{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:13:43Z","timestamp":1783469623194,"version":"3.55.0"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006182","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa e Inova\u00e7\u00e3o do Esp\u00edrito Santo","doi-asserted-by":"publisher","award":["FAPES\/CNPq\/Decit\u2013SCTIE-MS\/SESA n\u02da 03\/2018 and FAPES n\u00ba 15\/2022 - PROFIX"],"award-info":[{"award-number":["FAPES\/CNPq\/Decit\u2013SCTIE-MS\/SESA n\u02da 03\/2018 and FAPES n\u00ba 15\/2022 - PROFIX"]}],"id":[{"id":"10.13039\/501100006182","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abdominal dynapenic obesity, defined by the combination of excessive abdominal fat accumulation and reduced muscle strength, is an important marker for assessing nutritional status in hemodialysis patients. However, evidence on how dietary patterns influence this condition is limited. Therefore, this study aimed to explore factors associated with adherence to dietary patterns in patients who require hemodialysis and assess the link between these patterns and dynapenic abdominal obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross-sectional study involving 996 patients requiring hemodialysis in Southeastern Brazil. Dietary patterns were identified using principal component analysis. Dynapenic abdominal obesity was defined by abdominal obesity and reduced muscle strength (measured by handgrip).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, three dietary patterns were identified: ovovegetarian; cafeteria; and traditional Brazilian. Higher adherence was associated with approximately twofold higher odds among individuals with an income above two minimum wages and those who engaged in physical activity. Men, patients undergoing hemodialysis for a longer duration, those who engaged in physical activity, and alcohol consumers were more likely to adhere to the cafeteria pattern, whereas older patients requiring hemodialysis and those without paid employment were less likely to adhere to this pattern. Individuals with more education adopted the traditional Brazilian pattern less often, but men and exclusive users of the public health system adhered to it more commonly. After adjustments for confounding variables, patients requiring hemodialysis with greater adherence to the traditional dietary pattern had 40.4% lower odds of dynapenic abdominal obesity (OR\u2009=\u20090.596, 95% CI 0.435\u20130.816,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings underscore the complexity of dietary choices in patients undergoing hemodialysis, as these are influenced by a wide range of factors, and highlight that greater adherence to the traditional Brazilian dietary pattern was associated with lower odds of dynapenic abdominal obesity in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-026-05032-7","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T04:45:31Z","timestamp":1778647531000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Traditional Brazilian dietary pattern as a factor associated with lower prevalence of dynapenic abdominal obesity in hemodialysis patients"],"prefix":"10.1186","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8973-622X","authenticated-orcid":false,"given":"Monica","family":"Cattafesta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0306","authenticated-orcid":false,"given":"Luciane Bresciani","family":"Salaroli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"5032_CR1","unstructured":"Organizaci\u00f3n Mundial de la Salud (OMS). Es hora de actuar. Informe de la Comisi\u00f3n. Independiente de Alto Nivel de la OMS sobre Enfermedades No Transmisibles; 2018."},{"key":"5032_CR2","doi-asserted-by":"publisher","unstructured":"McAuley EA, Ross LA, Hannan-Jones MT, MacLaughlin HL. Diet quality, Self-efficacy and Health Literacy in Adults with Chronic Kidney Disease: A Cross-Sectional Study. J Ren Nutr. 2024;S1051227624001419https:\/\/doi.org\/10.1053\/j.jrn.2024.06.005.","DOI":"10.1053\/j.jrn.2024.06.005"},{"key":"5032_CR3","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","volume":"12","author":"CP Kovesdy","year":"2022","unstructured":"Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Supplements. 