Mediterranean Diet Adherence and Nutritional Status in Dalmatian Diabetic Hypertensive Patients Regarding Presence of Chronic Kidney Disease-Is There Any Difference?

Dora Bučan Nenadić,Marijana Vučković,Ela Kolak,Marija Selak,Mislav Radić,Ivana Novak,Josipa Radić

doi:10.3390/ijerph19042293

Abstract

In recent years, the Mediterranean diet has emerged as one of the dietary patterns that could have positive effects on overall health as well in the treatment of non-communicable chronic diseases. The aim of this cross-sectional study was to determine differences in adherence to the Mediterranean diet (MeDi) and nutritional status in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) regarding the presence of chronic kidney disease (CKD). Two hundred and forty-eight Dalmatian diabetic hypertensive patients (DDHP) were included, and 164 (66.1%) of them had CKD. Data about anthropometric parameters, clinical and laboratory parameters, as well as lifestyle questionnaire and Mediterranean Diet Serving Score (MDSS) were collected for each study participant. Furthermore, body composition was assessed using MC-780 Multi Frequency Segmental Body Mass Analyzer (Tanita). Body mass index (BMI) as well as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Results showed that only 8.9% of DDHP were adherent to the MeDi without significant differences regarding the presence of CKD. Therefore, only 9.1% of participants with CKD were adherent to the MeDi. Dietary recommendations were received by 52.8% of DDHP and 49.4% with CKD, while only 12.8% of those with CKD were adherent to the given recommendations. The results showed that 88.3% of DDHP and 87.8% of the DDHP with CKD were overweight or obese. Statically significant lower frequency of nut intake suggested by the MeDi was found in those participants with CKD (p = 0.02). Therefore, the significant associations between adherence to each MeDi component as well as MDSS score with the development of CKD among all study subjects were not found. In conclusion, the results showed a low level of nutritional care in our region and low adherence to MeDi among DDHP. According to the results, there is an urgent need to improve nutritional care in our region, with a special focus on the MeDi for this especially vulnerable population of patients.

Highlights

Arterial hypertension (AH) is the leading cause of death [1], and diabetes mellitus (DM) is among the top 10 causes of death around the world [2]
Out of 248 participants with type 2 diabetes mellitus (T2DM) and AH included in this study, 164 (66.1%) of them were diagnosed with chronic kidney disease (CKD), with higher disease prevalence in older and male participants
Our results showed that family members significantly more often prepare meals for those participants with CKD, which may be due to numerous dietary restrictions, high prevalence of depression [42] and cognitive dysfunction [43], and other associated diseases in this population of patients

Summary

Introduction

Arterial hypertension (AH) is the leading cause of death [1], and diabetes mellitus (DM) is among the top 10 causes of death around the world [2]. CroDiab data, diabetes was the third leading cause of death, with a share of 7.8% in 2019 in Croatia [3]. In 2020, 310,212 people were diagnosed with diabetes, which makes up only. 60% of all, so it is considered that the total number of people suffering from DM in Croatia.

Results

Discussion

Conclusion