Dietary intake on dialysis and interdialytic days: a study with older adults

Dietary intake on dialysis and interdialytic days: a study with older adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Dietary intake on dialysis and interdialytic days: a study with older adults Flávia Ferreira Prado, Angela Márcia da Silva Ivenção, Tatiana Império de Freitas, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8981196/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective The older adult population is growing, increasing the incidence of chronic diseases such as kidney disease, which may progress to the need for hemodialysis (HD). The objective of the present study was to compare the dietary intake among older adults with chronic kidney disease (CKD) on HD and during the interdialytic period. Methods The study was conducted with individuals (n = 40) aged 60 years or older undergoing HD at a specialized clinic. Dietary intake was assessed using four non-consecutive food records (two HD days and two non-HD days). Participants and their families received instructions on completing the records after receiving a manual and guidance from a specialized nutritionist at the clinic. Total energy, macro- and micronutrient intake was analyzed using the software NDSR (Nutrition Data System for Research), and the results were adjusted for intrapersonal variability. Results On HD days, food intake was lower (p < 0.05) for total energy, total fats, proteins (total and animal-derived), dietary fiber (total and insoluble), and most minerals and vitamins. Additionally, the percentage of protein in total energy intake was higher, with animal meat being the primary protein source. Conclusions The older adults undergoing HD in this study exhibited inadequate dietary intake on HD days. Despite the recognized role of adequate nutrition during hemodialysis, inadequate planning of food and oral supplement provision is still observed in practice, along with difficulties in adherence to nutritional guidance and effective intervention, as well as the planning and provision of nutritionally appropriate snacks and dietary supplements. Dietary Intake Older adults Renal Dialysis Introduction Older adults represent a significant segment of the population. According to the World Health Organization, their numbers are expected to grow to approximately 2 billion individuals by 2050 [ 1 ]. Aging increases the risk of chronic diseases, including kidney disease, which manifests as a reduction in the glomerular filtration rate (GFR). A GFR below 15 mL/min/1.73m² is considered kidney failure, requiring renal replacement therapy (RRT) with hemodialysis (HD) being the most commonly used dialysis modality [ 2 , 3 ]. Older adults with kidney disease face a high risk of severe clinical outcomes, including geriatric conditions such as functional impairment and cognitive decline, hospitalizations, cardiovascular events, and even death [ 4 ]. Patients undergoing HD require nutritional and dietary guidance, as certain substances are not effectively eliminated during the HD process. Food intake must be controlled, which introduces a set of challenges and emotions that can impact dietary intake and discourage adherence to treatment, particularly when restrictions are imposed without adequate individualized guidance [ 5 , 6 ]. Several studies have shown that individuals undergoing HD have insufficient dietary intake of various nutrients, particularly those related to energy and protein, with notable differences between HD and non-HD days [ 7 , 8 ]. In addition to energy and nutrient intake, inadequate dietary patterns, food combinations, food groups, and bioactive substances—some of which may have synergistic protective effects—have been studied to a lesser extent in the context of chronic kidney disease (CKD) [ 9 ]. Given the importance of diet and nutrition, along with the dietary intake changes observed in older adults on HD, it is essential to monitor food consumption to enable timely interventions aimed at preventing malnutrition, sarcopenia, and other health-related consequences [ 10 ]. Thus, this study aimed to compare the dietary intake of older adults on HD days and during the interdialytic period, while also evaluating their food consumption and the main sources of energy and protein in their diet. Methods Study design and population This observational, cross-sectional field study was conducted in 2022 and included a convenience sample of older adults (aged 60 and above) undergoing HD (n = 40) at a clinic in the eastern region of the city of São Paulo (SP), Brazil. It included participants of both sexes who had been undergoing HD for at least six months, typically three times per week for four hours per session, and who agreed to participate by signing an Informed Consent Form. The study was approved by the Research Ethics Committee of Universidade São Judas Tadeu (USJT, São Judas University, approval no. 4.964.543). Demographic variables (age, sex, and ethnicity) as well as health-related variables (comorbidities and anthropometric measurements) were either collected or self-reported. Dietary Intake Assessment Habitual dietary intake was assessed using food records, with two collected on HD days and two during the interdialytic period, including one weekend day, following recommendations for estimating energy and nutrient intake in individuals with CKD [ 3 ]. Participants were monitored throughout the data collection period, and the records were received and reviewed by a trained nutritionist. Total energy, macronutrient (carbohydrates, proteins, and lipids), and micronutrient (vitamins and minerals) intake was analyzed using the Nutrition Data System for Research (NDSR) software, developed by the United States Department of Agriculture (USDA). After calculations, the results were adjusted for intrapersonal variability using the MSM (Multiple Source Method) of the EPIC (European Prospective Investigation into Cancer and Nutrition) [ 11 ]. The micronutrients evaluated in individuals with CKD, as outlined in the 2020 update of the "KDOQI Clinical Practice Guideline for Nutrition in CKD" for those undergoing HD, included sodium, potassium, phosphorus, calcium, selenium, zinc, B-complex vitamins, folate, vitamin C, and the fat-soluble vitamins A, D, E, and K. The percentage of energy provided by protein (%E) from consumed foods was also assessed, with foods categorized into the following groups: cereals, fruits and vegetables, meats and eggs, dairy products, oils and fats, sugars and sweets, and a category labeled "other foods." Statistical analysis Variable analysis considered central tendency measures (median, mean, and standard deviation). Comparisons between the variables studied were conducted using the Student’s T-test, with a significance level of 5%. Statistical tests were performed using SPSS® (Statistical Package for the Social Sciences, Inc., Chicago, IL, USA), version 21.0 for Windows. Results A total of 60 patients from the clinic were invited to participate, and 40 individuals were included (55% female and 45% male). The mean age was 68.5 ± 8.1 years, with the highest proportion of participants (47.5%) in the 60–65 age group. Regarding chronic diseases, hypertension was the most common condition in both women and men (86.4% and 94.4%, respectively). An analysis of nutrient intake on HD days versus the interdialytic period revealed significant differences in energy, total fat, carbohydrates, total protein, and animal protein intake, with lower nutrient consumption on HD days (p < 0.05). In terms of vitamin intake, consumption was lower on HD days for fat-soluble vitamins E and K and water-soluble vitamins B1, B3, B6, B9, B12, and C ( (p < 0.05). Mineral intake was lower for calcium, magnesium, iron, zinc, selenium, sodium, phosphorus, and potassium (Table 1 ). Table 1 Mean of dietary intake of macronutrients and micronutrients on hemodialysis days and the interdialytic interval , São Paulo, Brazil 2022. Energy and Nutrient Total (n=40) Male (n=18) Female (n=22) HD Days Interdialytic interval HD Days Interdialytic interval HD Days Interdialytic interval Mean ( ± SD) Mean ( ± SD) p-value Mean ( ± SD) Mean ( ± SD) p-value Mean ( ± SD) Mean ( ± SD) p-value Energy (kcal) 1249.6±323.54 1479.5±252.5 <0.001 1274.9 ±304.1 1448.5±240.5 0.011 1228.8±344.3 1504.9±264.8 0.002 Total Fat (g) 45.76±12.2 53.86±8.78 <0.001 45.3±10.85 48.7±6.93 0.160 46.15±13.46 58.09±7.91 0.001 Carbohydrate (g) 159.69±43.53 175.77±39.34 0.017 164.57±43.85 183.55±41.62 0.040 155.69±43.88 169.4±37.12 0.167 Sugar (g) 16.42±11.44 16.28±10.73 0.913 15.14±10.92 14.4±10.19 0.700 17.46±12.01 17.83 ±11.14 0.820 Protein (g) 52.75±14.57 74.84±16.28 <0.001 55.61±13.94 71.3±12.62 0.001 50.42±14.98 77.75±18.54 <0.001 Animal Protein (g) 29.75±9.04 50.28±14.86 <0.001 31.75±8.90 45.2±11.74 <0.001 28.11±9.03 54.45±16.06 <0.001 Vegetable Protein(g) 23.01±6.83 24.56±5.82 0.146 23.78±7.32 26.2±6.57 0.081 22.39±6.50 23.21±4.87 0.604 Leucine (g) 3.95±1.12 