Researchers have found in a new study that higher consumption of ultra-processed foods (UPFs) was significantly associated with an increased risk of clinical weakness in hemodialysis (HD) patients. However, it showed no significant association with malnutrition. The study was published in BMC Nephrology by Ramazan M. and colleagues.
The nutritional problems of hemodialysis patients are distinctive in the fact that they have to adhere to a restrictive diet while simultaneously consuming increased amounts of protein necessary to cope with muscle atrophy. While conventional dietary recommendations tend to focus on potassium, phosphorus, and protein levels, little is known about the effects of industrially processed foods.
For the study, the researchers performed a cross-sectional analysis of 90 patients, collecting a number of variables pertaining to sociodemographics, anthropometrics, and lab results. Dietary behaviors were studied using a validated questionnaire based on the NOVA criteria of classifying foods. In particular, foods were identified depending on how much they had been processed by industrial means, thus allowing the authors to separate the patients into two groups: M1 with low consumption of UPFs and M2 with high consumption. Clinical weakness was quantified using the HGS Index, while malnutrition was measured with NRI.
Key findings:
The most important results are reflected in the results of strength tests. The Hand Grip Strength (HGS) test was statistically greater in the M1 group (89.6 ± 24.1) compared to the M2 group (77.7 ± 23.9).
Based on the simple statistical analysis model, the odds ratio of clinically defined weakness was 3.70-fold greater in the UPF intake group (95% CI 1.41–9.70, p-value = 0.008).
The effect proved to be consistent even when adjusted for potential confounders during multiple regression analyses.
Even in the multivariate logistic regression analysis, the OR for odds in Model 2 was significantly higher, ranging from 1.30 to 11.77 (p-value = 0.015), while in Model 3 the OR range was 1.28 to 12.08 (p-value = 0.017).
However, despite all the evidence of physical weakness, there is no correlation between the odds of malnutrition in any of the adjusted or unadjusted models.
The study reveals that the more UPF consumed by an individual, the greater the chances of having clinical weakness. However, the findings do not support any association between the high consumption of UPF and malnutrition in HD patients. Even though the diet may seem satisfactory in terms of providing sufficient calories and proteins, the heavy food processing is causing a loss of energy and stamina. In light of the ongoing research and development regarding diets in chronic kidney disease, this study supports the adoption of a “whole foods” diet to minimize clinical weakness in HD patients.
Reference:
Atan, R., Yılmaz, H.Ö. Ultra-processed food consumption and the prevalence of malnutrition and clinical weakness among hemodialysis patients: a single-center cross-sectional study. BMC Nephrol (2026). https://doi.org/10.1186/s12882-026-04935-9
