Abstract Background 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. Methods 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). Results 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 = 0.596, 95% CI 0.435–0.816, p < 0.001). Conclusions 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. Clinical trial number Not applicable.
Cattafesta et al. (Wed,) studied this question.