary Intake and B... http://www.fasebj.org/content/31/1_Supplement/140.3.

abstract

The FASEB Journal

www.fasebj.org

April 2017
The FASEB Journal vol. 31 no. 1 Supplement 140.3

Effects of a 6-Month Lifestyle Intervention

on Dietary Intake and Blood Pressure in
Hemodialysis Patients
Lauren E. Chan1, Luis Perez2, Brett Burrows2, Annabel Biruete2,
Jennifer L Barnes1 and Kenneth R Wilund2

+ Author Affiliations

Abstract

Previous studies have demonstrated a positive correlation between dietary sodium

intake and blood pressure (BP) in hemodialysis (HD) patients. High BP is linked to
increased cardiovascular (CV) mortality, and CV disease contributes to 41% of
deaths among HD patients. To reduce these risks, HD patients are often counseled
to restrict their dietary sodium intake, but few studies have examined the efficacy
of this strategy.

In this study, we aimed to assess the impacts of individualized low sodium dietary
counseling in conjunction with a liberalized diet approach on sodium intake and
BP. Liberalized dietary guidelines include more whole food consumption,
decreasing foods eaten outside the home, and increased food label reading.

32 patients (age = 53.8 ± 13.5y, 44% female) enrolled in the study and underwent
baseline testing, including three 24-hour recalls, and standardized BP
measurement. Dietary recalls were analyzed using the Nutrition Data System for
Research. During the 6-month intervention, participants received weekly one-on-
one dietary counseling to reduce sodium intake, address a liberalized diet, and set
individual goals. Study coordinators performed counseling, supervised by both
research and clinical dietitians. Baseline testing measures were repeated at the end
of the 6-month intervention period.

Comparing baseline (BL) measurements to those post-intervention (6m), average

kilocalorie (kcal) intake was not significantly different (BL 1489 ± 968 vs. 6m 1445
± 484 kcal, p= 0.876). Daily protein intake did not change over 6 months (BL
55.16 ± 21.62 vs. 6m 59.63 ± 21.15 grams, p=0.605). Total sodium intake
numerically decreased (BL 2780.4 ± 1112.6 vs 6m 2482.5 ± 1147.6 mg,
p=0.297), as did milligrams of sodium normalized per kcal (BL 2.07 ± 0.87 vs
1.68 ± 0.54 mg/kcal, p=0.08). Systolic BP (BL 154.71 ± 26.89 vs. 6m 157.57 ±
25.07 mmHg, p=0.674) and diastolic BP (BL 77.78 ± 20.54 vs 6m 77.85 ± 16.17
mmHg, p= 0.991) showed no significant changes, but total number of BP
medications prescribed to patients (BL 2.93 ± 1.26 vs 6m 1.5 ± 1.09 medications)
were significantly reduced (p=0.004).

Maintenance of energy and protein intake is important for HD patients to preserve

their lean mass and serum protein values, a potential challenge during sodium
restrictions. Notably, this six-month dietary intervention was not associated with
decreases in kcal and protein intake, although patients remain below
recommendations. Though not statistically significant, the modestly reduced
sodium intake that was found may suggest developing changes in consumption
due to our intervention. Minimal changes in sodium intake had no significant
effects on systolic and diastolic BP values, but may have played a role in the
significant decrease in number of BP medications. This indicates that a six-month
dietary intervention may be meaningful for both systolic and diastolic BP
maintenance with decreased BP medication usage.

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