5.71±1.29 <0.001 4.21±1.10 5.45±1.02 <0.001 3.74±1.12 5.92±1.47 <0.001 Fiber (g) 12.63±4.76 14.54±3.79 0.019 13.62 ±4.97 15.1 ±4.10 0.145 11.82±4.54 14.10±3.55 0.073 Soluble Fiber (g) 3.55±1.25 3.74±1.46 0.413 3.6±1.12 3.7±1.32 0.687 3.51±1.4 3.76±1.60 0.486 Insoluble Fiber (g) 9.07±3.95 10.8±2.9 0.014 10.02±4.36 11.4±3.12 0.154 8.30±3.5 10.28±2.67 0.052 Vitamin D (µg) 2.96 ±0.99 2.97±1.04 0.943 8.09 ±1.01 2.89±0.94 0.375 2.86±0.99 3.04±1.13 0.373 Vitamin E (µg) 7.41±2.92 6.45±2.13 0.016 7.63±3.23 6.51±2.50 0.020 7.23±2.71 6.40 ±1.84 0.154 Vitamin A (µg) 781.81±209.17 740.52±339.40 0.462 933.47±193.54 699.3±278.74 0.001 657.72±122.83 774.24±385.2 0.130 Vitamin K (µg) 70.49± 73.36 90.74± 69.94 0.044 83.4±95.77 90.09±64.81 0.713 59.92±48.06 91.26±75.39 0.004 Vitamin C (mg) 51.72±43.49 83.63±53.69 <0.001 54.53±33.83 80.97±47.98 0.021 49.42±50.74 85.79±58.98 0.001 Thiamine (mg) 1.12±0.35 1.27±0.36 0.005 1.16±0.43 1.31±0.36 0.067 1.09±0.26 1.24±0.36 0.041 Riboflavin (mg) 1.17±0.29 1.20±0.3 0.405 1.19±0.34 1.18±0.26 0.833 1.15±0.25 1.22±0.31 0.148 Niacin (mg) 13.97±4.09 19.33±3.17 <0.001 14.56±4.43 19.12±2.77 0.001 13.48±3.82 19.5±3.52 <0.001 Vitamin B6 (mg) 0.93±0.36 1.39±0.14 <0.001 1.00±0.35 1.34±0.13 0.001 0.87±0.36 1.42±0.13 <0.001 Folate (µg) 300.15±87.52 327.53±79.2 0.033 303.55±91.24 337.7±89.9 0.076 297.37±86.42 319.18±70.35 0.222 Vitamin B12 (µg) 2.03 ±1.05 2.58±1.13 0.003 2.20±1.16 2.40±1.08 0.506 1.92±0.96 2.74±1.17 <0.001 Calcium (mg) 492.81±185.82 551.87±227.78 0.048 493.99±176.1 522.40±215.21 0.329 491.85± 97.52 575.98±239.81 0.090 Phosphor (mg) 717.64±231.45 941.41±256.17 <0.001 750.49±221.81 891.50±226.23 0.002 690.76 ±240.78 982.22±276.7 <0.01 Magnesium (mg) 162.23±57.28 201.7±39.73 <0.001 173.3±59.03 205.57±43.55 0.020 153.17±55.53 198.51±37.06 0.001 Iron (mg) 10.02±3.77 11.56±2.23 0.008 10.58±4.00 11.73±2.2 0.150 9.56±3.59 11.42 ±2.32 0.027 Zinc (mg) 6.52±2.99 9.28±2.09 <0.001 7.07±3.20 8.73±1.83 0.062 6.06±2.84 9.72±2.22 <0.001 Selenium (µg) 76.82±19.71 102.8±23.75 <0.001 82.86±19.70 101.60±22.45 0.002 71.87±18.67 103.81±25.24 <0.001 Sodium (mg) 1860.51±539.15 2254.2±464.20 <0.001 1877.75±533.3 2135.8±386.23 0.020 1846.42±556.04 2351.76±507.37 0.001 Potassium (mg) 1772.1±700.90 2311.15±296.29 <0.001 1902.3±724.20 2265.7±305.60 0.0320 1665.53±679.21 2348.29±290.14 <0.001 When comparing nutrient intake relative to total energy intake by sex, both women and men consumed a lower percentage of protein on HD days (16.78% vs. 20.18%) and a higher percentage of carbohydrates (50.48% vs. 47.02%) ( p < 0.05) (Table 2 ). Table 2 Percentage total of energy (%TE) of macronutrients in the diet on HD days and in the interdialytic interval, São Paulo, Brazil, 2022. Percentage total of energy (%TE) Total (n = 40) Male (n = 18) Female (n = 22) HD Mean (± SD) Interdialytic Mean (± SD) p-value HD Mean (± SD) Interdialytic Mean (± SD) p-value HD Mean (± SD) Interdialytic Mean (± SD) p-value Protein (%TE) 16.78 (± 2.6) 20.18 (± 3.2) < 0.001 17.41 (± 2.8) 19.7 (± 2.7) 0.008 16.278 (± 2.4) 20.57 (± 3.5) < 0.001 Carbohydrate (%TE) 50.48 (± 4.5) 47.02 (± 6.2) 0.001 50.91 (± 5.1) 49.97 (± 5.9) 0.487 50.125 (± 4.1) 44.59 (± 5.4) 0.001 Fat (%TE) 32.73 (± 4.2) 32.81 (± 4.2) 0.917 31.67 (± 3.63) 30.33 (± 3.8) 0.196 33.59 (± 4.4) 34.83 (± 3.4) 0.221 In terms of energy contribution, the largest contributor on HD days was the bread group (21.8%), followed by meat (10.8%), rice (9.3%), margarine and butter (8.7%), and milk and yogurt (6.1%). The remaining food groups contributed less than 5% of total energy intake on HD days. During the interdialytic period, the largest contributor was meat (21.6%), followed by bread (11.9%), rice (11.4%), oil (7.03%), cheese (6.7%), and beans (5.9%). On HD days, individuals consumed more bread, oils and fats, and dairy products but less meat (Table 3 ). Regarding protein intake, meat was the largest contributor (34.1%), followed by bread (21.5%), beans (8.9%), and milk and yogurt (7.8%). Other food groups contributed less than 5% of total protein intake on HD days. During the interdialytic period, meat was also the primary protein source (52.0%) but in a higher proportion, followed by bread (9.2%), beans (7.8%), and cheese (7.6%) (Table 3 ). Table 3 Energy and protein supply in relation to food groups on hemodialysis days and interdialytic interval, São Paulo, Brazil, 2022. Food Group HD Interdialytic HD Interdialytic Energy (%) Energy (%) Protein (%) Protein (%) Cereal Group¹ Bread 21.8 11.9 21.5 9.2 Rice 9.3 11.4 <5.0 <5.0 Fruit and Vegetable Group² Fruit and Vegetable ​<5.0 * ​<5.0 * Protein Group³ Meat 10.8 21.6 34.1 52 Beans 5.3 5.9 8.9 7.8 Dairy Group 4 Milk and yogurt 6.1 < 5 7.8 < 5.0 Cheese < 5.0 6.7 < 5.0 7.6 Oils and Fats Group 5 Margarine and Butter 8.7 < 5.0 < 5.0 * Olive oil and Oils 5.3 7.1 * * Sausages <5.0 < 5.0 * * 1 Cereal Group: potatoes, breads, biscuits, rice, pasta and pies, cakes and breakfast cereals, corn and couscous. 2 Fruit and Vegetable Group: vegetables, fruits, fruit juice. 3 Protein Group: meat, eggs, beans, nuts. 4 Dairy Group: milk and yogurt, cheese. 5 Oils and Fats Group: margarine and butter, olive oil and oils, processed meats. * Values ​​below 5% energy/protein were not listed. Discussion This study aimed to compare the dietary intake of older adults with CKD on HD days and during the interdialytic period and found that intake was lower on HD days for most studied nutrients. Additionally, the percentage of protein in total energy intake was lower on HD days, while the proportion of carbohydrates increased. The contribution of energy- and protein-rich foods also varied between the periods analyzed. Several factors may contribute to these findings. Patients often experience difficulties in eating on HD days due to the time spent traveling to and from the clinic or the dialysis schedule itself, leading them to skip meals, which negatively impacts their dietary intake. The observed energy intake was below the recommended 25–35 kcal/kg/day on both HD and interdialytic days. This aligns with other studies that found energy intake lower than the recommended levels for this population, which may contribute to malnutrition and frailty [ 12 – 16 ]. Another study also observed insufficient daily energy intake in older adults, with an even lower intake on HD days, a result that aligns with the findings of the present study [ 17 ]. One of the key findings of this study was that older adults consumed less protein on HD days compared to the interdialytic period. This aligns with the study by [ 18 ], which investigated whether dietary intake during dialysis was sufficient to compensate for amino acid losses and maintain muscle mass. Protein intake was insufficient, below 1.2 g/kg/day, which aligns with findings from other studies that also reported inadequate protein intake on both HD and interdialytic days [ 19 , 20 ]. However, researchres found lower energy and protein intake levels during the interdialytic period among older adults in Tunisia, which contrasts with the findings of the present study [ 17 ]. Assessment of vitamin and mineral intake revealed that most of the micronutrients analyzed failed to meet recommended levels, especially on HD days, underscoring the dietary risks for older adults undergoing HD. Key nutrients associated with dialysis efficiency, such as potassium, sodium, and phosphorus, remained below recommended levels on HD days and were consumed in even lower amounts during the interdialytic period, potentially offering a protective effect. Researchers examined nutrient intake in patients undergoing HD and found that potassium, calcium, and phosphorus intake aligned with guideline recommendations [ 21 ]. The importance of adequate nutrition in HD has been extensively documented [ 22 – 25 ]. The National Kidney Foundation’s consensus established that meals or supplements during dialysis sessions can be an effective strategy for improving nutritional status; however, this practice is not yet routinely observed [ 5 ]. Ongoing multicenter randomized clinical trials are expected to further support the inclusion of meals and supplements during dialysis as part of standard care for HD patients. Given that multiple studies have highlighted inadequate dietary intake in this population, it is crucial to reconsider nutritional strategies and the role of dietitians in HD clinics [ 26 ]. Oral supplementation can provide an additional 7–10 kcal/kg/day and 0.3–0.4 g protein/kg/day, with a minimum intake requirement of 20 kcal/kg/day and 0.4–0.8 g protein/kg/day to meet recommendations and prevent malnutrition and sarcopenia, particularly in older adults [ 27 , 28 ]. A key challenge identified in this study was patients' perception of their diet and their ability to self-monitor their intake. As the primary agents in their treatment, patients' awareness and understanding of their nutritional needs are crucial. In 2024, researchers highlighted the importance of patients' perception of their dietary needs and the role of family