Relationship between Nutrient Intake and Food Purchasing Behavior During the COVID-19 Pandemic in an Inner-City Population of Dialysis Patients

OBJECTIVES: Pts who receive hemodialysis require strict dietary restrictions and have encountered increased difficulties due to COVID-19. We examined food purchasing patterns and dietary intake during the pandemic in a population of inner-city dialysis patients. METHODS: A random sample of 32 dialysis patients were surveyed regarding general food purchasing habits and changes due to COVID-19. Dietary intake was assessed using 24-hour food recall and analyzed using ASA-24. RESULTS: Mean age was 56.8 ± 18.2 years. Mean dialysis time was 88.0 ± 104.0 months. There were 20 (62.5%) male, 29 (90.6%) identified as black, 18 (56%) had a high school diploma or less, and 14 (44%) completed some college or more. Mean calories was 1438.0 ± 650.5 kcal, protein was 70.2 ± 39.7 g, fat was 52.5 ± 29.6 g, carbohydrate was 173.3 ± 92.5 g, and phosphorus was 986.0 ± 537.7 mg. 11 pts purchased breakfast rather than making it at home at least once a week (PUR). Calories (1686.2 ± 674.0 vs. 1031.8 ± 346.7, p = 0.006), protein (83.5 ± 42.6 vs. 48.5 ± 22.0, p = 0.018), fat (62.8 ± 29.6 vs. 35.6 ± 21.5, p = 0.014), carbohydrates (199.5 ± 104.1 vs. 130.5 ± 48.9, p = 0.023) and phosphorus levels (1145.2 ± 609.2 vs. 725.6 ± 241.6, p = 0.015) were higher in the 18 pts who never purchased breakfast (NOPUR) vs. PUR. NOPUR pts had an increase consumption of starchy vegetables including potatoes (0.32 ± 0.50 vs. 0.04 ± 0.08 cups, p = 0.030) and added sugars (10.9 ± 8.7 vs. 5.4 ± 4.2 tsp, p = 0.030). NOPUR pts also had an increase intake of solid fats (27.1 ± 21.4 vs. 10.6 ± 10.8, p = 0.011). There was a significant difference in age between PUR and NOPUR (45.9 ± 14.8 vs. 65.3 ± 16.1, p = 0.001), but no statistically significant difference between the groups for sex, race, or education. CONCLUSIONS: In our population pts who made their breakfast at home were older and consumed more calories, protein, fat, carbohydrates, and phosphorus than those who purchased it. This may have been due to increased consumption of starchy vegetables, added sugars, and solid fats. These findings could represent misunderstanding of nutritional guidance or persistence of unhealthy behaviors. The lower caloric intake in younger patients who purchase breakfast may represent food insecurity, or other challenges due to the COVID-19 pandemic. These dietary patterns should be further explored to prevent adverse outcomes in our inner-city dialysis population. FUNDING SOURCES: Unfunded.