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Permanent link (DOI): https://doi.org/10.7939/R3JQ0T348

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Vitamin K Intake in Patients with Diabetes and Chronic Kidney Disease Open Access

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Other title
Subject/Keyword
Vitamin K
Diabetes
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Li, Ping
Supervisor and department
Senior, Peter (Department of Medicine)
Mager, Diana (Department of Agricultural, Food, and Nutritional Science)
Examining committee member and department
Farmer, Anna (Department of Agricultural, Food, and Nutritional Science & The School of Public Health)
Department
Department of Agricultural, Food, and Nutritional Science
Specialization
Nutrition and Metabolism
Date accepted
2015-01-30T14:44:02Z
Graduation date
2015-06
Degree
Master of Science
Degree level
Master's
Abstract
Background: Diabetes and chronic kidney disease are two leading public health concerns. Patients with both diabetes and chronic kidney disease may be at elevated risk for suboptimal nutrient status due to diet restrictions, electrolyte and fluid imbalance, and altered metabolism. Objectives: The study objectives were to investigate dietary vitamin K intake in participants with diabetes and chronic kidney disease (CKD) and to identify their major food sources of vitamin K. Methods: Sixty-two adult participants were enrolled. The anthropometric/demographic data collected included: weight, height, Body Mass Index (BMI), age, and stage of CKD as reflected by the Glomerular Filtration Rate (GFR). The vitamin K intake was assessed by using two validated tools: a semi-quantitative Food Frequency Questionnaire (FFQ) and food records (FR). The FFQ was analyzed by using a systematic approach based on the United States Department of Agriculture (USDA) nutrient database (SR16-1), followed by a subset analysis of vegetables according to a validated classification, while the FR were analyzed by following a standard methodology using the USDA database (SR 27). Both estimates were compared to the Adequate Intake (AI). The reported energy intake was analyzed by using the Food Processor software. Results: The median age of the cohort was 65 years, and 36 (59%) participants had a GFR below 60mL/min/1.73 m2. Fifty-five (89%) and 37 (60%) participants had a BMI above 25kg/m2(overweight) and 30kg/m2(obese), respectively. The FFQ indicated that 37 (63%) participants (median=117mcg/d) met the AI for vitamin K, while the FR suggested only 12 (20%) participants (median=68mcg/d) met the AI by diet alone. The discrepancy existed partially because the FFQ was able to capture the episodically consumed vitamin K-rich foods. The major contributors to vitamin K were leafy vegetables (61%). Twenty-seven (44%) participants were likely to under-report, and 15 (56%) of them were obese. Conclusions: Adults with diabetes and CKD are at risk for suboptimal vitamin K intake by diet alone. The FFQ in general estimated a higher intake of vitamin K compared with the FR. More robust tools (e.g., recovery biomarkers as the reference instrument) may help detect under- or over-reporting and correct systematic bias and/or random errors associated with dietary intake assessment tools.
Language
English
DOI
doi:10.7939/R3JQ0T348
Rights
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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