HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. PHASE I: Development of HD-FFQ
2.2. PHASE II: Face and Content Validity of HD-FFQ
2.3. PHASE III: Relative Validity of HD-FFQ
2.3.1. Patients’ Recruitment
2.3.2. Biochemical Assessment
2.3.3. Dietary Assessment
2.3.4. Analysis of Dietary Information from 3DDR and HD-FFQ
2.3.5. Misreporting
2.4. Statistical Analyses
3. Results
3.1. PHASE II: Face and Content Validation of HD-FFQ
3.2. PHASE III: Relative Validation of the HD-FFQ
3.2.1. Study Population Characteristics
3.2.2. Validity Tests between HD-FFQ and the 3DDR
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Food Groups | Median Score a | p-Value b | |
---|---|---|---|
Experts (n = 10) | Lay Person (n = 10) | ||
Cereals and Products | 4.0 (4.0–4.4) | 4.0 (3.4–4.3) | ns |
Cooked Rice | 4.0 (3.8– 4.3) | 4.4 (4.0–4.7) | 0.03 * |
Noodles | 4.0 (4.0–4.2) | 4.4 (4.0–4.6) | ns |
Traditional Kuih | 4.1 (3.8–4.5) | 4.0 (3.9–4.4) | ns |
Bakery and Sweets | 4.0 (4.0–4.3) | 4.1 (3.8–4.4) | ns |
Snacks and Finger Foods | 4.0 (3.9–4.6) | 3.9 (3.6–4.5) | ns |
Meat, Poultry and Products | 4.1 (4.0–4.5) | 4.4 (3.9–4.7) | ns |
Fruit | 4.2 (4.0–4.8) | 4.4 (4.2–4.7) | ns |
Jam and Spread | 4.1 (4.0–4.7) | 4.2 (3.8–4.6) | ns |
Beverages | 4.1 (3.8–4.7) | 4.2 (4.0–4.6) | ns |
Sauces, Condiments and Soups | 4.0 (4.0–4.3) | 4.1 (4.0–4.3) | ns |
Health Supplements | 4.0 (3.8–5.0) | 3.8 (3.5–4.1) | ns |
Fast Food Chain | 4.0 (4.0–4.7) | 4.0 (3.8–4.5) | ns |
Fish, Shellfish and Products | 4.2 (4.0–4.6) | 4.4 (3.8–5.0) | ns |
Legumes | 4.0 (4.0–4.3) | 4.0 (3.5–4.4) | ns |
Vegetables | 4.1 (4.0–4.7) | 4.0 (3.8–4.5) | ns |
Milk and Dairy Products | 4.0 (4.0–5.0) | 3.9 (3.8–4.1) | ns |
Characteristics (n = 121) | n (%) |
---|---|
Age (years), mean ± SD 20–30 years old 31–40 years old 41–50 years old 51–60 years old >60 years old | 53 ± 12 4 (3%) 18 (13.6%) 24 (18.2%) 39 (29.5%) 36 (27.3%) |
Dialysis vintage (months), mean ± SD | 78 ± 60 |
Gender Male Female | 67 (55.4) 54 (44.6) |
Ethnicity Malay Chinese Indian | 77 (63.7) 28 (23.1) 16 (13.2) |
Educational level No formal education | 1 (0.8) |
Primary Secondary Tertiary (College/University) | 20 (16.5) 67 (55.4) 33 (27.3) |
Marital status Single Married Others | 22 (18.2) 97 (80.2) 2 (1.7) |
Working status Yes No | 39 (32.3) 82 (67.8) |
Income level a Low Income (Less than RM 3000) Medium Income (RM 3000 to RM 6275) High Income (More than RM 6275) | 97 (80.2) 13 (10.7) 11 (9.1) |
Alcohol drinker Yes No | 4 (3.3) 117 (96.7) |
Nutrients | Unadjusted | Energy-Adjusted | Age, Gender and BMI-Adjusted | |||
---|---|---|---|---|---|---|
r | p-Value | r | p-Value | r | p-Value | |
Energy (Kcal/day) | 0.46 | <0.01 | - | - | 0.35 | <0.01 |
Carbohydrate (g/day) | 0.43 | <0.01 | 0.31 | <0.05 | 0.35 | <0.01 |
Protein (g/day) | 0.40 | <0.01 | 0.32 | <0.01 | 0.27 | <0.05 |
Fat (g/day) | 0.38 | <0.01 | 0.33 | <0.01 | 0.34 | <0.01 |
Sodium (mg/day) | 0.35 | <0.01 | 0.19 | <0.05 | 0.27 | <0.05 |
Potassium (mg/day) | 0.40 | <0.01 | 0.20 | <0.05 | 0.28 | <0.05 |
Phosphate (mg/day) | 0.37 | <0.01 | 0.20 | <0.05 | 0.29 | <0.05 |
Calcium (mg/day) | 0.51 | <0.01 | 0.42 | <0.01 | 0.45 | <0.01 |
Iron (mg/day) | 0.39 | <0.01 | 0.01 | ns | 0.29 | <0.05 |
Nutrients | Renal Profile | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Serum Urea | Serum Creatinine | Serum Potassium | Serum Phosphate | |||||||||||||