2022;12:7\u201311. https:\/\/doi.org\/10.1016\/j.kisu.2021.11.003.","journal-title":"Kidney Int Supplements"},{"key":"5032_CR4","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","volume":"395","author":"B Bikbov","year":"2020","unstructured":"Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395:709\u201333. https:\/\/doi.org\/10.1016\/S0140-6736(20)30045-3.","journal-title":"Lancet"},{"key":"5032_CR5","doi-asserted-by":"publisher","first-page":"e20230062","DOI":"10.1590\/2175-8239-jbn-2023-0062pt","volume":"46","author":"FB Nerbass","year":"2024","unstructured":"Nerbass FB, Lima HDN, Moura-Neto JA, Lugon JR, Sesso R. Censo Brasileiro de Di\u00e1lise 2022. Braz J Nephrol. 2024;46:e20230062. https:\/\/doi.org\/10.1590\/2175-8239-jbn-2023-0062pt.","journal-title":"Braz J Nephrol"},{"key":"5032_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26633\/RPSP.2017.113","volume":"41","author":"GA Pedroza Cos\u00edo","year":"2017","unstructured":"Pedroza Cos\u00edo GA, S\u00e1nchez Escobar LE, Mungu\u00eda Lozano S, Beltr\u00e1n Lagunes L, Ferrer \u00c1lvarez JG, Medina Arregu\u00edn R, et al. Evaluaci\u00f3n de la Escala EFD-66 como herramienta para predecir la adherencia al tratamiento en pacientes con enfermedades cr\u00f3nicas no transmisibles. Revista Panam de Salud P\u00fablica. 2017;41:1. https:\/\/doi.org\/10.26633\/RPSP.2017.113.","journal-title":"Revista Panam de Salud P\u00fablica"},{"key":"5032_CR7","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1186\/s12882-019-1573-x","volume":"20","author":"LGG Dantas","year":"2019","unstructured":"Dantas LGG, De Seixas Rocha M, Junior JAM, Paschoalin EL, Paschoalin SRKP, Sampaio Cruz CM. Non-adherence to Haemodialysis, Interdialytic weight gain and cardiovascular mortality: a cohort study. BMC Nephrol. 2019;20:402. https:\/\/doi.org\/10.1186\/s12882-019-1573-x.","journal-title":"BMC Nephrol"},{"key":"5032_CR8","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1053\/j.jrn.2018.04.009","volume":"29","author":"Y Tamaura","year":"2019","unstructured":"Tamaura Y, Nishitani M, Akamatsu R, Tsunoda N, Iwasawa F, Fujiwara K, et al. Association Between Interdialytic Weight Gain, Perception About Dry Weight, and Dietary and Fluid Behaviors Based on Body Mass Index Among Patients on Hemodialysis. J Ren Nutr. 2019;29:24\u2013e325. https:\/\/doi.org\/10.1053\/j.jrn.2018.04.009.","journal-title":"J Ren Nutr"},{"key":"5032_CR9","doi-asserted-by":"publisher","first-page":"12","DOI":"10.11606\/s1518-8787.2023057004744","volume":"57","author":"MLDC Louzada","year":"2023","unstructured":"Louzada MLDC, Cruz GLD, Silva KAAN, Grassi AGF, Andrade GC, Rauber F, et al. Consumo de alimentos ultraprocessados no Brasil: distribui\u00e7\u00e3o e evolu\u00e7\u00e3o temporal 2008\u20132018. Rev sa\u00fade p\u00fablica. 2023;57:12. https:\/\/doi.org\/10.11606\/s1518-8787.2023057004744.","journal-title":"Rev sa\u00fade p\u00fablica"},{"key":"5032_CR10","doi-asserted-by":"publisher","first-page":"1043620","DOI":"10.3389\/fnut.2022.1043620","volume":"9","author":"EAF Nilson","year":"2022","unstructured":"Nilson EAF, Ferrari G, Louzada MLDC, Levy RB, Monteiro CA, Rezende LFM. The estimated burden of ultra-processed foods on cardiovascular disease outcomes in Brazil: A modeling study. Front Nutr. 2022;9:1043620. https:\/\/doi.org\/10.3389\/fnut.2022.1043620.","journal-title":"Front Nutr"},{"key":"5032_CR11","doi-asserted-by":"publisher","first-page":"100341","DOI":"10.1016\/j.jcte.2024.100341","volume":"36","author":"MM Ali","year":"2024","unstructured":"Ali MM, Parveen S, Williams V, Dons R, Uwaifo GI. Cardiometabolic comorbidities and complications of obesity and chronic kidney disease (CKD). J Clin Translational Endocrinol. 2024;36:100341. https:\/\/doi.org\/10.1016\/j.jcte.2024.100341.","journal-title":"J Clin Translational Endocrinol"},{"key":"5032_CR12","doi-asserted-by":"publisher","first-page":"494","DOI":"10.3390\/ijms21020494","volume":"21","author":"S Hong","year":"2020","unstructured":"Hong S, Choi KM. Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences. IJMS. 2020;21:494. https:\/\/doi.org\/10.3390\/ijms21020494.","journal-title":"IJMS"},{"key":"5032_CR13","doi-asserted-by":"publisher","unstructured":"Manini TM, Clark BC. Dynapenia and Aging: An Update. Journals Gerontology: Ser A. 2012;67A:28\u201340. https:\/\/doi.org\/10.1093\/gerona\/glr010.","DOI":"10.1093\/gerona\/glr010"},{"key":"5032_CR14","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1007\/s12603-023-1975-0","volume":"27","author":"X Wang","year":"2023","unstructured":"Wang X, Jiang J, Hu W, Hu Y, Qin L-Q, Hao Y, et al. Dynapenic Abdominal Obesity and Risk of Heart Disease among Middle-Aged and Older Adults: A Prospective Cohort Study. J Nutr health aging. 2023;27:752\u20138. https:\/\/doi.org\/10.1007\/s12603-023-1975-0.","journal-title":"J Nutr health aging"},{"key":"5032_CR15","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1016\/j.numecd.2023.05.011","volume":"33","author":"L De Paiva Souza","year":"2023","unstructured":"De Paiva Souza L, Martins CA, Cattafesta M, Theodoro Dos Santos-Neto E, Salaroli LB. Waist-to-height ratio and dynapenic abdominal obesity in users of hemodialysis services. Nutr Metabolism Cardiovasc Dis. 2023;33:1583\u201390. https:\/\/doi.org\/10.1016\/j.numecd.2023.05.011.","journal-title":"Nutr Metabolism Cardiovasc Dis"},{"key":"5032_CR16","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1053\/j.akdh.2023.07.007","volume":"30","author":"H Bakis","year":"2023","unstructured":"Bakis H, Chauveau P, Combe C, Pfirmann P. Mediterranean Diet for Cardiovascular Risk Reduction in Chronic Kidney Disease. Adv Kidney Disease Health. 2023;30:496\u2013501. https:\/\/doi.org\/10.1053\/j.akdh.2023.07.007.","journal-title":"Adv Kidney Disease Health"},{"key":"5032_CR17","doi-asserted-by":"publisher","first-page":"237","DOI":"10.36311\/jhgd.v32.13856","volume":"32","author":"NMP Marques","year":"2022","unstructured":"Marques NMP, Cattafesta M, Lacerda Pires Soares F, Blaser Petarli G, Patr\u00edcia Castro Pereira Paix\u00e3o M, Alves Martins C, et al. Consumption of minimally processed and ultra-processed foods by individuals on hemodialysis in southeastern Brazil. jhgd. 2022;32:237\u201351. https:\/\/doi.org\/10.36311\/jhgd.v32.13856.","journal-title":"jhgd"},{"key":"5032_CR18","doi-asserted-by":"publisher","first-page":"212","DOI":"10.3390\/obesities4030019","volume":"4","author":"SJ Gering","year":"2024","unstructured":"Gering SJ, Martins CA, Marques NMP, Cattafesta M, Da Cunha AC, Soares FLP, et al. The Consumption of Ultra-Processed Foods Is Associated with Abdominal Obesity in Individuals on Hemodialysis in Brazil. Obesities. 2024;4:212\u201325. https:\/\/doi.org\/10.3390\/obesities4030019.","journal-title":"Obesities"},{"key":"5032_CR19","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1590\/1516-3180.2014.00533004","volume":"133","author":"LW Mannato","year":"2015","unstructured":"Mannato LW, Pereira TSS, Velasquez-Melendez G, Cardoso LDO, Bense\u00f1or IM, Molina MDCB. Comparison of a short version of the Food Frequency Questionnaire with its long version - a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Sao Paulo Med J. 2015;133:414\u201320. https:\/\/doi.org\/10.1590\/1516-3180.2014.00533004.","journal-title":"Sao Paulo Med J"},{"key":"5032_CR20","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1590\/S0102-311X2013000600024","volume":"29","author":"MDCB Molina","year":"2013","unstructured":"Molina MDCB, Bense\u00f1or IM, Cardoso LDO, Velasquez-Melendez G, Drehmer M, Pereira TSS, et al. Reprodutibilidade e validade relativa do Question\u00e1rio de Frequ\u00eancia Alimentar do ELSA-Brasil. Cad Sa\u00fade P\u00fablica. 2013;29:379\u201389. https:\/\/doi.org\/10.1590\/S0102-311X2013000600024.","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"5032_CR21","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1590\/S0102-311X2003000500027","volume":"19","author":"RG Andrade","year":"2003","unstructured":"Andrade RG, Pereira RA, Sichieri R. Consumo alimentar de adolescentes com e sem sobrepeso do Munic\u00edpio do Rio de Janeiro. Cad Sa\u00fade P\u00fablica. 