Sodium Intake in Inner-City Patients with Diabetes and Chronic Kidney Disease (CKD): Relationship to Age, Depression/Anxiety, and Diet Quality (P04-112-19)

Abstract

ObjectivesWe examined factors associated with adherence to 2.3 g/d sodium intake in a population of inner-City patients from specialty clinics where sodium restriction is advised. MethodsA random sample of 109 patients from an inner-city CKD (37), dialysis (23), medicine/diabetes (18) and transplant clinic (31) were studied. Dietary intake was assessed by 24-hour food recall, analyzed using ASA24 software and used to calculate Healthy Eating Index (HEI). Nutritional literacy was assessed via the Newest Vital Signs toolkit. Depression and anxiety were assessed using PHQ-9 and PSS scales. ResultsThere were 41 (38%) men and 67 (62%) women with 89 black, 5 white, 3 Hispanic and 14 other. 71 (65%) pts were foreign born (time in the US 35.9 ± 15.3 yrs). 43/81 (53%) pts made <$20 K/yr. Mean BMI was 29.2 ± 6.4. Mean sodium intake was 2.53 ± 0.99 g/d (range 0.95 to 6.67 g). 14 pts (14%) restricted sodium to <1.5 g/d. 45 (41%) pts ate 2.3 g or less sodium/day (LoNa). LoNa pts were older than pts who ate > 2.3 g/d (HiNa) (69.1 ± 11.4 vs 58.4 ± 15.9, P < 0.001), but did not differ for BMI, gender, education, nutritional literacy, exposure to nutrition counseling, income or marital status. LoNa had lower scores for depression (2.33 ± 4.3 vs 4.22 ± 4.3, P = 0.016) and anxiety (7.83 ± 7.4 vs 11.7 ± 6.6, P = 0.019). LoNa pts ate fewer calories overall (1093 ± 258.9 vs 1594 ± 401.5, P < 0.0001), less B1, B2, Niacin, B6 and folate but did not differ for vitamins C, E, D or K. They ate less cured meat and total grains, but similar total fat and vegetable intake, eggs, dairy, or added sugars. They ate a higher % of calories from carbohydrates (50.4 ± 13.4 vs 44.4 ± 10.9, P = 0.012), but did not differ for fat or protein. LoNa pts scored lower for food insecurity than HiNa (3.67 ± 0.69 vs 3.17 ± 1.1, P = 0.012, 4 = food secure, < 4 = food insecure) and had higher HEI (61.0 ± 12.9 vs 54.3 ± 11.5, P = 0.009). ConclusionsIn our population of inner-City pts: 1. Most patients ate >2.3 g sodium/day. 2. Pts who ate low sodium were older, ate fewer calories overall, and scored lower for depression, anxiety, and food insecurity. 3. Pts who ate low sodium ate a higher percentage of calories from carbohydrates and less B vitamins, cured meat and grains but did not differ for fat, fat soluble vitamins, vit C, vegetables, eggs, dairy or added sugar. 3. The contribution of depression/anxiety, stress and food insecurity to higher sodium intake is unclear, but warrants further study. Funding Sourcesnone.