HD-FFQ | 3DDR | HD-FFQ | 3DDR | HD-FFQ | 3DDR | HD-FFQ | 3DDR | |||||||||
r | pa | r | pa | r | pa | r | pa | r | pa | r | pa | r | pa | r | pa | |
Energy | 0.09 | ns | 0.03 | ns | 0.14 | ns | 0.07 | ns | 0.19 | <0.05 | 0.04 | ns | 0.18 | <0.05 | 0.04 | ns |
Carbohydrate | −0.04 | ns | −0.05 | ns | 0.08 | ns | 0.07 | ns | 0.11 | ns | 0.02 | ns | 0.09 | ns | −0.02 | ns |
Protein | 0.25 | <0.01 | 0.15 | ns | 0.22 | <0.05 | 0.08 | ns | 0.15 | ns | 0.09 | ns | 0.26 | <0.01 | 0.11 | ns |
Fat | 0.17 | ns | 0.08 | ns | 0.16 | ns | 0.02 | ns | 0.29 | <0.01 | 0.03 | ns | 0.23 | <0.05 | 0.07 | ns |
Sodium | 0.23 | <0.05 | 0.05 | ns | 0.16 | ns | 0.07 | ns | 0.23 | <0.05 | 0.13 | ns | 0.28 | <0.01 | 0.13 | ns |
Potassium | 0.15 | ns | 0.13 | ns | 0.10 | ns | 0.11 | ns | 0.22 | <0.05 | 0.002 | ns | 0.26 | <0.01 | 0.14 | ns |
Phosphate | 0.18 | <0.05 | 0.06 | ns | 0.16 | ns | 0.04 | ns | 0.18 | ns | 0.06 | ns | 0.22 | <0.05 | 0.02 | ns |
Calcium | 0.16 | ns | −0.05 | ns | 0.10 | ns | 0.02 | ns | 0.29 | <0.01 | 0.20 | <0.05 | 0.21 | <0.05 | 0.03 | ns |
Iron | 0.14 | ns | 0.08 | ns | 0.13 | ns | 0.06 | ns | 0.25 | <0.01 | 0.11 | ns | 0.17 | ns | 0.11 | ns |
Dietary Intake | HD-FFQ | 3DDR | Mean Difference | % Mean Difference b | p-Value a |
---|---|---|---|---|---|
Mean (SD) | Mean (SD) | ||||
Energy (kcal/day) | 1826 (649) | 1555 (401) | 271 | 17.4 | <0.01 |
Carbohydrate (g/day) | 262 (91) | 231 (64) | 31 | 13.4 | <0.01 |
Protein (g/day) | 68 (29) | 53 (19) | 15 | 28.3 | <0.01 |
Fat (g/day) | 58 (27) | 47 (20) | 11 | 23.4 | <0.01 |
Sodium (mg/day) | 3015 (1375) | 2395 (890) | 620 | 25.9 | <0.01 |
Potassium (mg/day) | 1526 (613) | 1093 (421) | 433 | 39.6 | <0.01 |
Phosphate (mg/day) | 860 (361) | 643 (241) | 217 | 33.7 | <0.01 |
Calcium (mg/day) | 410 (181) | 313 (171) | 97 | 31.0 | <0.01 |
Iron (mg/day) | 14 (6) | 11 (5) | 3 | 27.3 | <0.01 |
Nutrients | Same Quartile (%) | Adjacent Quartile (%) | Grossly Misclassified (%) |
---|---|---|---|
Energy (kcal/day) | 40.5 | 36.4 | 6.6 |
Carbohydrate (g/day) | 36.4 | 36.4 | 3.3 |
Protein (g/day) | 29.8 | 39.7 | 5.0 |
Fat (g/day) | 36.4 | 40.5 | 5.8 |
Sodium (mg/day) | 33.9 | 42.1 | 7.4 |
Potassium (mg/day) | 36.4 | 38.0 | 3.3 |
Phosphate (mg/day) | 36.4 | 33.9 | 5.8 |
Calcium (mg/day) | 40.5 | 41.3 | 5.0 |
Iron (mg/day) | 36.4 | 39.7 | 5.0 |
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Md Ali, M.S.; Yeak, Z.-W.; Khor, B.-H.; Sahathevan, S.; Sualeheen, A.; Lim, J.-H.; Adanan, N.I.H.; Abdul Gafor, A.H.; Zakaria, N.F.; Khosla, P.; et al. HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population. Nutrients 2020, 12, 1585. https://doi.org/10.3390/nu12061585
Md Ali MS, Yeak Z-W, Khor B-H, Sahathevan S, Sualeheen A, Lim J-H, Adanan NIH, Abdul Gafor AH, Zakaria NF, Khosla P, et al. HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population. Nutrients. 2020; 12(6):1585. https://doi.org/10.3390/nu12061585
Chicago/Turabian StyleMd Ali, Mohammad Syafiq, Zu-Wei Yeak, Ban-Hock Khor, Sharmela Sahathevan, Ayesha Sualeheen, Jun-Hao Lim, Nurul Iman Hafizah Adanan, Abdul Halim Abdul Gafor, Nor Fadhlina Zakaria, Pramod Khosla, and et al. 2020. "HD-FFQ to Detect Nutrient Deficiencies and Toxicities for a Multiethnic Asian Dialysis Population" Nutrients 12, no. 6: 1585. https://doi.org/10.3390/nu12061585