Understanding food insecurity in kidney disease

If you have skipped meals in the past year because you could not afford them, given up kidney-friendly foods because they are too expensive or feel that you do not have access to healthy food options, you may be experiencing food insecurity.

The U.S. Department of Agriculture defines food insecurity as "limited or uncertain availability of nutritionally adequate foods." When you are worrying about where your next meal is coming from, following a kidney-friendly eating plan may feel like an extra burden to take on.

According to a 2014 study published in the American Journal of Nephrology, if you often skip meals to save money, or you don't live near places to buy fresh food, it may be harder to manage conditions like diabetes or high blood pressure, which can place you at higher risk for developing kidney disease. In another study published in the same journal in 2017, researchers found that if you have kidney disease and struggle to afford healthy food, your kidney disease might progress faster.

Finding kidney-healthy foods under a kidney-friendly eating plan and budget concerns is extremely challenging when you are starting or continuing to follow a kidney-friendly eating plan. Buying pricier healthy foods can be difficult when you're managing healthcare expenses for treatments, medicines and healthcare bills. As a result, you may have to buy cheaper foods to lower the budget for food. However, these less expensive foods are more likely to be processed and ready-to-eat products. These products often have high sodium, potassium or phosphorus from additives that are used for better taste and a longer shelf life. Eating too much of these nutrients can put extra stress on your kidneys and may lead to further damage or even kidney failure. Therefore, it is very challenging to have a kidney-friendly eating plan when food options are limited and your meal planning is disrupted by money concerns.

Although food insecurity is a complex problem and has no easy fix, please remember you are not fighting alone. Here are some tips to help you stretch your food dollars:

• Plan meals and recipes and write a grocery list ahead of time. The American Kidney Fund's (AKF) Kidney Kitchen® provides various kidney-friendly recipes for you to try out. Make sure to check what you already have on hand to avoid wasting money and food. Visit the grocery shopping list on our Kidney Kitchen website for more guidance!
• Choose fresh, frozen and shelf-stable foods. Frozen and shelf-stable foods are as nutritious as fresh produce and can be stored for longer. Make sure to choose low- or no-salt/sugar added products. Also, check food labels and avoid products that have "phos" in the ingredient list, such as phosphoric acid and aluminum phosphate.
• Check out the foods that are in season. They tend to be cheaper and easier to get.         

If you are facing food insecurity concerns, there are also other available resources and programs to further support you, including financial assistance programs, if eligible.

• The Supplemental Nutrition Assistance Program (SNAP) provides you and your family with nutrition benefits to supplement your food budget to meet your needs.
• The Temporary Assistance for Needy Families program supports families with children with basic needs.
• Food banks collect donated food and distribute it to people in need.
• Special Supplementation Nutrition Program for Women, Infants, and Children (WIC) offers supplemental foods, nutrition education, and healthcare referral.
• Findhelp connects you with food pantries, financial assistance, and other free or reduced-cost help in your local community. You can also contact your social worker from the medical team to help you find resources around you.

AKF also provides need-based financial assistance programs to help lower healthcare expenses. Check out the webpage for more information and see if you are eligible.

Food insecurity can present great challenges for managing kidney disease. But remember: you are not fighting alone and there are resources and help for you to fight both food insecurity and kidney disease.

References

1. Food Security in the U.S., USDA, https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-u-s/

2. Crews DC, Kuczmarski MF, Grubbs V, et al. Effect of food insecurity on chronic kidney disease in lower-income Americans. Am J Nephrol. 2014;39(1):27-35. doi:10.1159/000357595

3. Banerjee T, Crews DC, Wesson DE, et al. Food Insecurity, CKD, and Subsequent ESRD in US Adults [published correction appears in Am J Kidney Dis. 2017 Nov;70(5):736]. Am J Kidney Dis. 2017;70(1):38-47. doi:10.1053/j.ajkd.2016.10.035