2003;19:1485\u201395. https:\/\/doi.org\/10.1590\/S0102-311X2003000500027.","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"5032_CR22","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1079\/PHN2001318","volume":"5","author":"J Cade","year":"2002","unstructured":"Cade J, Thompson R, Burley V, Warm D. Development, validation and utilisation of food-frequency questionnaires \u2013 a review. Public Health Nutr. 2002;5:567\u201387. https:\/\/doi.org\/10.1079\/PHN2001318.","journal-title":"Public Health Nutr"},{"key":"5032_CR23","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1017\/S0029665113000013","volume":"72","author":"MC Ock\u00e9","year":"2013","unstructured":"Ock\u00e9 MC. Evaluation of methodologies for assessing the overall diet: dietary quality scores and dietary pattern analysis. Proc Nutr Soc. 2013;72:191\u20139. https:\/\/doi.org\/10.1017\/S0029665113000013.","journal-title":"Proc Nutr Soc"},{"key":"5032_CR24","first-page":"213","volume-title":"Epidemiologia nutricional","author":"MTA Olinto","year":"2007","unstructured":"Olinto MTA. Padr\u00f5es alimentares: an\u00e1lise de componentes principais. In: Kac G, Sichieri R, Gigante DP, editors. Epidemiologia nutricional. Rio de Janeiro: Fiocruz; Atheneu; 2007. pp. 213\u201325."},{"key":"5032_CR25","unstructured":"Hair JF Jr., Black WC, Babin BJ, Anderson RE, Tatham RL. An\u00e1lise multivariada de dados. 6th edition. Porto Alegre: Bookman; 2009."},{"key":"5032_CR26","doi-asserted-by":"publisher","unstructured":"Nogueira VC, Arruda SPM, Sampaio HA, de Rodrigues C, Silva BC, Farias EB et al. BO,. Fatores socioecon\u00f4micos, demogr\u00e1ficos e de estilo de vida associados a padr\u00f5es alimentares de trabalhadores em turnos. Ci\u00eanc sa\u00fade coletiva. 2019;24:761\u20139. https:\/\/doi.org\/10.1590\/1413-81232018243.03362017","DOI":"10.1590\/1413-81232018243.03362017"},{"key":"5032_CR27","doi-asserted-by":"publisher","first-page":"3909","DOI":"10.1590\/1413-812320182410.31342017","volume":"24","author":"M Cattafesta","year":"2019","unstructured":"Cattafesta M, Zandonade E, Bissoli NS, Salaroli LB. Padr\u00f5es alimentares de trabalhadores banc\u00e1rios e sua associa\u00e7\u00e3o com fatores socioecon\u00f4micos, comportamentais e laborais. Ci\u00eanc sa\u00fade coletiva. 2019;24:3909\u201322. https:\/\/doi.org\/10.1590\/1413-812320182410.31342017.","journal-title":"Ci\u00eanc sa\u00fade coletiva"},{"key":"5032_CR28","volume-title":"Anthropometric standardization reference manual","author":"TG Lohman","year":"1988","unstructured":"Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Champaign: Champaign Human Kinetics Books; 1988."},{"key":"5032_CR29","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1080\/09637480500195066","volume":"56","author":"M Ashwell","year":"2005","unstructured":"Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56:303\u20137. https:\/\/doi.org\/10.1080\/09637480500195066.","journal-title":"Int J Food Sci Nutr"},{"key":"5032_CR30","doi-asserted-by":"publisher","first-page":"1390","DOI":"10.1007\/s00198-006-0133-y","volume":"17","author":"SA Jamal","year":"2006","unstructured":"Jamal SA, Leiter RE, Jassal V, Hamilton CJ, Bauer DC. Impaired muscle strength is associated with fractures in hemodialysis patients. Osteoporos Int. 2006;17:1390\u20137. https:\/\/doi.org\/10.1007\/s00198-006-0133-y.","journal-title":"Osteoporos Int"},{"key":"5032_CR31","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","volume":"48","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruy\u00e8re O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16\u201331. https:\/\/doi.org\/10.1093\/ageing\/afy169.","journal-title":"Age Ageing"},{"key":"5032_CR32","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1053\/j.jrn.2023.01.006","volume":"33","author":"C Garagarza","year":"2023","unstructured":"Garagarza C, Valente A, Caetano C, Ramos I, Sebasti\u00e3o J, Pinto M, et al. Mediterranean Diet: A Dietary Pattern Related to Nutritional Benefits for Hemodialysis Patients. J Ren Nutr. 2023;33:472\u201381. https:\/\/doi.org\/10.1053\/j.jrn.2023.01.006.","journal-title":"J Ren Nutr"},{"key":"5032_CR33","doi-asserted-by":"publisher","first-page":"e2023037","DOI":"10.4178\/epih.e2023037","volume":"45","author":"J Fu","year":"2023","unstructured":"Fu J, Shin S. The association of dietary patterns with incident chronic kidney disease and kidney function decline among middle-aged Korean adults: a cohort study. Epidemiol Health. 2023;45:e2023037. https:\/\/doi.org\/10.4178\/epih.e2023037.","journal-title":"Epidemiol Health"},{"key":"5032_CR34","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12986-018-0322-7","volume":"15","author":"G Asghari","year":"2018","unstructured":"Asghari G, Momenan M, Yuzbashian E, Mirmiran P, Azizi F. Dietary pattern and incidence of chronic kidney disease among adults: a population-based study. Nutr Metab (Lond). 