ULTRAPROCESSED FOODS: DETERMINANTS AND RELATIONSHIP WITH BIOCHEMICAL PARAMETERS IN CHRONIC HEMODIALYSIS PATIENTS

ULTRAPROCESSED FOODS: DETERMINANTS AND RELATIONSHIP WITH BIOCHEMICAL PARAMETERS IN CHRONIC HEMODIALYSIS PATIENTS

Ultraprocessed foods (UPFs) are defined as products containing ingredients exclusive to industrial processing using sophisticated equipment and technology for production. UPFs are usually energy-dense foods with added sugar, fats, sodium, and additives. We aimed to assess UPFs intake, its determinants and its relationship with biochemical parameters in chronic hemodialysis patients.

Multicenter study that included patients on chronic hemodialysis from seven dialysis units in Southern Brazil. We applied a simplified dietary questionnaire validated for the Brazilian population, consisting of 13 questions covering UPFs subgroups  (group 4 of the NOVA classification, Dietary Guideline for Brazilian Population). The questionnaire was applied on two days, including a day without dialysis treatment (interview in the dialysis session) and another with dialysis treatment (telephone interview). The UPFs score (0 to 13) was obtained by summing the affirmative answers regarding consumption on the day before the interview of any food from each subgroup. The average of the two days was calculated to obtain the UPFs score. Demographic, clinical variables, and laboratory tests were obtained from electronic medical records.

We included 297 patients (mean age: 52.1±14.1 years old; men: 57.9%; dialysis vintage 38 (18-86) months; body mass index (BMI): 25.5 (22.3-28.5) kg/m2). The median UPFs score was 2.5 (2 - 4), a value used to divide the sample into two groups. In the univariate analysis, participants with higher UPFs intake (score > 2.5) were younger (47.8 ± 13.7 versus 56.2 ± 13.2; p<0.001). In the multiple logistic regression that included variables with p<0.1 in the univariate analysis, the independent determinants of higher UPFs score were younger age, male sex, and obesity (BMI ≥ 30 Kg/m2). Regarding biochemical parameters, the group with higher UPFs score had higher serum phosphorus (5.6 (4.5 - 6.6) versus 5.0 (4.2 - 6.1) mg/dL; p=0.01) and higher prevalence of hyperphosphatemia (51.4 versus 32.7%; p=0.001). A higher UPFs score was an independent determinant of hyperphosphatemia in a model controlled for several confounders.

In this multicenter study with chronic hemodialysis participants, UPFs intake was influenced by age, sex, and nutritional status. Furthermore, it was an independent determinant of hyperphosphatemia.