support in ensuring proper nutrition [ 29 ]. The role of dietitians in monitoring individuals undergoing HD is crucial for a positive prognosis. Also in 2024, another study emphasized that specialized renal dietitians should perform regular dietary assessments and ensure proper meal provision during dialysis sessions, particularly for older adults, to ensure adequate daily energy and protein intake [ 30 ]. Another important aspect that has been investigated is the impact of Ultra-Processed food on the increased consumption of phosphorus additives and on the diet quality of individuals undergoing dialysis [ 31 – 35 ]. In the present study, consumption was frequent but did not impact values ​​above 5% on energy and protein intake, perhaps due to the insistent guidance on controlled consumption of foods high in salt/sodium. This study has several limitations, primarily related to representativeness (convenience sampling) and sample size. These findings do not reflect the reality of all regional and national dialysis clinics and cannot be generalized to other HD patient groups. Regarding dietary assessment, food records may lead to underreporting, particularly in estimating portion sizes. However, the monitoring conducted by the nutritionist responsible for data collection and record review, along with necessary adjustments to food items and quantities, ensured the most accurate possible dietary calculations. Additionally, the use of specialized software for dietary intake analysis is a strength of this research. Another notable limitation in assessing dietary intake in this population is the dietary restrictions imposed, which may affect the adequate intake of various vitamins and minerals. Conclusion Older adults had lower intake of energy, protein, vitamins, and minerals on dialysis days, which could negatively impact their nutritional status. Despite the recognized role of adequate nutrition during hemodialysis and the extensive literature on the subject, inadequate planning of food and oral supplement provision is still observed in practice, along with difficulties in adherence to nutritional guidance and effective intervention. This study underscores the importance of nutritional monitoring in HD, as insufficient intake of energy, proteins, and micronutrients increases the risk of malnutrition, sarcopenia, and mortality. To support adequate nutritional status, particularly in older adults, it is recommended to offer meals with high nutritional density, energy- and protein-rich foods, and plant-based diets to ensure sufficient vitamins and minerals. Oral supplementation should also be considered. The findings of this study emphasize the importance of dialysis clinics offering personalized nutritional care and, when needed, providing dietary and nutritional supplementation. This approach is essential not only for meeting nutritional needs but also for encouraging adherence to a healthy and protective dietary pattern. Declarations Competing Interest declaration: The authors declare that they don’t have competing interests as defined by Springer, or other interests that might be perceived to influence the results and/or discussion reported in this paper. Ethics, Consent to Participate, and Consent to Publish declarations: All participants provided their consent by signing an Informed Consent Form. The study was approved by the Research Ethics Committee of Universidade São Judas Tadeu (USJT, São Judas University, approval no. 4.964.543). Data Availability declaration: The data that support the findings of this study are available on request from the corresponding author (Rita de Cassia de Aquino) who coordinated the study, from data collection to database construction and, subsequently, statistical analyses. Author Contribution declaration: Prado F.F . reviewed the literature, analyzed and interpreted the results, and wrote the article. Inveção A.M.S . and Freitas T.I . participated in the analysis and interpretation of the results. Previdelli A.N . performed the statistical analysis and interpreted the results, and critical review of the manuscript Aquino R.C. designed and coordinated the study and the final proofreading of the article. Funding statement: The authors received no financial support for the research References World Health Organization. Ageing and health (2025). https://www.who.int/news-room/fact-sheets/detail/ageing-and-health Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. 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PMID: 26480252. https://pubmed.ncbi.nlm.nih.gov/26480252/ Sabatino A, Regolisti G, Karupaiah T, Sahathevan S, Sadu Singh BK, Khor BH, Salhab N, Karavetian M, Cupisti A, Fiaccadori E (2017) Protein-energy wasting and nutritional supplementation in patients with end-stage renal disease on hemodialysis. Clin Nutr. 2017 Jun;36 3:663-671. doi: https://doi.org/10.1016/j.clnu.2016.06.007. Fotiadou E, Georgianos PI, Chourdakis M, Zebekakis PE, Liakopoulos V (2020). Eating during the Hemodialysis Session: Practice Improving Nutritional Status or a Risk Factor for Intradialytic Hypotension and Reduced Dialysis Adequacy? Nutrients. 2020 Jun 6;12 6:1703. doi: https://doi.org/10.3390/nu12061703 Nerbass FB, Antunes A de A, Cuppari L (2024). Práticas de nutricionistas em unidades de diálise no Brasil: avaliação e intervenção nutricionais. Braz J Nephrol. 9AD; 46 3. doi: https://doi.org/10.1590/2175-8239-JBN-2023-0092pt Alp Ikizler T, Cano NJ, Franch H, et al (2013). Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney International. 2013; 84 6:1096-1107. doi: https://doi.org/10.1038/ki.2013.147 Inoshita H, Asaoka D, Matsuno K, Yanagisawa N, Suzuki Y, Miyauchi K (2023) Cross-Sectional Study on the Association between Dietary Patterns and Sarcopenia in Elderly Patients with Chronic Kidney Disease Receiving Conservative Treatment. Nutrients. 2023; 15 23:4994. https://doi.org/10.3390/nu15234994 Padial M, Avesani CM, García-Testal A, Cana-Poyatos A, Lindholm B, Segura-Ortí E (2025) Dietary needs, barriers, and facilitators among patients on hemodialysis and their caregivers: The GoodRENal Project in Spain. J of Renal Nutrition (2024); 35 2:337-343. doi: https://doi.org/10.1053/j.jrn.2024.08.005 Shaaker H, Davenport A (2025). Assessment of Nutritional Intake in Patients with Kidney Failure Treated by Haemodialysis on Dialysis and Non-dialysis days. J of Renal Nutrition. Published online July 1, 2024;35 1:172-180 doi: https://doi.org/10.1053/j.jrn.2024.07.009 Watanabe MT, Araujo RM, Vogt BP, Barretti P, Caramori JCT (2016) Most processed foods consumed by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio. Clin Nutr ESPEN. 2016 Aug;14:37-41. doi: https://doi.org/10.1016/j.clnesp.2016.05.001 Epub 2016 Jun 1. PMID: 28531397. Martins AM, Bello Moreira AS, Canella DS, Rodrigues J, Santin F, Wanderley B, Lourenço RA, Avesani CM (2017) Elderly patients on hemodialysis have worse dietary quality and higher consumption of ultraprocessed food than elderly without chronic kidney disease. Nutrition. 2017 Sep;41:73-79. doi: https://doi.org/10.1016/j.nut.2017.03.013. Epub 2017 Apr 19. PMID: 28760432. Shateri Z, Eskandarzadeh S, Nouri M, Jahromi SE, Mansouri F, Babajafari S (2024) The role of ultra-processed food consumption in protein-energy wasting and sarcopenia development in patients with chronic kidney diseases. BMC Nephrol. 2024 Jan 3;25 1 :4. doi: https://doi.org/10.1186/s12882-023-03409-6 . PMID: 38172690; PMCID: PMC10763225. Sczip AC, Morais JG, Calegari A, Kruger TS, Oliveira JC, Scatone NK, Dos Santos RG, Barreto FC, Nerbass FB (2025). Hyperphosphatemia in Patients on Hemodialysis May be Driven by the Consumption of Ultraprocessed Foods. J Ren Nutr. 2025 Nov;35 6:780-786. doi: https://doi.org/10.1053/j.jrn.2025.07.007 . Epub 2025 Jul 21. PMID: 40701305. Cunha LNP, dos Santos MF, de Oliveira SV, Vieira, NM et al (2025). Consumption of ultra-processed foods and its impact on health outcomes in Hemodialysis patients: a prospective observational study. Nutrire. 2025;50 44. https://doi.org/10.1186/s41110-025-00348-0. Additional Declarations No competing interests reported. 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According to the World Health Organization, their numbers are expected to grow to approximately 2\u0026nbsp;billion individuals by 2050 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Aging increases the risk of chronic diseases, including kidney disease, which manifests as a reduction in the glomerular filtration rate (GFR).