Diet Quality, Food Insecurity and Chronic Kidney Disease: Insights from the U.S. National Health and Nutrition Examination Survey

Top Things to Know

Higher-quality diets significantly reduce CKD risk among patients with diabetes and hypertension.

Food insecurity alone does not fully explain poor diet quality (income and education are major drivers).

Embedding dietitians and nutrition counseling into healthcare settings can help translate prescriptions into sustainable dietary changes.

Summary of Conclusion/Findings

This study analyzed data from 5,974 U.S. adults in the 2017–2020 NHANES to examine relationships between diet quality, food insecurity, and chronic kidney disease (CKD). Overall, diet quality was poor (mean Healthy Eating Index score ≈51), and 16% of participants were food insecure. Diet quality was not significantly associated with CKD prevalence in the general population, but among individuals with diabetes and hypertension, every 10-point increase in HEI score was linked to 24% and 20% lower odds of CKD, respectively. Food insecurity correlated with lower diet quality in unadjusted models, but this association disappeared after adjusting for income and education, suggesting socioeconomic factors drive much of the disparity. The findings highlight the importance of improving diet quality for CKD prevention, especially in high-risk groups, and addressing systemic barriers beyond food access.