Browsing by Author "Smith, Alice C."

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    A Comparison of Dietary Intake Between Individuals Undergoing Maintenance Hemodialysis in the United Kingdom and China
    (Elsevier, 2022-03) Song, Yan; March, Daniel S.; Biruete, Annabel; Kistler, Brandon M.; Nixon, Daniel D. G.; Highton, Patrick J.; Vogt, Barbara P.; Ruddock, Nicola; Wilund, Kenneth R.; Smith, Alice C.; Burton, James O.; Medicine, School of Medicine
    OBJECTIVE: Protein-energy wasting is highly prevalent in people with end-stage kidney disease receiving regular hemodialysis. Currently, it is unclear what the optimal nutritional recommendations are, which is further complicated by differences in dietary patterns between countries. The aim of the study was to understand and compare dietary intake between individuals receiving hemodialysis in Leicester, UK and Nantong, China. METHODS: The study assessed 40 UK and 44 Chinese participants' dietary intake over a period of 14 days using 24-hour diet recall interviews. Nutritional blood parameters were obtained from medical records. Food consumed by participants in the UK and China was analyzed using the Nutritics and Nutrition calculator to quantify nutritional intake. RESULTS: Energy and protein intake were comparable between UK and Chinese participants, but with both below the recommended daily intake. Potassium intake was higher in UK participants compared to Chinese participants (2,115 [888] versus 1,159 [861] mg/d; P < .001), as was calcium (618 [257] versus 360 [312] mg/d; P < .001) and phosphate intake (927 [485] versus 697 [434] mg/d; P = .007). Vitamin C intake was lower in UK participants compared to their Chinese counterparts (39 [51] versus 64 [42] mg/d; P = .024). Data are reported here as median (interquartile range). CONCLUSION: Both UK and Chinese hemodialysis participants have insufficient protein and energy in their diet. New strategies are required to increase protein and energy intakes. All participants had inadequate daily intake of vitamins C and D; there may well be a role in the oral supplementation of these vitamins, and further studies are urgently needed.
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    Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care
    (Elsevier, 2022-07) Bennett, Paul N.; Kohzuki, Masahiro; Bohm, Clara; Roshanravan, Baback; Bakker, Stephan J. L.; Viana, Joao L.; MacRae, Jennifer M.; Wilkinson, Thomas J.; Wilund, Kenneth R.; Van Craenenbroeck, Amaryllis H.; Sakkas, Giorgos K.; Mustata, Stefan; Fowler, Kevin; McDonald, Jamie; Aleamany, Geovana Martin; Anding, Kirsten; Avin, Keith G.; Escobar, Gabriela Leal; Gabrys, Iwona; Goth, Jill; Isnard, Myriam; Jhamb, Manisha; Kim, Jun Chul; Li, John Wing; Lightfoot, Courtney J.; McAdams-DeMarco, Mara; Manfredini, Fabio; Meade, Anthony; Molsted, Stig; Parker, Kristen; Seguri-Orti, Eva; Smith, Alice C.; Verdin, Nancy; Zheng, Jing; Zimmerman, Deb; Thompson, Stephanie; Global Renal Exercise Network (GREX); Medicine, School of Medicine
    Objective Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. Design and Methods Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. Results We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional examples where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. Conclusions We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.