\u003c/p\u003e \u003cp\u003eA GFR below 15 mL/min/1.73m\u0026sup2; is considered kidney failure, requiring renal replacement therapy (RRT) with hemodialysis (HD) being the most commonly used dialysis modality [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Older adults with kidney disease face a high risk of severe clinical outcomes, including geriatric conditions such as functional impairment and cognitive decline, hospitalizations, cardiovascular events, and even death [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePatients undergoing HD require nutritional and dietary guidance, as certain substances are not effectively eliminated during the HD process. Food intake must be controlled, which introduces a set of challenges and emotions that can impact dietary intake and discourage adherence to treatment, particularly when restrictions are imposed without adequate individualized guidance [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies have shown that individuals undergoing HD have insufficient dietary intake of various nutrients, particularly those related to energy and protein, with notable differences between HD and non-HD days [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition to energy and nutrient intake, inadequate dietary patterns, food combinations, food groups, and bioactive substances\u0026mdash;some of which may have synergistic protective effects\u0026mdash;have been studied to a lesser extent in the context of chronic kidney disease (CKD) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGiven the importance of diet and nutrition, along with the dietary intake changes observed in older adults on HD, it is essential to monitor food consumption to enable timely interventions aimed at preventing malnutrition, sarcopenia, and other health-related consequences [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThus, this study aimed to compare the dietary intake of older adults on HD days and during the interdialytic period, while also evaluating their food consumption and the main sources of energy and protein in their diet.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and population\u003c/h2\u003e \u003cp\u003eThis observational, cross-sectional field study was conducted in 2022 and included a convenience sample of older adults (aged 60 and above) undergoing HD (n\u0026thinsp;=\u0026thinsp;40) at a clinic in the eastern region of the city of S\u0026atilde;o Paulo (SP), Brazil. It included participants of both sexes who had been undergoing HD for at least six months, typically three times per week for four hours per session, and who agreed to participate by signing an Informed Consent Form. The study was approved by the Research Ethics Committee of \u003cem\u003eUniversidade S\u0026atilde;o Judas Tadeu\u003c/em\u003e (USJT, S\u0026atilde;o Judas University, approval no. 4.964.543). Demographic variables (age, sex, and ethnicity) as well as health-related variables (comorbidities and anthropometric measurements) were either collected or self-reported.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eDietary Intake Assessment\u003c/h3\u003e\n\u003cp\u003eHabitual dietary intake was assessed using food records, with two collected on HD days and two during the interdialytic period, including one weekend day, following recommendations for estimating energy and nutrient intake in individuals with CKD [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Participants were monitored throughout the data collection period, and the records were received and reviewed by a trained nutritionist.\u003c/p\u003e \u003cp\u003eTotal energy, macronutrient (carbohydrates, proteins, and lipids), and micronutrient (vitamins and minerals) intake was analyzed using the Nutrition Data System for Research (NDSR) software, developed by the United States Department of Agriculture (USDA). After calculations, the results were adjusted for intrapersonal variability using the MSM (Multiple Source Method) of the EPIC (European Prospective Investigation into Cancer and Nutrition) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e The micronutrients evaluated in individuals with CKD, as outlined in the 2020 update of the \"KDOQI Clinical Practice Guideline for Nutrition in CKD\" for those undergoing HD, included sodium, potassium, phosphorus, calcium, selenium, zinc, B-complex vitamins, folate, vitamin C, and the fat-soluble vitamins A, D, E, and K.\u003c/p\u003e \u003cp\u003eThe percentage of energy provided by protein (%E) from consumed foods was also assessed, with foods categorized into the following groups: cereals, fruits and vegetables, meats and eggs, dairy products, oils and fats, sugars and sweets, and a category labeled \"other foods.\"\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eVariable analysis considered central tendency measures (median, mean, and standard deviation). Comparisons between the variables studied were conducted using the Student\u0026rsquo;s T-test, with a significance level of 5%. Statistical tests were performed using SPSS\u0026reg; (Statistical Package for the Social Sciences, Inc., Chicago, IL, USA), version 21.0 for Windows.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 60 patients from the clinic were invited to participate, and 40 individuals were included (55% female and 45% male). The mean age was 68.5\u0026thinsp;\u0026plusmn;\u0026thinsp;8.1 years, with the highest proportion of participants (47.5%) in the 60\u0026ndash;65 age group. Regarding chronic diseases, hypertension was the most common condition in both women and men (86.4% and 94.4%, respectively).\u003c/p\u003e \u003cp\u003eAn analysis of nutrient intake on HD days versus the interdialytic period revealed significant differences in energy, total fat, carbohydrates, total protein, and animal protein intake, with lower nutrient consumption on HD days \u003cem\u003e(p\u0026thinsp;\u0026lt;\u003c/em\u003e\u0026thinsp;0.05). In terms of vitamin intake, consumption was lower on HD days for fat-soluble vitamins E and K and water-soluble vitamins B1, B3, B6, B9, B12, and C (\u003cem\u003e(p\u0026thinsp;\u0026lt;\u003c/em\u003e\u0026thinsp;0.05). Mineral intake was lower for calcium, magnesium, iron, zinc, selenium, sodium, phosphorus, and potassium (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e Mean of dietary intake of macronutrients and micronutrients on hemodialysis days and the interdialytic interval\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003eS\u0026atilde;o Paulo, Brazil 2022.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"922\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEnergy and Nutrient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 269px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal (n=40)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 253px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale (n=18)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 267px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale (n=22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHD Days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterdialytic interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHD Days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 154px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterdialytic interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHD Days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterdialytic interval\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep-value \u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean (\u003c/strong\u003e\u0026plusmn;\u003cstrong\u003eSD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEnergy (kcal)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1249.6\u0026plusmn;323.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1479.5\u0026plusmn;252.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e1274.9 \u0026plusmn;304.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1448.5\u0026plusmn;240.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.011\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1228.8\u0026plusmn;344.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1504.9\u0026plusmn;264.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Fat (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e45.76\u0026plusmn;12.2\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e53.86\u0026plusmn;8.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e45.3\u0026plusmn;10.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e48.7\u0026plusmn;6.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e46.15\u0026plusmn;13.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e58.09\u0026plusmn;7.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCarbohydrate (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e159.69\u0026plusmn;43.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e175.77\u0026plusmn;39.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e164.57\u0026plusmn;43.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e183.55\u0026plusmn;41.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.040\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e155.69\u0026plusmn;43.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e169.4\u0026plusmn;37.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSugar (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16.42\u0026plusmn;11.44\u0026nbsp;\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e16.28\u0026plusmn;10.