Adaptation and Validation of Alternative Healthy Eating Index in Hemodialysis Patients (AHEI-HD) and Its Association with all-Cause Mortality: A Multi-Center Follow-Up Study
Tuyen Van Duong 1
, I-Hsin Tseng 1, Te-Chih Wong 2, Hsi-Hsien Chen 3,4, Tso-Hsiao Chen 3,5, Yung-Ho Hsu 3,6, Sheng-Jeng Peng 7, Ko-Lin Kuo 8, Hsiang-Chung Liu 9, En-Tzu Lin 10, Yi-Wei Feng 1 and Shwu-Huey Yang 1,11,12,*
, I-Hsin Tseng 1, Te-Chih Wong 2, Hsi-Hsien Chen 3,4, Tso-Hsiao Chen 3,5, Yung-Ho Hsu 3,6, Sheng-Jeng Peng 7, Ko-Lin Kuo 8, Hsiang-Chung Liu 9, En-Tzu Lin 10, Yi-Wei Feng 1 and Shwu-Huey Yang 1,11,12,*
1
School of Nutrition and Health Sciences, Taipei Medical University, Taipei 110, Taiwan
2
Department of Nutrition and Health Sciences, Chinese Culture University, Taipei 110, Taiwan
3
Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
4
Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
5
Department of Nephrology, Taipei Medical University-Wan Fang Hospital, Taipei 110, Taiwan
6
Division of Nephrology, Department of Internal Medicine, Taipei Medical University- Shuang Ho Hospital, Taipei 110, Taiwan
7
Division of Nephrology, Cathay General Hospital, Taipei 110, Taiwan
8
Division of Nephrology, Taipei Tzu-Chi Hospital, New Taipei 231, Taiwan
9
Department of Nephrology, Wei Gong Memorial Hospital, Miaoli 351, Taiwan
10
Department of Nephrology, Lotung Poh-Ai Hospital, Yilan 265, Taiwan
11
Research Center of Geriatric Nutrition, Taipei Medical University, Taipei 110, Taiwan
12
Nutrition Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(6), 1407; https://doi.org/10.3390/nu11061407
Received: 15 May 2019 / Revised: 1 June 2019 / Accepted: 20 June 2019 / Published: 21 June 2019
(This article belongs to the Special Issue Targeted Nutrition in Chronic Disease)
Abstract
A valid diet quality assessment scale has not been investigated in hemodialysis patients. We aimed to adapt and validate the alternative healthy eating index in hemodialysis patients (AHEI-HD), and investigate its associations with all-cause mortality. A prospective study was conducted on 370 hemodialysis patients from seven hospital-based dialysis centers. Dietary data (using three independent 24-hour dietary records), clinical and laboratory parameters were collected. The construct and criterion validity of original AHEI-2010 with 11 items and the AHEI-HD with 16 items were examined. Both scales showed reasonable item-scale correlations and satisfactory discriminant validity. The AHEI-HD demonstrated a weaker correlation with energy intake compared with AHEI-2010. Principle component analysis yielded the plateau scree plot line in AHEI-HD but not in AHEI-2010. In comparison with patients in lowest diet quality (tertile 1), those in highest diet quality (tertile 3) had significantly lower risk for death, with a hazard ratio (HR) and 95% confidence intervals (95%CI) of HR: 0.40; 95%CI: 0.18 – 0.90; p = 0.028, as measured by AHEI-2010, and HR: 0.37; 95%CI: 0.17–0.82; p = 0.014 as measured by AHEI-HD, respectively. In conclusion, AHEI-HD was shown to have greater advantages than AHEI-2010. AHEI-HD was suggested for assessments of diet quality in hemodialysis patients. View Full-TextKeywords:
alternative healthy eating index; all-cause mortality; diet quality; diet quantity; hemodialysis; end-stage renal disease; principal component analysis; complex and multidimensional; validation; prospective cohort
▼
Figures
Figure 1
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
Share & Cite This Article
MDPI and ACS Style
Van Duong, T.; Tseng, I.-H.; Wong, T.-C.; Chen, H.-H.; Chen, T.-H.; Hsu, Y.-H.; Peng, S.-J.; Kuo, K.-L.; Liu, H.-C.; Lin, E.-T.; Feng, Y.-W.; Yang, S.-H. Adaptation and Validation of Alternative Healthy Eating Index in Hemodialysis Patients (AHEI-HD) and Its Association with all-Cause Mortality: A Multi-Center Follow-Up Study. Nutrients 2019, 11, 1407.
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.
Related Articles
Article Metrics
Comments
[Return to top]
Nutrients
EISSN 2072-6643
Published by MDPI AG, Basel, Switzerland
RSS
E-Mail Table of Contents Alert