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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1547181
This article is part of the Research Topic The Relationship between Nutrition and Frailty/Multimorbidity: Prevention and Clinical Nutritional Management View all 3 articles

Dietary Quality and Adherence to Dietary Recommendations in Chinese Patients with Chronic Kidney Disease

Provisionally accepted
Wenwei Ouyang Wenwei Ouyang 1,2Bingjie Xiao Bingjie Xiao 3Huifen Chen Huifen Chen 4Lizhe Fu Lizhe Fu 1Fang Tang Fang Tang 1Gaetano Marrone Gaetano Marrone 2Xusheng Liu Xusheng Liu 1Yifan Wu Yifan Wu 1*Juan Jesus Carrero Juan Jesus Carrero 2
  • 1 The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
  • 2 Karolinska Institutet (KI), Solna, Stockholm, Sweden
  • 3 The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China
  • 4 Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Objectives: There is a lack of data regarding the quality of the diet and the adherence to dietary guidelines of patients with non-dialysis CKD (NDD-CKD) in China.Design and Methods: Single-center cross-sectional study of 261 patients with CKD stages 3-5, who responded to 3-day dietary records and undertook 24-hour urine samples along with clinical, laboratory, and anthropometric assessments. We compared their food intake with Chinese recommendations for CKD patients, assessed dietary quality through the Chinese Healthy Eating Index (CHEI), and calculated the contribution to energy intake by processed foods according to the NOVA classification.Results: Average energy intake was 30±9 Kcal/kg/d, and 65% consumed less energy than recommended. The average protein intake was 1.2±0.5 g/Kg/d, and 81% consumed more than recommended. 71% of patients consumed excess sodium and 80% consumed too little fiber. These proportions worsened across more severe CKD stages (all P trend value <0.05). The diet was considered of moderate quality (CHEI score 59.5±11.0), and patients with CKD stages 4-5 scored progressively worse (P trend=0.008). Total grains and tubers supplied 50% and 30% of the total energy and protein intake, respectively. Processed and ultra-processed foods contributed to 23.3% of dietary energy and 11.7% of food weight.Conclusions: A large proportion of NDD-CKD at our center showed low adherence to diet recommendations. Although consumption of processed foods was low, diet quality worsened with more severe CKD, with low intake of whole grains, dairy, and soybean.

    Keywords: Chronic Kidney Disease, nutrient, Dietary quality, guideline, adherence

    Received: 18 Dec 2024; Accepted: 15 Jan 2025.

    Copyright: © 2025 Ouyang, Xiao, Chen, Fu, Tang, Marrone, Liu, Wu and Carrero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yifan Wu, The Second Affiliated Hospital, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China

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