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.913\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e15.14\u0026plusmn;10.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e14.4\u0026plusmn;10.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.700\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e17.46\u0026plusmn;12.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e17.83 \u0026plusmn;11.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.820\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProtein (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e52.75\u0026plusmn;14.57\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e74.84\u0026plusmn;16.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e55.61\u0026plusmn;13.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e71.3\u0026plusmn;12.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e50.42\u0026plusmn;14.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e77.75\u0026plusmn;18.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAnimal Protein (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e29.75\u0026plusmn;9.04\u003cbr\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e50.28\u0026plusmn;14.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e31.75\u0026plusmn;8.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e45.2\u0026plusmn;11.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e28.11\u0026plusmn;9.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e54.45\u0026plusmn;16.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVegetable Protein(g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e23.01\u0026plusmn;6.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e24.56\u0026plusmn;5.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e23.78\u0026plusmn;7.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e26.2\u0026plusmn;6.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.081\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e22.39\u0026plusmn;6.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e23.21\u0026plusmn;4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.604\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeucine (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.95\u0026plusmn;1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e5.71\u0026plusmn;1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e4.21\u0026plusmn;1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e5.45\u0026plusmn;1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.74\u0026plusmn;1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e5.92\u0026plusmn;1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFiber (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e12.63\u0026plusmn;4.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e14.54\u0026plusmn;3.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e13.62 \u0026plusmn;4.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e15.1 \u0026plusmn;4.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e11.82\u0026plusmn;4.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e14.10\u0026plusmn;3.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.073\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSoluble Fiber (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.55\u0026plusmn;1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.74\u0026plusmn;1.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.413\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e3.6\u0026plusmn;1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e3.7\u0026plusmn;1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.51\u0026plusmn;1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.76\u0026plusmn;1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInsoluble Fiber (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9.07\u0026plusmn;3.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e10.8\u0026plusmn;2.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.014\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e10.02\u0026plusmn;4.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e11.4\u0026plusmn;3.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e8.30\u0026plusmn;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e10.28\u0026plusmn;2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 52px;\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin D (\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.96 \u0026plusmn;0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.97\u0026plusmn;1.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e8.09 \u0026plusmn;1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e2.89\u0026plusmn;0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.86\u0026plusmn;0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3.04\u0026plusmn;1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin E (\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e7.41\u0026plusmn;2.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6.45\u0026plusmn;2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.016\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e7.63\u0026plusmn;3.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e6.51\u0026plusmn;2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e7.23\u0026plusmn;2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6.40 \u0026plusmn;1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.154\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin A (\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e781.81\u0026plusmn;209.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e740.52\u0026plusmn;339.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.462\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e933.47\u0026plusmn;193.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e699.3\u0026plusmn;278.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e657.72\u0026plusmn;122.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e774.24\u0026plusmn;385.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin K \u0026nbsp;(\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e70.49\u0026plusmn; 73.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e90.74\u0026plusmn; 69.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.044\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e83.4\u0026plusmn;95.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e90.09\u0026plusmn;64.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e59.92\u0026plusmn;48.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e91.26\u0026plusmn;75.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin C (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e51.72\u0026plusmn;43.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e83.63\u0026plusmn;53.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e54.53\u0026plusmn;33.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e80.97\u0026plusmn;47.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.021\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e49.42\u0026plusmn;50.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e85.79\u0026plusmn;58.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThiamine (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.12\u0026plusmn;0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.27\u0026plusmn;0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.16\u0026plusmn;0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.31\u0026plusmn;0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.067\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.09\u0026plusmn;0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.24\u0026plusmn;0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRiboflavin (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.17\u0026plusmn;0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.20\u0026plusmn;0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.19\u0026plusmn;0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.18\u0026plusmn;0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.15\u0026plusmn;0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.22\u0026plusmn;0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNiacin (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e13.97\u0026plusmn;4.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e19.33\u0026plusmn;3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e14.56\u0026plusmn;4.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e19.12\u0026plusmn;2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e13.48\u0026plusmn;3.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e19.5\u0026plusmn;3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin B6 \u0026nbsp;(mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.93\u0026plusmn;0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.39\u0026plusmn;0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.00\u0026plusmn;0.