Food Access, Chronic Kidney Disease, and Hypertension in the U.S

Introduction: Greater distance to full-service supermarkets and low income may impair access to healthy diets and contribute to chronic kidney disease (CKD) and hypertension. The study aim was to determine relationships among residence in a "food desert," low income, CKD, and blood pressure.

Methods: Adults in the 2003-2010 National Health and Nutrition Examination Survey (N=22,173) were linked to food desert data (www.ers.usda.gov) by Census Tracts. Food deserts have low median income and are further from a supermarket or large grocery store (>1 mile in urban areas, >10 miles in rural areas). Weighted regression was used to determine the association of residence in a food desert and family income with dietary intake; systolic blood pressure (SBP); and odds of CKD. Data analysis was performed in 2014-2015.

Results: Compared with those not in food deserts, participants residing in food deserts had lower levels of serum carotenoids (p<0.01), a biomarker of fruit and vegetable intake, and higher SBP (1.53 mmHg higher, 95% CI=0.41, 2.66) after adjustment for demographics and income. Residence in a food desert was not associated with odds of CKD (OR=1.20, 95% CI=0.96, 1.49). Lower, versus higher, income was associated with lower serum carotenoids (p<0.01) and higher SBP (2.00 mmHg higher for income-poverty ratio ≤1 vs >3, 95% CI=1.12, 2.89), but also greater odds of CKD (OR=1.76 for income-poverty ratio ≤1 vs >3, 95% CI=1.48, 2.10).

Conclusions: Limited access to healthy food due to geographic or financial barriers could be targeted for prevention of CKD and hypertension.