title: Comparison of the Availability and Cost of Foods Compatible With a Renal Diet Versus an Unrestricted Diet Using the Nutrition Environment Measures Survey.
abstract: Hemodialysis patients' ability to access food that is both compatible with a renal diet and affordable is affected by the local food environment. Comparisons of the availability and cost of food items suitable for the renal diet versus a typical unrestricted diet were completed using the standard Nutrition Environment Measures Survey and a renal diet-modified Nutrition Environment Measures Survey.
  
  
  
  Cross-sectional study.
  
  
  
  Twelve grocery stores in Northeast Ohio.
  
  
  
  Availability and cost of food items in 12 categories.
  
  
  
  The mean total number of food items available differed significantly (P ≤ .001) between the unrestricted diet (38.9 ± 4.5) and renal diet (32.2 ± 4.7). The mean total cost per serving did not differ significantly (P = 0.48) between the unrestricted diet ($5.67 ± 2.50) and renal diet ($5.76 ± 2.74).
  
  
  
  The availability of renal diet food items is significantly less than that of unrestricted diet food items, but there is no difference in the cost of items that are available in grocery stores. Further work is needed to determine how to improve the food environment for patients with chronic diseases.
authors.affiliation: Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio. Electronic address: csullivan1@metrohealth.org.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Sullivan
authors.affiliation: Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pencak
authors.affiliation: Prevention Research Center for Healthy Neighborhoods, Cleveland, Ohio; Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Freedman
authors.affiliation: Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio; Division of Nephrology and Hypertension, Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio; Division of Nephrology, Department of Medicine, The MetroHealth System, Cleveland, Ohio.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Huml
authors.affiliation: Center for Clinical Informatics Research and Education and Department of Medicine, The MetroHealth System, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Janeen B
authors.initials: JB
authors.lastname: León
authors.affiliation: Centers for Dialysis Care, Cleveland, Ohio.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Nemcek
authors.affiliation: Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Theurer
authors.affiliation: Center for Reducing Health Disparities, The MetroHealth System, Cleveland, Ohio; Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio; Division of Nephrology, Department of Medicine, The MetroHealth System, Cleveland, Ohio; Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Ashwini R
authors.initials: AR
authors.lastname: Sehgal
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000191:economics*; D005523:Food Supply / Q000191:economics*; D006801:Humans; D007674:Kidney Diseases / Q000178:diet therapy*; D018673:Nutrition Policy; D009749:Nutrition Surveys; D009820:Ohio; D006435:Renal Dialysis