Marguerite Conley MNutDiet, BSci(ExSportSci(Hons)) , Hannah L. Mayr BHsc(Nut&Diet), PhD , Mikeeley Hoch BNutDiet(Hons) , David W. Johnson MB BS (Hons, Univ Medal), FRACP, DMed(Res), FASN, FAHMS, PhD , Andrea K. Viecelli MD FRACP PhD , Helen MacLaughlin AD
{"title":"肥胖和慢性肾病患者低能量饮食的可接受性、依从性、安全性和体验:一项混合方法研究。","authors":"Marguerite Conley MNutDiet, BSci(ExSportSci(Hons)) , Hannah L. Mayr BHsc(Nut&Diet), PhD , Mikeeley Hoch BNutDiet(Hons) , David W. Johnson MB BS (Hons, Univ Medal), FRACP, DMed(Res), FASN, FAHMS, PhD , Andrea K. Viecelli MD FRACP PhD , Helen MacLaughlin AD","doi":"10.1053/j.jrn.2023.09.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>Obesity is a modifiable risk factor for chronic kidney disease<span> (CKD) progression. Low energy diets (LEDs) have not been adequately studied in people with CKD. This study aimed to explore acceptability, adherence, safety, and experiences of two LED prescriptions in adults living with obesity and CKD.</span></p></div><div><h3>Design and Methods</h3><p>In a mixed-methods study, obese adults with CKD were prescribed two LEDs (∼800 to 1000 kcal/day each), in a randomised order for 2 weeks each. One diet consisted of four meal replacement products daily (Optifast®, Nestlé Health Science) and the other two pre-prepared frozen meals (Lite n’ Easy®, Mitchell's Quality Foods). Participants received weekly dietitian support, completed daily adherence checklists (converted to % of provided meals/replacements consumed) and participated in post-intervention semi-structured interviews to capture their experience.</p></div><div><h3>Results</h3><p><span>Nine participants were included (mean age 46.5 ± 14.3 years, estimated glomerular filtration rate 64 ± 26 mL/min/1.73 m</span><sup>2</sup><span>, 4/9 male). Mean self-reported adherence was 88 ± 11% and mean 4-week weight change<span> was −7.3 ± 5.6 kg. Two participants withdrew at week two. Most frequently reported side effects were hunger and headaches. Adverse events of interest included one episode each of hyperkalaemia and hypoglycaemia. No serious adverse events occurred. Four overarching themes of patient experiences were identified: strategies used to adapt, disruption to the norm, individual preferences, and influences on acceptability.</span></span></p></div><div><h3>Conclusions</h3><p>LEDs were found to be acceptable and safe with high self-reported adherence rates. Future LED trials should include specialist diabetes management, close monitoring for hyperkalaemia and adequate support to assist with managing side effects and dietary and social adjustments.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Acceptability, Adherence, Safety and Experiences of Low Energy Diets in People With Obesity and Chronic Kidney Disease: A Mixed Methods Study\",\"authors\":\"Marguerite Conley MNutDiet, BSci(ExSportSci(Hons)) , Hannah L. Mayr BHsc(Nut&Diet), PhD , Mikeeley Hoch BNutDiet(Hons) , David W. Johnson MB BS (Hons, Univ Medal), FRACP, DMed(Res), FASN, FAHMS, PhD , Andrea K. Viecelli MD FRACP PhD , Helen MacLaughlin AD\",\"doi\":\"10.1053/j.jrn.2023.09.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>Obesity is a modifiable risk factor for chronic kidney disease<span> (CKD) progression. Low energy diets (LEDs) have not been adequately studied in people with CKD. This study aimed to explore acceptability, adherence, safety, and experiences of two LED prescriptions in adults living with obesity and CKD.</span></p></div><div><h3>Design and Methods</h3><p>In a mixed-methods study, obese adults with CKD were prescribed two LEDs (∼800 to 1000 kcal/day each), in a randomised order for 2 weeks each. One diet consisted of four meal replacement products daily (Optifast®, Nestlé Health Science) and the other two pre-prepared frozen meals (Lite n’ Easy®, Mitchell's Quality Foods). Participants received weekly dietitian support, completed daily adherence checklists (converted to % of provided meals/replacements consumed) and participated in post-intervention semi-structured interviews to capture their experience.</p></div><div><h3>Results</h3><p><span>Nine participants were included (mean age 46.5 ± 14.3 years, estimated glomerular filtration rate 64 ± 26 mL/min/1.73 m</span><sup>2</sup><span>, 4/9 male). Mean self-reported adherence was 88 ± 11% and mean 4-week weight change<span> was −7.3 ± 5.6 kg. Two participants withdrew at week two. Most frequently reported side effects were hunger and headaches. Adverse events of interest included one episode each of hyperkalaemia and hypoglycaemia. No serious adverse events occurred. Four overarching themes of patient experiences were identified: strategies used to adapt, disruption to the norm, individual preferences, and influences on acceptability.</span></span></p></div><div><h3>Conclusions</h3><p>LEDs were found to be acceptable and safe with high self-reported adherence rates. Future LED trials should include specialist diabetes management, close monitoring for hyperkalaemia and adequate support to assist with managing side effects and dietary and social adjustments.</p></div>\",\"PeriodicalId\":50066,\"journal\":{\"name\":\"Journal of Renal Nutrition\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Renal Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1051227623001541\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Renal Nutrition","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1051227623001541","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Acceptability, Adherence, Safety and Experiences of Low Energy Diets in People With Obesity and Chronic Kidney Disease: A Mixed Methods Study
Objectives
Obesity is a modifiable risk factor for chronic kidney disease (CKD) progression. Low energy diets (LEDs) have not been adequately studied in people with CKD. This study aimed to explore acceptability, adherence, safety, and experiences of two LED prescriptions in adults living with obesity and CKD.
Design and Methods
In a mixed-methods study, obese adults with CKD were prescribed two LEDs (∼800 to 1000 kcal/day each), in a randomised order for 2 weeks each. One diet consisted of four meal replacement products daily (Optifast®, Nestlé Health Science) and the other two pre-prepared frozen meals (Lite n’ Easy®, Mitchell's Quality Foods). Participants received weekly dietitian support, completed daily adherence checklists (converted to % of provided meals/replacements consumed) and participated in post-intervention semi-structured interviews to capture their experience.
Results
Nine participants were included (mean age 46.5 ± 14.3 years, estimated glomerular filtration rate 64 ± 26 mL/min/1.73 m2, 4/9 male). Mean self-reported adherence was 88 ± 11% and mean 4-week weight change was −7.3 ± 5.6 kg. Two participants withdrew at week two. Most frequently reported side effects were hunger and headaches. Adverse events of interest included one episode each of hyperkalaemia and hypoglycaemia. No serious adverse events occurred. Four overarching themes of patient experiences were identified: strategies used to adapt, disruption to the norm, individual preferences, and influences on acceptability.
Conclusions
LEDs were found to be acceptable and safe with high self-reported adherence rates. Future LED trials should include specialist diabetes management, close monitoring for hyperkalaemia and adequate support to assist with managing side effects and dietary and social adjustments.
期刊介绍:
The Journal of Renal Nutrition is devoted exclusively to renal nutrition science and renal dietetics. Its content is appropriate for nutritionists, physicians and researchers working in nephrology. Each issue contains a state-of-the-art review, original research, articles on the clinical management and education of patients, a current literature review, and nutritional analysis of food products that have clinical relevance.