Dietary Patterns of Caribbean/Central American and US Born Patients with Chronic Kidney Disease (CKD) in an Inner-City Setting (P04-110-19)

Abstract

Objectives: Adherence to the dietary restrictions imposed by CKD may be impacted by cultural dietary patterns. Understanding dietary patterns of specific groups can better guide nutrition and dietary counseling among immigrant populations. Methods: A random sample of 86 patients from an inner-city CKD (35), dialysis (22) and transplant clinic (29) were surveyed. Nutrient intake from 24-hour food recall was analyzed using ASA24 software and used to calculate the Healthy Eating Index (HEI). Nutrition literacy was assessed via the Newest Vital Signs toolkit. Food frequencies for Caribbean diet staples were hand scored. Results: 54 (63%) patients identified as Caribbean/Central American (CARIB) and 32 (37%) pts US born (US). There was no difference in age (64.5 ± 13.7 CARIB vs 58.9 ± 14.8 US) or gender (F/M 27/27 CARIB, 22/10 US). More CARIB had income < $20 K (50% vs 28%, P = 0.029). Mean time in the US was 34.1 ± 15.2 yrs. CARIB had lower nutritional literacy (1.34 ± 1.6 vs 3.0 ± 1.9, P < 0.001), but better HEI (60.7 ± 12.9 vs 53.8 ± 9.1) and were more likely to report small local specialty/ethnic grocery stores (89% vs 60%, P = 0.015) and available fresh produce (96% vs 63%, P = 0.002). CARIB had significantly lower intake of foods like spaghetti, pizza, pasta (4%) vs US (20.7%) (P = 0.018), greater consumption of whole grains (1.55 ± 0.25 vs. 0.758 ± 0.24 P = 0.023), and lower intake of cheese (0.162 ± 0.058 vs. 0.415 ± 0.11 P = 0.032) but no differences in cereal, other meats, total vegetables, total fruits, takeout/fast food, American brand snacks, drinks, or desserts. CARIB consumed significantly different sources of legumes (P = 0.040 by Chi square), seafood, including salt fish (6%), vegetables, including cassava (2%), green banana/plantain (6%), callaloo (4%), and meats including jerk chicken (2%), mutton/cow foot/chicken stew (8%) and oxtail (6%). Conclusions: In our inner-City population: 1. CARIB had lower nutritional literacy but higher HEI score. 2. CARIB were more likely to report small ethnic grocery stores and better access to healthy food, although they were more likely to report low income. 3. There were significant differences in nutrient sources including (legumes), whole grains and dairy. 3. CARIB incorporated Caribbean staples into their diet, including fish dishes and fresh vegetables. 4. Cultural background should be considered when counseling even in long-term immigrants with CKD. Funding Sources: none.