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1.34\u0026plusmn;0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.87\u0026plusmn;0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.42\u0026plusmn;0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFolate (\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e300.15\u0026plusmn;87.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e327.53\u0026plusmn;79.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.033\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e303.55\u0026plusmn;91.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e337.7\u0026plusmn;89.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.076\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e297.37\u0026plusmn;86.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e319.18\u0026plusmn;70.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVitamin B12 \u0026nbsp;(\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.03 \u0026plusmn;1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.58\u0026plusmn;1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e2.20\u0026plusmn;1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e2.40\u0026plusmn;1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.92\u0026plusmn;0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2.74\u0026plusmn;1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCalcium (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e492.81\u0026plusmn;185.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e551.87\u0026plusmn;227.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e493.99\u0026plusmn;176.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e522.40\u0026plusmn;215.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e491.85\u0026plusmn; 97.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e575.98\u0026plusmn;239.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhosphor (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e717.64\u0026plusmn;231.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e941.41\u0026plusmn;256.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e750.49\u0026plusmn;221.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e891.50\u0026plusmn;226.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e690.76 \u0026plusmn;240.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e982.22\u0026plusmn;276.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.01\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMagnesium (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e162.23\u0026plusmn;57.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e201.7\u0026plusmn;39.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e173.3\u0026plusmn;59.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e205.57\u0026plusmn;43.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e153.17\u0026plusmn;55.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e198.51\u0026plusmn;37.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIron (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e10.02\u0026plusmn;3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e11.56\u0026plusmn;2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e10.58\u0026plusmn;4.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e11.73\u0026plusmn;2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9.56\u0026plusmn;3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e11.42 \u0026plusmn;2.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.027\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZinc (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6.52\u0026plusmn;2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9.28\u0026plusmn;2.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e7.07\u0026plusmn;3.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e8.73\u0026plusmn;1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6.06\u0026plusmn;2.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9.72\u0026plusmn;2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelenium (\u0026micro;g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e76.82\u0026plusmn;19.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e102.8\u0026plusmn;23.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e82.86\u0026plusmn;19.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e101.60\u0026plusmn;22.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e71.87\u0026plusmn;18.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e103.81\u0026plusmn;25.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSodium (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1860.51\u0026plusmn;539.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2254.2\u0026plusmn;464.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1877.75\u0026plusmn;533.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e2135.8\u0026plusmn;386.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1846.42\u0026plusmn;556.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2351.76\u0026plusmn;507.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePotassium (mg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1772.1\u0026plusmn;700.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2311.15\u0026plusmn;296.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e1902.3\u0026plusmn;724.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e2265.7\u0026plusmn;305.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.0320\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1665.53\u0026plusmn;679.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2348.29\u0026plusmn;290.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003c/br\u003e \u003cp\u003eWhen comparing nutrient intake relative to total energy intake by sex, both women and men consumed a lower percentage of protein on HD days (16.78% vs. 20.18%) and a higher percentage of carbohydrates (50.48% vs. 47.02%) (\u003cem\u003ep\u0026thinsp;\u0026lt;\u003c/em\u003e\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePercentage total of energy (%TE) of macronutrients in the diet on HD days and in the interdialytic interval, S\u0026atilde;o Paulo, Brazil, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePercentage total of energy (%TE)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;18)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eHD\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eInterdialytic\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eHD\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eInterdialytic\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eHD\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eInterdialytic\u003c/b\u003e Mean (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProtein (%TE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16.78 (\u0026plusmn;\u0026thinsp;2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.18 (\u0026plusmn;\u0026thinsp;3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17.41 (\u0026plusmn;\u0026thinsp;2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.7 (\u0026plusmn;\u0026thinsp;2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16.278 (\u0026plusmn;\u0026thinsp;2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20.57 (\u0026plusmn;\u0026thinsp;3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCarbohydrate (%TE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50.48 (\u0026plusmn;\u0026thinsp;4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.02 (\u0026plusmn;\u0026thinsp;6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50.91 (\u0026plusmn;\u0026thinsp;5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.97 (\u0026plusmn;\u0026thinsp;5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.487\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e50.125 (\u0026plusmn;\u0026thinsp;4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e44.59 (\u0026plusmn;\u0026thinsp;5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFat (%TE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.73 (\u0026plusmn;\u0026thinsp;4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.81 (\u0026plusmn;\u0026thinsp;4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.67 (\u0026plusmn;\u0026thinsp;3.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e30.33 (\u0026plusmn;\u0026thinsp;3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33.59 (\u0026plusmn;\u0026thinsp;4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e34.83 (\u0026plusmn;\u0026thinsp;3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of energy contribution, the largest contributor on HD days was the bread group (21.8%), followed by meat (10.8%), rice (9.3%), margarine and butter (8.7%), and milk and yogurt (6.1%). The remaining food groups contributed less than 5% of total energy intake on HD days. During the interdialytic period, the largest contributor was meat (21.6%), followed by bread (11.9%), rice (11.4%), oil (7.03%), cheese (6.7%), and beans (5.9%). On HD days, individuals consumed more bread, oils and fats, and dairy products but less meat (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding protein intake, meat was the largest contributor (34.1%), followed by bread (21.5%), beans (8.9%), and milk and yogurt (7.8%). Other food groups contributed less than 5% of total protein intake on HD days. During the interdialytic period, meat was also the primary protein source (52.0%) but in a higher proportion, followed by bread (9.2%), beans (7.8%), and cheese (7.6%) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEnergy and protein supply in relation to food groups on hemodialysis days and interdialytic interval, S\u0026atilde;o Paulo, Brazil, 2022.