Vitamin K Intake in Patients with Diabetes and Chronic Kidney Disease

  • Author / Creator
    Li, Ping
  • 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.

  • Subjects / Keywords
  • Graduation date
    Spring 2015
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.