Evaluating the association between food insecurity and risk of nephrolithiasis: an analysis of the National Health and Nutrition Examination Survey

Benjamin W. Green, Kevin Labagnara, Eric Macdonald, Nathan Feiertag, Michael Zhu, Kavita Gupta, Charan Mohan, Kara L. Watts, Arun Rai, Alexander C. Small

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: This study aimed to investigate the relationship between self-reported food security and kidney stone formation. Methods: Data were collected from the National Health and Nutrition Examination Survey (NHANES), a database representative of the United States population. Food security status was assessed using the US Household Food Security Survey Module: Six-Item Short Form. Characteristics of patients were compared using the Chi-square test and the student t-test. Multivariate logistic regression was performed using a multi-model approach. Results: We analyzed 6,800 NHANES survey respondents. 37.2% of respondents were categorized as having “low food security” (scores 2–4) and 24.0% having “very low food security” (scores 5–6). 8.4% of respondents had a history of kidney stones. We found that people with very low food security had a 42% increased likelihood of developing kidney stones compared to those with high or marginal food security, after controlling for race, age, and comorbidities (OR 1.42; 95% CI 1.01–1.99). Between the different food security groups, no significant differences were observed in age, race/ethnicity, body mass index, gout history, osteoporosis history, or coronary artery disease history. Lower food security was associated with slightly younger age (< 1 year difference, p = 0.001), higher poverty-income ratio (p = 0.001), and many comorbidities, including kidney stones (p = 0.007). Conclusion: Our study provides evidence for an association between food access and the risk of kidney stone disease. Given these findings, food insecurity should be investigated as a modifiable risk factor for the development of kidney stone disease.

Original languageEnglish (US)
Pages (from-to)2641-2647
Number of pages7
JournalWorld Journal of Urology
Volume40
Issue number11
DOIs
StatePublished - Nov 2022

Keywords

  • Food access
  • Food insecurity
  • Health disparities
  • Social determinants of health
  • Urolithiasis

ASJC Scopus subject areas

  • Urology

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