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Thomas H. Watson, Daniel E. Weiner, Jerry Yee, Jeffrey Silberzweig, and for the Outpatient Dialysis Subcommittee of the American Society of Nephrology COVID-19 Response Team

Nearly 800,000 patients in the United States have end-stage kidney disease, with more than 550,000 receiving maintenance dialysis (1). Compared to the general population, dialysis patients incur a greater burden of illness, with more comorbid conditions, including diabetes mellitus, hypertension, intrinsic pulmonary disease, cardiovascular and cerebrovascular disease, obesity, and frailty. Individuals dependent on maintenance dialysis are extremely vulnerable to the effects of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus that causes Coronavirus Disease 2019 (COVID-19), with COVID-associated mortality likely exceeding 20% (2).

In October 2020, the National Academy of Medicine released its

Sharon M. Moe, Deidra C. Crews, Orlando M. Gutiérrez, Pamela Hoyt-Hudson, Susie Q. Lew, Beth Shanaman, Barry H. Smith, Daniel E. Weiner, and Donald Wesson

Health food stores abound in strip malls. Vitamin shops are a multibillion dollar business. Consumer labeling such as “gluten free,” “heart healthy,” “organic,” “non-GMO” and “contains anti-oxidants” adorn food labels, encouraging purchase. Organic foods and farmers markets have become the newest trend. The overall goal of equating nutrition with health is becoming better recognized, but messaging is filled with contradictions from food marketers, the media, and health care. People generally want to be healthy and recognize that good food may be the way to go, but following a “diet” can have a negative, forced, or even punitive connotation. “Diet” usually