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

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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.

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Author information

Authors and Affiliations

  1. Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Pl, Tower 1 Penthouse, Bronx, NY, 10461, USA

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

  2. Smith Institute for Urology, Northwell Health System, New Hyde Park, NY, USA

    Charan Mohan & Arun Rai

Authors
  1. Benjamin W. Green
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  2. Kevin Labagnara
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  3. Eric Macdonald
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  4. Nathan Feiertag
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  5. Michael Zhu
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  6. Kavita Gupta
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  7. Charan Mohan
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  8. Kara L. Watts
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  9. Arun Rai
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  10. Alexander C. Small
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Contributions

BWG, KL, and EM contributed to project development, data compilation, data analysis, and manuscript writing. NF and ACS were involved in project development and manuscript writing. MZ, KG, CM, KLW, and AR contributed to manuscript writing.

Corresponding author

Correspondence to Alexander C. Small.

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Conflict of interest

The authors did not receive support from any organization for the submitted work. All the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethics approval

This research involved human participants and was granted Institutional Review Board approval before it commenced. We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Participation was voluntary informed consent was obtained: all participants receive a completed and detailed description of the study’s aims as well as what is asked of the participant and the risks and benefits of participation, including publication of their data.

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Green, B., Labagnara, K., Macdonald, E. et al. Evaluating the association between food insecurity and risk of nephrolithiasis: an analysis of the National Health and Nutrition Examination Survey. World J Urol 40, 2641–2647 (2022). https://doi.org/10.1007/s00345-022-04150-9

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  • DOI: https://doi.org/10.1007/s00345-022-04150-9

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