School of Nutrition and Health Sciences, Taipei Medical University, Taipei City 11031, Taiwan.
Division of Dietetics and Nutrition, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung City 42743, Taiwan.
Nutrients. 2022 Nov 2;14(21):4617. doi: 10.3390/nu14214617.
Hemodialysis patients are at high risk of muscle loss as a result of aging and disease, and combined with inadequate dietary intake. The Healthy Eating Index for HemoDialysis patients (HEI-HD) was developed to assess the dietary quality of hemodialysis patients. The purposes of this study were to examine the effects of different nutritional education models using HEI-HD-based education on dietary quality and muscle mass in hemodialysis patients.
A quasi-experimental study was conducted from May 2019 to April 2021, with four groups, including no course for patients and nurses (Non-C), course for nurses (CN), course for patients (CP), and course for patients and nurses (CPN). The courses were delivered by registered dietitians. The data of 94 patients were collected and analyzed at baseline, after 2 months of intervention, and 2 months follow-up, including demographics, body composition, 3-day dietary records, and hemodialysis dietary knowledge. The HEI-HD index score was calculated.
Patients aged 58.3 ± 10.1 years. The dietary quality change in the CPN group was improved as compared with the Non-C group (-3.4 ± 9.5 vs. 3.0 ± 5.5, 0.04). The skeletal muscle mass of the Non-C group at intervention was also significantly lower than baseline, but the CPN group was not.
The HEI-HD-based nutritional education for both patients and nurses showed a positive effect on improving the dietary quality and maintaining muscle mass in hemodialysis patients.
由于衰老和疾病，以及饮食摄入不足，血液透析患者存在肌肉流失的高风险。健康饮食指数用于血液透析患者（HEI-HD）旨在评估血液透析患者的饮食质量。本研究旨在检验基于 HEI-HD 的不同营养教育模式对血液透析患者饮食质量和肌肉量的影响。
这是一项从 2019 年 5 月至 2021 年 4 月进行的准实验研究，共包括 4 组，分别为患者和护士未接受课程（Non-C）、护士接受课程（CN）、患者接受课程（CP）和患者和护士接受课程（CPN）。课程由注册营养师提供。在基线、干预 2 个月后和 2 个月随访时收集并分析了 94 名患者的人口统计学、身体成分、3 天饮食记录和血液透析饮食知识的数据。计算了 HEI-HD 指数得分。
患者的平均年龄为 58.3±10.1 岁。与 Non-C 组相比，CPN 组的饮食质量变化得到改善（-3.4±9.5 比 3.0±5.5，0.04）。Non-C 组在干预时的骨骼肌量也明显低于基线，但 CPN 组没有。
针对患者和护士的基于 HEI-HD 的营养教育对改善血液透析患者的饮食质量和维持肌肉量有积极作用。
