title: Foods with added fiber improve stool frequency in individuals with chronic kidney disease with no impact on appetite or overall quality of life.
abstract: BACKGROUND
  Fiber intake may be low in individuals with chronic kidney disease (CKD) due to diet restriction and/or poor appetite associated with uremic symptoms, contributing to constipation and reduced quality of life. This report describes the effects of foods with added fiber on gastrointestinal function and symptoms, clinical markers, and quality of life in CKD patients.
  
  
  RESULTS
  Adults with CKD (n = 15; 9 F, 6 M; 66 ± 15 y) were provided with cereal, cookies and snack bars without added fiber for 2 weeks, followed by similar foods providing 23 g/d of added fiber for 4 weeks, to incorporate into their usual diets. Participants completed the Kidney Disease Quality of Life (KDQOL-36) questionnaire, the Simplified Nutritional Appetite Questionnaire (SNAQ) and the Epworth Sleepiness Scale (ESS) bi-weekly, the Gastrointestinal Symptom Rating Scale (GSRS) weekly, and daily stool frequency and compliance. Control and intervention serum cholesterol and glucose were assessed. Providing 23 g/d of added fiber increased stool frequency (1.3 ± 0.2 to 1.6 ± 0.2 stools/d; P = 0.02), decreased total cholesterol (175 ± 12 to 167 ± 11 mg/dL; P = 0.02) and improved TC:HDL ratio (4.0 ± 0.3 to 3.7 ± 0.2; P = 0.02). GSRS and SNAQ scores did not change, but SNAQ scores suggested poor appetite in 7 participants with or without added fiber. KDQOL Mental Health Composite decreased from 53 ± 2 to 48 ± 2 (P = 0.01) while Physical Health Composite increased from 31 ± 2 to 35 ± 3 (P = 0.02), with no change in overall QOL. The ESS score decreased from 10 ± 1 to 8 ± 1 (P = 0.04).
  
  
  CONCLUSIONS
  Consuming foods with added fiber may be an effective means of increasing fiber intakes, improving stool frequency, and lipid profile in individuals with CKD.
  
  
  BACKGROUND
  ClinicalTrials.gov, # NCT01842087.
authors.affiliation: Food Science and Human Nutrition, University of Florida, 359 FSHN Building Newell Drive, Gainesville, FL 32611, USA. wdahl@ufl.edu.
authors.forename: Younis A
authors.initials: YA
authors.lastname: Salmean
authors.forename: Gordon A
authors.initials: GA
authors.lastname: Zello
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Dahl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001066:Appetite; D003248:Constipation / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D003672:Defecation / Q000502:physiology; D004043:Dietary Fiber / Q000008:administration & dosage*; D002523:Edible Grain; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D016896:Treatment Outcome