2018;15:88. https:\/\/doi.org\/10.1186\/s12986-018-0322-7.","journal-title":"Nutr Metab (Lond)"},{"key":"5032_CR35","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1590\/S1415-52732010000200011","volume":"23","author":"ACP Volp","year":"2010","unstructured":"Volp ACP, Alfenas R, de Costa CG, Minim NMB, Stringueta VPR, Bressan PC. \u00cdndices diet\u00e9ticos para avalia\u00e7\u00e3o da qualidade de dietas. Rev Nutr. 2010;23:281\u201396. https:\/\/doi.org\/10.1590\/S1415-52732010000200011.","journal-title":"Rev Nutr"},{"key":"5032_CR36","doi-asserted-by":"publisher","unstructured":"Liu RH. Potential synergy of phytochemicals in cancer prevention: mechanism of action. J Nutr. 2004;134:3479S-3485S. https:\/\/doi.org\/10.1093\/jn\/134.12.3479S.","DOI":"10.1093\/jn\/134.12.3479S"},{"key":"5032_CR37","unstructured":"World Health Organization (WHO). Report of a Joint FAO\/WHO Consultation. Preparation and use of food-based dietary guidelines. 1998."},{"key":"5032_CR38","doi-asserted-by":"publisher","unstructured":"Antunes ABS, Cunha DB, Baltar VT, Steluti J, Pereira RA, Yokoo EM, et al. Padr\u00f5es alimentares de adultos brasileiros em 2008\u20132009 e 2017\u20132018. Rev sa\u00fade p\u00fablica. 2021;55 Supl.1:1\u201311. https:\/\/doi.org\/10.11606\/s1518-8787.2021055003437.","DOI":"10.11606\/s1518-8787.2021055003437"},{"key":"5032_CR39","unstructured":"Minist\u00e9rio da Sa\u00fade. Ag\u00eancia Nacional de Vigil\u00e2ncia Sanit\u00e1ria. 2014."},{"key":"5032_CR40","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1111\/jhn.12870","volume":"34","author":"TJ Brown","year":"2021","unstructured":"Brown TJ, Williams H, Mafrici B, Jackson HS, Johansson L, Willingham F, et al. Dietary interventions with dietitian involvement in adults with chronic kidney disease: A systematic review. J Hum Nutr Diet. 2021;34:747\u201357. https:\/\/doi.org\/10.1111\/jhn.12870.","journal-title":"J Hum Nutr Diet"},{"key":"5032_CR41","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1017\/S1368980018003762","volume":"22","author":"CA Monteiro","year":"2019","unstructured":"Monteiro CA, Cannon G, Levy RB, Moubarac J-C, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22:936\u201341. https:\/\/doi.org\/10.1017\/S1368980018003762.","journal-title":"Public Health Nutr"},{"key":"5032_CR42","unstructured":"Instituto Brasileiro de Pesquisa e Estat\u00edstica (IBGE). Pesquisa de or\u00e7amentos familiares 2017\u20132018: an\u00e1lise do consumo alimentar pessoal no Brasil. Rio de Janeiro: Minist\u00e9rio da Economia. Instituto Brasileiro de Geografia e Estat\u00edstica - IBGE. Diretoria de Pesquisas. Coordena\u00e7\u00e3o de Trabalho e Rendimento; 2020."},{"key":"5032_CR43","doi-asserted-by":"publisher","first-page":"e200035","DOI":"10.1590\/1980-549720200035","volume":"23","author":"IKSD Santos","year":"2020","unstructured":"Santos IKSD, Conde WL. Tend\u00eancia de padr\u00f5es alimentares entre adultos das capitais brasileiras. Rev bras epidemiol. 2020;23:e200035. https:\/\/doi.org\/10.1590\/1980-549720200035.","journal-title":"Rev bras epidemiol"},{"key":"5032_CR44","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3390\/nu14010029","volume":"14","author":"N Neufingerl","year":"2021","unstructured":"Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients. 2021;14:29. https:\/\/doi.org\/10.3390\/nu14010029.","journal-title":"Nutrients"},{"key":"5032_CR45","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.atherosclerosis.2015.11.015","volume":"244","author":"DM Rocha","year":"2016","unstructured":"Rocha DM, Caldas AP, Oliveira LL, Bressan J, Hermsdorff HH. Saturated fatty acids trigger TLR4-mediated inflammatory response. Atherosclerosis. 