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Food Cost Concerns Affect Food Choice and Dietary Intake in a Population of Inner City Kidney Transplant Recipients
Author(s) -
Ruff Eric,
Mincer Shifra,
Markell Mariana
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.791.30
Subject(s) - medicine , population , diabetes mellitus , kidney disease , calorie , environmental health , creatinine , demography , endocrinology , sociology
Background We have previously noted hypophosphatemia and low protein and phosphate intake as prevalent in our population of indigent inner‐city kidney transplant recipients (KTR's). Factors that influence food choice are not known in this predominantly ethnic minority population at high risk for diabetes, hypertension and cardiovascular disease. Methods 23 randomly selected long term KTRs were recruited from the Transplant Clinic. Laboratory values were obtained from chart review. Demographics and factors influencing food choice and preparation were obtained from face to face interview. Patient concern regarding food cost and its influence on choice was assessed using a 5 point Likert scale. Dietary intake was estimated from 3‐day diet diary and 1 day diet recall. Nutrient values were extrapolated using the USDA Supertracker. Results There were 18 (60%) men and 20 Black (67%) patients. 17 (80%) reported income <$20,000 and Medicaid as primary Insurance. 15 (72%) reported receiving disability payments and 7/10 (70%) reported using EBT coupons to buy food. Mean age was 44.7±10.1, BMI 27.9±5.6, months since transplant 87.7±59.4, sPO4 2.79±0.7, creatinine 0.88±0.1 mg/dl, albumin 4.23±0.1, Hgb 13.6±0.4, total cholesterol 184.9±7.8. 6(29%) pts reported that cost of food was very important for their food choices (FDCOST). By Mann‐Whitney U‐test, FDCOST pts ate fewer calories per day (1127±84.8 vs 1786±150.5, p <0.05), less PO4 (887.3±174 vs 1257±127.5, p=NS) and less protein (48.5±17.5 vs 85.8±8.2, p=NS) but had similar serum PO4, BMI and albumin values. In 10 second sit to stand test, 2 (30%) FDCOST pts were unable to complete the test. All of the pts who did not report concern with food cost completed the test successfully. Conclusions In our population of indigent inner‐City KTR's 1). Despite the availability of EBT coupons, 30% of patients felt that food cost was an important factor in their dietary choices. 2) Patients who reported concern with food cost ate fewer calories, and less protein and PO4 than those who made choices based on other factors. 3) Although laboratory tests and BMI were similar between the two groups, the relative weakness in 30% of the patients who reported food cost concerns should be explored further, as frailty has important prognostic significance in the post‐transplant patient.