For people whose kidneys don’t function properly, hemodialysis is a lifesaving process. Patients visit dialysis centers multiple times per week, getting hooked up to machines that filter impurities and excess fluid out of their blood. Between sessions, dietary choices — especially sodium intake — determine the amount of fluid patients accumulate, affecting weight gain and overall quality of life. And the more fluid that needs to be taken off, the more difficult the dialysis session.

Even with the best intentions, it’s not always easy to choose low-sodium foods. That’s why researchers in the Division of Nutritional Sciences (DNS) at the University of Illinois Urbana-Champaign have created a virtual reality program to educate dialysis patients from the comfort of their treatment chairs. The project was funded through the Kidney Wellness Institute of Illinois in the Discovery Partners Institute, part of the University of Illinois System. 

“I can go into a clinic and tell patients how to cook and how to shop, but with our VR program, they'll be able to absorb the information differently and maybe retain it better. We take them to the kitchen and to a grocery store while they're in the chair receiving dialysis treatment,” said Kaitlyn Pawelczyk, a graduate student in DNS, part of the College of Agricultural, Consumer and Environmental Sciences (ACES) at U. of I. 

Pawelczyk added that dialysis patients are bound to their treatment chairs for hours at a time, multiple days every week. “Virtual reality offers the benefit of allowing patients to escape the walls of the clinic.”

The VR program, shot in the Department of Health and Kinesiology’s metabolic kitchen and the aisles of Champaign’s Harvest Market, is a pilot to see how well dialysis patients in Champaign County respond to the material. If it’s a success, the program will be re-shot with professional actors and camera operators, with portions translated into Spanish, ahead of a wider launch. 

“Educating people on how to reduce salt in their diet really revolves around growing, shopping, and cooking, instead of going out to eat,” said Ken Wilund, director of the School of Nutritional Sciences and Wellness at the University of Arizona and leader of the project, which he started as a faculty member in DNS. 

“Even when you make the choice to buy groceries instead of eating out, you have to learn how to shop. I did some grocery shopping tours with a couple of participants in our research studies, and it was a bit concerning to see the types of food selections they were making. It became clear to me that many individuals do not have a good understanding of how to identify healthier unprocessed foods when at the grocery store,” Wilund added. “In many cases, they may as well have gone to a fast food restaurant.”

That’s why the VR program brings patients along on a walking tour of Harvest Market, encouraging them to purchase most of their groceries in the periphery of the store, a concept known as “perimeter shopping.” Most grocery stores place the healthiest, least-processed, and lowest-sodium foods around the walls of the store, in the produce section, the meat and seafood counters, and the dairy section. The middle aisles, on the other hand, are stocked with more processed, higher-sodium goods. 

The program also takes place in a home kitchen environment where Pawelczyk demonstrates tips and tricks for cooking still-flavorful food with less salt. “For example, we recommend cooking eggs without adding salt until it’s time to serve. When you just put a bit of salt on top, you tend to use less but taste it more.”

The team hopes that interactive experiences with the VR program, in which patients can pick up products, view nutritional labels, and play games, will make a lasting impression. 

“We hope to include this as a part of a comprehensive nutrition education program that offers training on growing, shopping, and cooking food. In addition to our shopping tour and virtual cooking classes, we want to host live cooking classes and develop gardens outside of dialysis clinics where the patients can come and pick herbs they can take home to spice up their low-sodium foods,” Wilund said.