Plant Based Eating (PBE) in Inner-City Family Medicine (FM) and Chronic Kidney Disease (CKD) Patients Is Related to Knowledge and Locus of Control

Abstract

Abstract Objectives Understanding the obstacles to adoption of PBE by inner-city patients is essential to provide effective nutrition counseling for management of chronic health conditions that may be improved by this dietary pattern. Methods A telephone survey was conducted in a random convenience sample of patients from FM (18) and CKD (13) clinics. Questionnaires regarding familiarity with PBE and the Multidimensional Health Locus Questionnaire (MHLC) were administered. Diet analysis was performed by 24-hr dietary recall using ASA24 software. Entries reporting <800 kcal were excluded as possibly incomplete. An PBE index (PB-I) was calculated by averaging the difference in grams cholesterol (only in animal products) and grams fiber (only in plant sources) over total kcal. Results Mean age was 63.13 ± 10.4 yrs. 10 were male (32%) and 21 female (68%). 22 were Black (71%), 3 Hispanic (10%), 1 white (3%), 4 other (17%). There was no difference between FM and CKD for nutrition parameters, including kcal (mean 1433.8 ± 444.7), protein (52.9 ± 22.8 g), fat (52.9 ± 22.8 g), and carbohydrates (173.5 ± 64.8 g). There was no significant difference in PB-I between FM and CKD. For both groups, lower PB-I was correlated with lack of information on PBD (r = −0.58, P = 0.002, n = 27). Higher PB-I was correlated with higher score for “Belief In Powerful Others” (r = 0.47, P = 0.14, n = 25) and “Reliance on Doctors” (r = 0.45, P = 0.02, n = 25). For FM, lower PB-I correlated with lack of information (r = −0.54, P = 0.05, n = 14) and someone else preparing their food (r = −0.65, P = 0.01, n = 14). Higher PB-I correlated with higher score for “Powerful Others” (r = 0.06, P = 0.02, n = 13), “Doctors” (r = 0.62, P = 0.02, n = 13), and “Internal” categories (r = 0.66, P = 0.01, n = 13). For CKD, lower PB-I also correlated with lack of information (r = 0.62, P = 0.02, n = 13) but did not correlate with MHLC responses. Conclusions In our population: 1. Pts with a lower PBE-I reported knowing less about PBE and had a lower external locus of control 2. FM patients who had a greater internal locus of control and relied more on doctors had a higher PBE-I and were less likely for to rely on someone else to prepare their food. 3. Understanding the patient's locus of control and improving education about PBE will be important in removing obstacles to adoption in our underserved inner-City population with a high prevalence of CKD and other chronic conditions. Funding Sources None.