Elevated Inflammation and Poor Diet Quality Associated with Lower eGFR in United States Adults: An NHANES 2015-2018 Analysis.

Chronic kidney disease is prevalent within the United States likely due to dietary habits. The purpose of this study was to examine the relationship between the high-sensitivity c-reactive protein (hs-CRP) and diet quality (DQ) and their effect on the eGFR. A cross-sectional secondary data analysis study was conducted among adults (n = 6230) using NHANES 2015-2018 data. DQ was determined by the Healthy Eating Index-2015 (HEI-2015). Multivariable linear regressions were conducted based on eGFR (≥90 or <60 mL/min/1.73 m2) after adjustments for age, race/ethnicity, hypertension, diabetes mellitus, cardiovascular disease, and kidney disease awareness. All analyses were performed in SAS version 9.4 with a statistical significance of p < 0.05. Results showed that participants who had an eGFR of <60 mL/min/1.73 m2 were older and had a higher prevalence of hypertension and diabetes and had higher hs-CRP compared to participants with an eGFR ≥ 90 (p < 0.005). Of participants with an eGFR < 60, 27% reported that they were aware they had kidney disease. Regardless of the eGFR at baseline, there was a negative interaction effect on the DQ scores and hs-CRP on the eGFR (p < 0.05). Independently, for participants with an eGFR < 60, their DQ scores had a positive significant relationship on their eGFR (p = 0.03), whereas their hs-CRP had a negative significant relationship on thier eGFR (p < 0.001). For participants with an eGFR < 60, age, hypertension, and kidney disease awareness influenced this relationship (p < 0.001). Overall, low DQ and elevated hs-CRP contributed to a reduction in kidney function. Efforts to improve dietary intake and strategies to reduce inflammation and improve kidney function are necessary.

Association between Dietary Habits, Food Attitudes, and Food Security Status of US Adults since March 2020: A Cross-Sectional Online Study.

Since COVID-19, global reports indicate changes in dietary habits and food security status of the population. As a follow-up to an earlier study conducted in 2020, the purpose of this online cross-sectional study was to examine food security and food attitudes and their subsequent impact on dietary habits since March 2020 and potential associations with demographics, health characteristics and lifestyle habits on dietary habits. Participants (n = 2036) responded to a 71-item online survey conducted between February−March 2022. Frequency counts and percentages were tabulated, and multivariate linear regressions were conducted to examine associations. Results showed that most participants indicated no change in dietary habits (45.9−88.8%) for the listed food and beverage items. A significant positive association for food attitudes scores (1.11, 95% CI 0.93 to 1.29; p < 0.001) and food security scores (0.53, 95% CI 0.35 to 0.71; p < 0.001) on total dietary habits was found. Further, significant positive associations were seen with various health characteristics such as medical conditions (p = 0.01) and lifestyle habits such as preparing meals at home (p < 0.001). A negative association was observed with females on total dietary habits (p < 0.001). It is necessary to encourage adults in the US to maintain the positive dietary and lifestyle habits they acquired since March 2020 in their daily living. Future studies should investigate the impact these habits have on their health long-term and sustained positive dietary and lifestyle habits.

Development and Relative Validity of the Chronic Kidney Disease Short Food Frequency Questionnaire (CKD SFFQ) to Determine Diet Quality and Dietary Habits among Adults with Chronic Kidney Disease.

Limited instruments are available to determine diet quality among US adults with chronic kidney disease (CKD). The purpose of this study was two-fold: (1) to develop a food frequency questionnaire, CKD SFFQ, for adults with CKD and (2) to validate the CKD SFFQ against two 24-h recalls in determining diet quality (DQ). A 57-item CKD SFFQ was developed through a content validation method. Adults with CKD (n = 46) completed the CKD SFFQ and 2-24-h recalls. Statistical analyses included descriptive statistics, frequencies, t-tests, Pearson correlations, and Bland-Altman plots. All data were analyzed using JMP SAS v15 with statistical significance detected at p < 0.05. Results showed no differences for the overall DQ (p = 0.11) and the nine whole-food components (p = 0.07 to p = 0.44) when comparing the CKD SFFQ to the 2-24-h recalls. Pearson correlation coefficients ranged from -0.39 (refined grains) to 0.60 (greens and beans). Bland-Altman plots showed overall good agreement and there was a systematic trend towards higher estimates with the CKD SFFQ, particularly for overall DQ, total proteins, and dairy. The majority of participants rarely or never consumed grains, fruits, vegetables, seafood, and plant proteins. The CKD SFFQ was demonstrated to be an acceptable method to determine DQ for adults with CKD.

Relationship between Dietary Habits, Food Attitudes and Food Security Status among Adults Living within the United States Three Months Post-Mandated Quarantine: A Cross-Sectional Study.

COVID-19 has disrupted the lives of many and may have influenced dietary habits through factors such as food security status and attitudes. The purpose of this study was to identify dietary habits and their associations with food insecurity and attitudes among adults living in the United States within three months post-mandated quarantine. An online cross-sectional study was conducted from April to June 2020. Participants (n = 3133) responded to a 71-item questionnaire regarding demographics (n = 7), health information (n = 5), lifestyle habits (n = 8), dietary habits (n = 37), food attitudes (n = 8), and food security status (n = 6). Frequency counts and percentages were tabulated, and multivariate linear regression was conducted to examine associations using STATA v14 at a statistical significance level of p < 0.05. Results showed that most participants indicated no change in dietary habits (43.6-87.4%), yet participants reported increased consumption of sweets (43.8%) and salty snacks (37.4%). A significant positive association for food attitude scores (1.59, 95% CI 1.48 to 1.70; p < 0.001) and food security scores (1.19, 95% CI 0.93 to 1.45; p < 0.001) on total dietary habit scores was found. Future extensive population studies are recommended to help public health authorities frame actions to alleviate the impact that mandated quarantine has on dietary habits.