2016;244:211\u20135. https:\/\/doi.org\/10.1016\/j.atherosclerosis.2015.11.015.","journal-title":"Atherosclerosis"},{"key":"5032_CR46","doi-asserted-by":"publisher","first-page":"101869","DOI":"10.1016\/j.redox.2021.101869","volume":"42","author":"K Aleksandrova","year":"2021","unstructured":"Aleksandrova K, Koelman L, Rodrigues CE. Dietary patterns and biomarkers of oxidative stress and inflammation: A systematic review of observational and intervention studies. Redox Biol. 2021;42:101869. https:\/\/doi.org\/10.1016\/j.redox.2021.101869.","journal-title":"Redox Biol"},{"key":"5032_CR47","doi-asserted-by":"publisher","first-page":"2158","DOI":"10.1017\/S0007114522000137","volume":"128","author":"MF Ju\u00e1rez-Chairez","year":"2022","unstructured":"Ju\u00e1rez-Chairez MF, Meza-M\u00e1rquez OG, M\u00e1rquez-Flores YK, Jim\u00e9nez-Mart\u00ednez C. Potential anti-inflammatory effects of legumes: a review. Br J Nutr. 2022;128:2158\u201369. https:\/\/doi.org\/10.1017\/S0007114522000137.","journal-title":"Br J Nutr"},{"key":"5032_CR48","doi-asserted-by":"publisher","first-page":"278","DOI":"10.3945\/ajcn.113.076901","volume":"100","author":"A Afshin","year":"2014","unstructured":"Afshin A, Micha R, Khatibzadeh S, Mozaffarian D. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100:278\u201388. https:\/\/doi.org\/10.3945\/ajcn.113.076901.","journal-title":"Am J Clin Nutr"},{"key":"5032_CR49","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3390\/toxins14030183","volume":"14","author":"N Ranganathan","year":"2022","unstructured":"Ranganathan N, Anteyi E. The Role of Dietary Fiber and Gut Microbiome Modulation in Progression of Chronic Kidney Disease. Toxins. 2022;14:183. https:\/\/doi.org\/10.3390\/toxins14030183.","journal-title":"Toxins"},{"key":"5032_CR50","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3390\/toxins17020057","volume":"17","author":"W Wathanavasin","year":"2025","unstructured":"Wathanavasin W, Cheungpasitporn W, Thongprayoon C, F\u00fcl\u00f6p T. Effects of Dietary Fiber Supplementation on Modulating Uremic Toxins and Inflammation in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Toxins. 2025;17:57. https:\/\/doi.org\/10.3390\/toxins17020057.","journal-title":"Toxins"},{"key":"5032_CR51","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.xkme.2020.04.007","volume":"2","author":"DJ Clegg","year":"2020","unstructured":"Clegg DJ, Headley SA, Germain MJ. Impact of Dietary Potassium Restrictions in CKD on Clinical Outcomes: Benefits of a Plant-Based Diet. Kidney Med. 2020;2:476\u201387. https:\/\/doi.org\/10.1016\/j.xkme.2020.04.007.","journal-title":"Kidney Med"},{"key":"5032_CR52","doi-asserted-by":"publisher","first-page":"e00206222","DOI":"10.1590\/0102-311xen206222","volume":"39","author":"MALD Silva","year":"2023","unstructured":"Silva MALD, Rodrigues LB, Domene SM\u00c1, Louzada MLDC. Household availability of foods from Brazilian biodiversity. Cad Sa\u00fade P\u00fablica. 2023;39:e00206222. https:\/\/doi.org\/10.1590\/0102-311xen206222.","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"5032_CR53","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica. Pesquisa nacional de sa\u00fade 2019: Percep\u00e7\u00e3o do estado de sa\u00fade, estilo de vida, doen\u00e7as cr\u00f4nicas e sa\u00fade buca. 2020."},{"key":"5032_CR54","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12937-020-00542-y","volume":"19","author":"M Cattafesta","year":"2019","unstructured":"Cattafesta M, Petarli GB, da Luz TC, Zandonade E, de Paula Alves Bezerra OM, Salaroli LB. Dietary patterns of Brazilian farmers and their relation with sociodemographic, labor, and lifestyle conditions. Nutr J. 2019;19:23. https:\/\/doi.org\/10.1186\/s12937-020-00542-y.","journal-title":"Nutr J"},{"key":"5032_CR55","doi-asserted-by":"publisher","first-page":"e0240756","DOI":"10.1371\/journal.pone.0240756","volume":"15","author":"M Cattafesta","year":"2020","unstructured":"Cattafesta M, Petarli GB, Zandonade E, Bezerra OM, de PA, Abreu SMR, Salaroli LB. Contribution of NOVA food groups to energy and nutritional profile of the Brazilian farmers\u2019 diets. PLoS ONE. 2020;15:e0240756.","journal-title":"PLoS ONE"},{"key":"5032_CR56","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1111\/obr.12694","volume":"19","author":"BM Popkin","year":"2018","unstructured":"Popkin BM, Reardon T. Obesity and the food system transformation in Latin America: Obesity and food system transformation. Obes Rev. 2018;19:1028\u201364. https:\/\/doi.org\/10.1111\/obr.12694.","journal-title":"Obes Rev"},{"key":"5032_CR57","doi-asserted-by":"publisher","first-page":"160595","DOI":"10.5888\/pcd14.160595","volume":"14","author":"SR Sterling","year":"2017","unstructured":"Sterling SR, Bertrand B, Judd S, Carson TL, Chandler-Laney P, Baskin ML. Longitudinal Analysis of Nut-Inclusive Diets and Body Mass Index Among Overweight and Obese African American Women Living in Rural Alabama and Mississippi, 2011\u20132013. Prev Chronic Dis. 2017;14:160595. https:\/\/doi.org\/10.5888\/pcd14.160595.","journal-title":"Prev Chronic Dis"},{"key":"5032_CR58","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1055\/s-0040-1712996","volume":"42","author":"MT Pereira","year":"2020","unstructured":"Pereira MT, Cattafesta M, Santos Neto ETD, Salaroli LB. Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women. Rev Bras Ginecol Obstet. 2020;42:380\u20139. https:\/\/doi.org\/10.1055\/s-0040-1712996.","journal-title":"Rev Bras Ginecol Obstet"},{"key":"5032_CR59","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.nut.2017.03.013","volume":"41","author":"AM Martins","year":"2017","unstructured":"Martins AM, Bello Moreira AS, Canella DS, Rodrigues J, Santin F, Wanderley B, et al. Elderly patients on hemodialysis have worse dietary quality and higher consumption of ultraprocessed food than elderly without chronic kidney disease. Nutrition. 2017;41:73\u20139. https:\/\/doi.org\/10.1016\/j.nut.2017.03.013.","journal-title":"Nutrition"},{"key":"5032_CR60","unstructured":"Food and Agriculture Organization of the United Nations (FAO). Livestock statistics: concepts, definitions and classifications. 2021."},{"key":"5032_CR61","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1093\/ije\/dyz064","volume":"49","author":"KE Bradbury","year":"2020","unstructured":"Bradbury KE, Murphy N, Key TJ. Diet and colorectal cancer in UK Biobank: a prospective study. Int J Epidemiol. 2020;49:246\u201358. https:\/\/doi.org\/10.1093\/ije\/dyz064.","journal-title":"Int J Epidemiol"},{"key":"5032_CR62","doi-asserted-by":"publisher","first-page":"108132","DOI":"10.1016\/j.ecolecon.2024.108132","volume":"219","author":"L Parzianello","year":"2024","unstructured":"Parzianello L, Carvalho TS. What if Brazilians reduce their beef consumption? Ecol Econ. 2024;219:108132. https:\/\/doi.org\/10.1016\/j.ecolecon.2024.108132.","journal-title":"Ecol Econ"},{"key":"5032_CR63","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1097\/GME.0000000000002032","volume":"29","author":"Y Choi","year":"2022","unstructured":"Choi Y, Cho J, Kim J, Bae JH, Cho E-J, Chang E, et al. Dynapenic-abdominal obesity as an independent risk factor for chronic kidney disease in postmenopausal women: a population-based cohort study. Menopause. 2022;29:1040\u20136. https:\/\/doi.org\/10.1097\/GME.0000000000002032.","journal-title":"Menopause"},{"key":"5032_CR64","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1002\/jcsm.12901","volume":"13","author":"C Li","year":"2022","unstructured":"Li C, Yu K, Shyh-Chang N, Jiang Z, Liu T, Ma S, et al. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J cachexia sarcopenia muscle. 2022;13:781\u201394. https:\/\/doi.org\/10.1002\/jcsm.12901.","journal-title":"J cachexia sarcopenia muscle"},{"key":"5032_CR65","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1053\/j.jrn.2023.08.010","volume":"34","author":"NS Freeman","year":"2024","unstructured":"Freeman NS, Turner JM. In the Plant-Based Era, Patients With Chronic Kidney Disease Should Focus on Eating Healthy. J Ren Nutr. 2024;34:4\u201310. https:\/\/doi.org\/10.1053\/j.jrn.2023.08.010.","journal-title":"J Ren Nutr"},{"key":"5032_CR66","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1053\/j.jrn.2021.09.008","volume":"32","author":"MV Betz","year":"2022","unstructured":"Betz MV, Nemec KB, Zisman AL. Plant-based Diets in Kidney Disease: Nephrology Professionals\u2019 Perspective. J Ren Nutr. 2022;32:552\u20139. https:\/\/doi.org\/10.1053\/j.jrn.2021.09.008.","journal-title":"J Ren Nutr"},{"key":"5032_CR67","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1053\/j.ajkd.2020.10.003","volume":"77","author":"S Joshi","year":"2021","unstructured":"Joshi S, McMacken M, Kalantar-Zadeh K. Plant-Based Diets for Kidney Disease: A Guide for Clinicians. Am J Kidney Dis. 2021;77:287\u201396. https:\/\/doi.org\/10.1053\/j.ajkd.2020.10.003.","journal-title":"Am J Kidney Dis"},{"key":"5032_CR68","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.3390\/nu12041007","volume":"12","author":"KE Adair","year":"2020","unstructured":"Adair KE, Bowden RG. Ameliorating Chronic Kidney Disease Using a Whole Food Plant-Based Diet. Nutrients. 