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFood Group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInterdialytic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eInterdialytic\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnergy (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEnergy (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProtein (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eProtein (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eCereal Group\u0026sup1;\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBread\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFruit and Vegetable Group\u0026sup2;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFruit and Vegetable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e​\u0026lt;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e​\u0026lt;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProtein Group\u0026sup3;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDairy Group\u003c/b\u003e\u003csup\u003e\u003cb\u003e4\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMilk and yogurt\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCheese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOils and Fats Group\u003c/b\u003e\u003csup\u003e\u003cb\u003e5\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMargarine and Butter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOlive oil and Oils\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSausages\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e1\u003c/sup\u003eCereal Group: potatoes, breads, biscuits, rice, pasta and pies, cakes and breakfast cereals, corn and couscous.\u003c/p\u003e \u003cp\u003e \u003csup\u003e2\u003c/sup\u003e Fruit and Vegetable Group: vegetables, fruits, fruit juice.\u003c/p\u003e \u003cp\u003e \u003csup\u003e3\u003c/sup\u003e Protein Group: meat, eggs, beans, nuts.\u003c/p\u003e \u003cp\u003e \u003csup\u003e4\u003c/sup\u003e Dairy Group: milk and yogurt, cheese.\u003c/p\u003e \u003cp\u003e \u003csup\u003e5\u003c/sup\u003e Oils and Fats Group: margarine and butter, olive oil and oils, processed meats.\u003c/p\u003e \u003cp\u003e* Values ​​below 5% energy/protein were not listed.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to compare the dietary intake of older adults with CKD on HD days and during the interdialytic period and found that intake was lower on HD days for most studied nutrients. Additionally, the percentage of protein in total energy intake was lower on HD days, while the proportion of carbohydrates increased. The contribution of energy- and protein-rich foods also varied between the periods analyzed.\u003c/p\u003e \u003cp\u003eSeveral factors may contribute to these findings. Patients often experience difficulties in eating on HD days due to the time spent traveling to and from the clinic or the dialysis schedule itself, leading them to skip meals, which negatively impacts their dietary intake.\u003c/p\u003e \u003cp\u003eThe observed energy intake was below the recommended 25\u0026ndash;35 kcal/kg/day on both HD and interdialytic days. This aligns with other studies that found energy intake lower than the recommended levels for this population, which may contribute to malnutrition and frailty [\u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Another study also observed insufficient daily energy intake in older adults, with an even lower intake on HD days, a result that aligns with the findings of the present study [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOne of the key findings of this study was that older adults consumed less protein on HD days compared to the interdialytic period. This aligns with the study by [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], which investigated whether dietary intake during dialysis was sufficient to compensate for amino acid losses and maintain muscle mass. Protein intake was insufficient, below 1.2 g/kg/day, which aligns with findings from other studies that also reported inadequate protein intake on both HD and interdialytic days [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. However, researchres found lower energy and protein intake levels during the interdialytic period among older adults in Tunisia, which contrasts with the findings of the present study [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAssessment of vitamin and mineral intake revealed that most of the micronutrients analyzed failed to meet recommended levels, especially on HD days, underscoring the dietary risks for older adults undergoing HD. Key nutrients associated with dialysis efficiency, such as potassium, sodium, and phosphorus, remained below recommended levels on HD days and were consumed in even lower amounts during the interdialytic period, potentially offering a protective effect. Researchers examined nutrient intake in patients undergoing HD and found that potassium, calcium, and phosphorus intake aligned with guideline recommendations [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe importance of adequate nutrition in HD has been extensively documented [\u003cspan additionalcitationids=\"CR23 CR24\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The National Kidney Foundation\u0026rsquo;s consensus established that meals or supplements during dialysis sessions can be an effective strategy for improving nutritional status; however, this practice is not yet routinely observed [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Ongoing multicenter randomized clinical trials are expected to further support the inclusion of meals and supplements during dialysis as part of standard care for HD patients.\u003c/p\u003e \u003cp\u003eGiven that multiple studies have highlighted inadequate dietary intake in this population, it is crucial to reconsider nutritional strategies and the role of dietitians in HD clinics [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Oral supplementation can provide an additional 7\u0026ndash;10 kcal/kg/day and 0.3\u0026ndash;0.4 g protein/kg/day, with a minimum intake requirement of 20 kcal/kg/day and 0.4\u0026ndash;0.8 g protein/kg/day to meet recommendations and prevent malnutrition and sarcopenia, particularly in older adults [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA key challenge identified in this study was patients' perception of their diet and their ability to self-monitor their intake. As the primary agents in their treatment, patients' awareness and understanding of their nutritional needs are crucial. In 2024, researchers highlighted the importance of patients' perception of their dietary needs and the role of family support in ensuring proper nutrition [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe role of dietitians in monitoring individuals undergoing HD is crucial for a positive prognosis. Also in 2024, another study emphasized that specialized renal dietitians should perform regular dietary assessments and ensure proper meal provision during dialysis sessions, particularly for older adults, to ensure adequate daily energy and protein intake [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother important aspect that has been investigated is the impact of Ultra-Processed food on the increased consumption of phosphorus additives and on the diet quality of individuals undergoing dialysis [\u003cspan additionalcitationids=\"CR32 CR33 CR34\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. In the present study, consumption was frequent but did not impact values ​​above 5% on energy and protein intake, perhaps due to the insistent guidance on controlled consumption of foods high in salt/sodium.\u003c/p\u003e \u003cp\u003eThis study has several limitations, primarily related to representativeness (convenience sampling) and sample size. These findings do not reflect the reality of all regional and national dialysis clinics and cannot be generalized to other HD patient groups. Regarding dietary assessment, food records may lead to underreporting, particularly in estimating portion sizes. However, the monitoring conducted by the nutritionist responsible for data collection and record review, along with necessary adjustments to food items and quantities, ensured the most accurate possible dietary calculations. Additionally, the use of specialized software for dietary intake analysis is a strength of this research. Another notable limitation in assessing dietary intake in this population is the dietary restrictions imposed, which may affect the adequate intake of various vitamins and minerals.