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Abstract: SA-OR73

Food Insecurity, Dietary Intake, and Mortality Among Adults with CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Kiryakos, Jenna, University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
  • Licon, Ana Laura, University of Michigan Department of Biostatistics, Ann Arbor, Michigan, United States
  • Veinot, Tiffany C., University of Michigan School of Information, Ann Arbor, Michigan, United States
  • Gillespie, Brenda W., University of Michigan Department of Biostatistics, Ann Arbor, Michigan, United States
  • Han, Yun, University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
  • Heung, Michael, University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
  • Onufrak, Stephen J., Centers for Disease Control and Prevention, Atlanta, Georgia, United States
  • Saran, Rajiv, University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
  • Bragg-Gresham, Jennifer L., University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
Background

Food insecurity in adults has been associated with a higher risk of diabetes, hypertension, chronic kidney disease (CKD), and mortality. We sought to examine the role of dietary intake in mortality risk due to food insecurity in adults with CKD.

Methods

We used data from the National Health and Nutrition Examination Survey (1999–2018) to assess differences in demographics, comorbidities, socioeconomic status (SES), and dietary intake in food secure versus food insecure adults with CKD (N=8935). Marginal, low, or very low household food security defined food insecure. Using publicly available mortality-linked data, we explored mortality related to food insecurity, food intake, and other risk factors using Cox regression.

Results

Approximately 22% of adults with CKD reported food insecurity. These adults were younger, had lower SES and rates of health insurance, were more likely to be from a racial minority group, and had higher prevalence of obesity and diabetes. Food insecure adults had overall higher calorie intake, but fiber and potassium intake were lower, while carbohydrate and sodium intake were higher. Adjusting for demographics only, food insecure adults had a higher mortality rate (HR=1.46, P<0.0001). Risk decreased when comorbidities, income, and education were considered (HR=1.22, P=0.006). Dietary intake did not further reduce this association.

Conclusion

Differing nutrient intake was seen in adults with CKD and food insecurity, yet these differences did not attenuate food insecure-related mortality risk; however, the potential role of diet in inducing comorbidities overtime is not excluded. Future work may consider the higher risk of comorbidities in food insecure adults with CKD to improve health outcomes.

Funding

  • Other U.S. Government Support