2020;12:1007. https:\/\/doi.org\/10.3390\/nu12041007.","journal-title":"Nutrients"},{"key":"5032_CR69","doi-asserted-by":"publisher","first-page":"3277","DOI":"10.3390\/nu13093277","volume":"13","author":"T Naber","year":"2021","unstructured":"Naber T, Purohit S. Chronic Kidney Disease: Role of Diet for a Reduction in the Severity of the Disease. Nutrients. 2021;13:3277. https:\/\/doi.org\/10.3390\/nu13093277.","journal-title":"Nutrients"},{"key":"5032_CR70","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1053\/j.ajkd.2015.08.028","volume":"67","author":"JA Kraut","year":"2016","unstructured":"Kraut JA, Madias NE. Metabolic Acidosis of CKD: An Update. Am J Kidney Dis. 2016;67:307\u201317. https:\/\/doi.org\/10.1053\/j.ajkd.2015.08.028.","journal-title":"Am J Kidney Dis"},{"key":"5032_CR71","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1053\/j.jrn.2017.08.013","volume":"28","author":"AS Parpia","year":"2018","unstructured":"Parpia AS, L\u2019Abb\u00e9 M, Goldstein M, Arcand J, Magnuson B, Darling PB. The Impact of Additives on the Phosphorus, Potassium, and Sodium Content of Commonly Consumed Meat, Poultry, and Fish Products Among Patients With Chronic Kidney Disease. J Ren Nutr. 2018;28:83\u201390. https:\/\/doi.org\/10.1053\/j.jrn.2017.08.013.","journal-title":"J Ren Nutr"},{"key":"5032_CR72","doi-asserted-by":"publisher","first-page":"65","DOI":"10.34067\/KID.0000222019","volume":"1","author":"BF Palmer","year":"2020","unstructured":"Palmer BF, Colbert G, Clegg DJ. Potassium Homeostasis, Chronic Kidney Disease, and the Plant-Enriched Diets. Kidney360. 2020;1:65\u201371. https:\/\/doi.org\/10.34067\/KID.0000222019.","journal-title":"Kidney360"},{"key":"5032_CR73","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1053\/j.ajkd.2020.05.006","volume":"76","author":"TA Ikizler","year":"2020","unstructured":"Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero J-J, Chan W, et al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020;76:S1\u2013107. https:\/\/doi.org\/10.1053\/j.ajkd.2020.05.006.","journal-title":"Am J Kidney Dis"},{"key":"5032_CR74","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1053\/j.jrn.2020.07.008","volume":"31","author":"J Stanford","year":"2021","unstructured":"Stanford J, Charlton K, Stefoska-Needham A, Zheng H, Bird L, Borst A, et al. Associations Among Plant-Based Diet Quality, Uremic Toxins, and Gut Microbiota Profile in Adults Undergoing Hemodialysis Therapy. J Ren Nutr. 2021;31:177\u201388. https:\/\/doi.org\/10.1053\/j.jrn.2020.07.008.","journal-title":"J Ren Nutr"},{"key":"5032_CR75","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1093\/ckj\/sfab169","volume":"15","author":"G Su","year":"2022","unstructured":"Su G, Qin X, Yang C, Sabatino A, Kelly JT, Avesani CM, et al. Fiber intake and health in people with chronic kidney disease. Clin Kidney J. 2022;15:213\u201325. https:\/\/doi.org\/10.1093\/ckj\/sfab169.","journal-title":"Clin Kidney J"},{"key":"5032_CR76","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1053\/j.ajkd.2022.08.013","volume":"81","author":"S Joshi","year":"2023","unstructured":"Joshi S, Kalantar-Zadeh K, Chauveau P, Carrero JJ. Risks and Benefits of Different Dietary Patterns in CKD. Am J Kidney Dis. 2023;81:352\u201360. https:\/\/doi.org\/10.1053\/j.ajkd.2022.08.013.","journal-title":"Am J Kidney Dis"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12882-026-05032-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-026-05032-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-026-05032-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:18:00Z","timestamp":1783466280000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12882-026-05032-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":76,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5032"],"URL":"https:\/\/doi.org\/10.1186\/s12882-026-05032-7","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"assertion":[{"value":"31 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee at Universidade Federal do Esp\u00edrito Santo (Ufes) under number 2.104.942 (CAAE 68528817.4.0000.5060). All participants provided informed consent prior to participation in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"409"}}