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOlder adults had lower intake of energy, protein, vitamins, and minerals on dialysis days, which could negatively impact their nutritional status. Despite the recognized role of adequate nutrition during hemodialysis and the extensive literature on the subject, inadequate planning of food and oral supplement provision is still observed in practice, along with difficulties in adherence to nutritional guidance and effective intervention. This study underscores the importance of nutritional monitoring in HD, as insufficient intake of energy, proteins, and micronutrients increases the risk of malnutrition, sarcopenia, and mortality. To support adequate nutritional status, particularly in older adults, it is recommended to offer meals with high nutritional density, energy- and protein-rich foods, and plant-based diets to ensure sufficient vitamins and minerals. Oral supplementation should also be considered.\u003c/p\u003e \u003cp\u003eThe findings of this study emphasize the importance of dialysis clinics offering personalized nutritional care and, when needed, providing dietary and nutritional supplementation. This approach is essential not only for meeting nutritional needs but also for encouraging adherence to a healthy and protective dietary pattern.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCompeting Interest declaration:\u003c/strong\u003e The authors declare that they don\u0026rsquo;t have competing interests as defined by Springer, or other interests that might be perceived to influence the results and/or discussion reported in this paper.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics, Consent to Participate, and Consent to Publish declarations:\u003c/strong\u003e All participants\u0026nbsp;provided their consent by signing an Informed Consent Form. The study was approved by the Research Ethics Committee of \u003cem\u003eUniversidade S\u0026atilde;o Judas Tadeu\u003c/em\u003e (USJT, S\u0026atilde;o Judas University, approval no. 4.964.543).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability declaration:\u003c/strong\u003e The data that support the findings of this study are available on request from the corresponding author (Rita de Cassia de Aquino) who coordinated the study, from data collection to database construction and, subsequently, statistical analyses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution declaration:\u003c/strong\u003e \u003cstrong\u003ePrado F.F\u003c/strong\u003e. reviewed the literature, analyzed and interpreted the results, and wrote the article. \u0026nbsp;\u003cstrong\u003eInve\u0026ccedil;\u0026atilde;o A.M.S\u003c/strong\u003e. and \u003cstrong\u003eFreitas T.I\u003c/strong\u003e. participated in the analysis and interpretation of the results. \u003cstrong\u003ePrevidelli A.N\u003c/strong\u003e. performed the statistical analysis and interpreted the results, and critical review of the manuscript \u003cstrong\u003eAquino R.C.\u003c/strong\u003e designed and coordinated the study and the final proofreading of the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement:\u0026nbsp;\u003c/strong\u003eThe authors received no financial support for the research\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization. Ageing and health (2025). https://www.who.int/news-room/fact-sheets/detail/ageing-and-health\u003c/li\u003e\n\u003cli\u003eKidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105(4S):S117–314. https://doi.org/10.1016/j.kint.2023.10.018.\u003c/li\u003e\n\u003cli\u003eIkizler T, Burrowes J, Byham-Gray L, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. American journal of kidney diseases : the official journal of the National Kidney Foundation. 2020;76 3S1:S1-S107. https://doi.org/10.1053/j.ajkd.2020.05.006\u003c/li\u003e\n\u003cli\u003eTang Y, Jiang J, Zhao Y, Du D. Aging and chronic kidney disease: epidemiology, therapy, management and the role of immunity. Clin Kidney J. 2024;17(9). https://doi.org/10.1093/ckj/sfae235\u003c/li\u003e\n\u003cli\u003eKistler BM, Benner D, Burrowes JD et al. 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Smith. Comparison of Dietary Patterns and Daily Food Intake Across Kidney Disease Stages in England: An A-Posteriori Cluster Analysis. J Ren Nutr. 2024;35 (1): 90 – 102. https://doi.org/10.1053/j.jrn.2024.07.010\u003c/li\u003e\n\u003cli\u003eAlvarenga L, Andrade B, Moreira MA, Nascimento R de P, Macedo ID, Aguiar AS. Nutritional profile of hemodialysis patients concerning treatment time. J Bras de nefrologia : Órgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia. 2017;39 3:283-286. https://doi.org/10.5935/0101-2800.20170052.\u003c/li\u003e\n\u003cli\u003eHarttig U, Haubrock J, Knüppel S, Boeing H (2011) The MSM program: the web-based statistics package for estimating usual dietary intake using the Multiple Source Method, 2011. 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PMID: 28760432.\u003c/li\u003e\n\u003cli\u003eShateri Z, Eskandarzadeh S, Nouri M, Jahromi SE, Mansouri F, Babajafari S (2024) The role of ultra-processed food consumption in protein-energy wasting and sarcopenia development in patients with chronic kidney diseases. BMC Nephrol. 2024 Jan 3;25 1 :4. doi: https://doi.org/10.1186/s12882-023-03409-6 . PMID: 38172690; PMCID: PMC10763225.\u003c/li\u003e\n\u003cli\u003eSczip AC, Morais JG, Calegari A, Kruger TS, Oliveira JC, Scatone NK, Dos Santos RG, Barreto FC, Nerbass FB (2025). Hyperphosphatemia in Patients on Hemodialysis May be Driven by the Consumption of Ultraprocessed Foods. J Ren Nutr. 2025 Nov;35 6:780-786. doi: https://doi.org/10.1053/j.jrn.2025.07.007 . Epub 2025 Jul 21. PMID: 40701305.\u003c/li\u003e\n\u003cli\u003eCunha LNP, dos Santos MF, de Oliveira SV, Vieira, NM et al (2025). Consumption of ultra-processed foods and its impact on health outcomes in Hemodialysis patients: a prospective observational study. Nutrire. 2025;50 44. https://doi.org/10.1186/s41110-025-00348-0.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Dietary Intake, Older adults, Renal Dialysis","lastPublishedDoi":"10.21203/rs.3.rs-8981196/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8981196/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThe older adult population is growing, increasing the incidence of chronic diseases such as kidney disease, which may progress to the need for hemodialysis (HD). The objective of the present study was to compare the dietary intake among older adults with chronic kidney disease (CKD) on HD and during the interdialytic period.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study was conducted with individuals (n\u0026thinsp;=\u0026thinsp;40) aged 60 years or older undergoing HD at a specialized clinic. Dietary intake was assessed using four non-consecutive food records (two HD days and two non-HD days). Participants and their families received instructions on completing the records after receiving a manual and guidance from a specialized nutritionist at the clinic. Total energy, macro- and micronutrient intake was analyzed using the software NDSR (Nutrition Data System for Research), and the results were adjusted for intrapersonal variability.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOn HD days, food intake was lower (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) for total energy, total fats, proteins (total and animal-derived), dietary fiber (total and insoluble), and most minerals and vitamins. Additionally, the percentage of protein in total energy intake was higher, with animal meat being the primary protein source.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe older adults undergoing HD in this study exhibited inadequate dietary intake on HD days. Despite the recognized role of adequate nutrition during hemodialysis, inadequate planning of food and oral supplement provision is still observed in practice, along with difficulties in adherence to nutritional guidance and effective intervention, as well as the planning and provision of nutritionally appropriate snacks and dietary supplements.\u003c/p\u003e","manuscriptTitle":"Dietary intake on dialysis and interdialytic days: a study with older adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-18 15:55:40","doi":"10.21203/rs.3.rs-8981196/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"99f81ed2-ec1f-49a9-9458-f4ed3d60eba6","owner":[],"postedDate":"March 18th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-13T11:12:33+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-18 15:55:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8981196","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8981196","identity":"rs-8981196","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}