Strategies for the inclusion of alkaline foods in the diets served to hospitalized patients

Abstract

Subclinical metabolic acidosis resulting from a high acid diet load may be a risk factor for various pathologies. Objective: To determine if through nutritional education strategies it is possible to modify the behavior of hospitalized patients regarding the choice of alkaline foods from the diets served in the Centro Médico Docente La Trinidad. Methods: the Potential Renal Acid Load (PRAL) of four types of diets was analyzed: complete (C), gastroduodenal protection (PG), low sodium (H) and for diabetics (D). A video, a talk and three support brochures were designed as Educational Intervention (EI) for the hospitalized patients. Patients' preferences were identified when selecting acidic and alkaline foods before and after the EI. Results: PRAL (mEq/day) before and after EI was: <0: 9 vs 26 patients; 0-20: 11 vs 21; >20: 40 vs 13. After EI, 49 (81.6%) patients decreased the PRAL of their diet and 11 (18.4%) increased it (p<0.0001). The mean PRAL for all diets chosen by the patients before vs. after EI was 29.35 vs. 4.60 (p<0.0001): diet C 27.67 vs. 2.43; PG diet 89.55 vs -10.1; H diet 22.27 vs -10.61; diet D 35.66 vs 30.53. The average PRAL of all the diets chosen by the patients for breakfast, lunch and dinner before vs after EI was 20.32 vs 16.32 (p<0.01), 0.02 vs -11, 80 (p<0.001) and 10.38 vs 0.55 (p<0.0001) respectively. Conclusions: The food combinations chosen by the patients before EI had an acid PRAL. Most patients significantly decreased dietary PRAL after EI.