My Plate Awareness and Engagement and Perceived and Objective Diet Quality in US Adults with Chronic Kidney Disease

Josiah Thule; Xue Yu; Maria E Montez-Rath; Glenn M Chertow

doi:10.1053/j.jrn.2024.04.007

My Plate Awareness and Engagement and Perceived and Objective Diet Quality in US Adults with Chronic Kidney Disease

J Ren Nutr. 2024 May 11:S1051-2276(24)00069-4. doi: 10.1053/j.jrn.2024.04.007. Online ahead of print.

Authors

Josiah Thule¹, Xue Yu², Maria E Montez-Rath², Glenn M Chertow³

Affiliations

¹ Morehouse School of Medicine, Atlanta, GA; Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
² Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
³ Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA. Electronic address: gchertow@stanford.edu.

PMID: 38740314
DOI: 10.1053/j.jrn.2024.04.007

Abstract

Objective: Awareness of federal dietary guidelines has been associated with better perceived and objective diet quality. Little is known about the awareness of federal dietary recommendations among persons with chronic kidney disease (CKD) and the associations between recognition of guidelines, perception of diet quality, and objective quality of the diet in this population.

Design: We compared awareness of, and engagement with, MyPlate (a representation of five food groups from the US Department of Agriculture) along with perceived and objective diet quality, the latter assessed via Dietary Approaches to Stop Hypertension (DASH) index scores, among US adults with and without CKD during 2017-2020.

Results: Among non-institutionalized adults in the US, 8.3% had albuminuria with normal or near normal kidney function, 4.0% had estimated glomerular filtration rate (eGFR) 45-59 mL/min/1.73m² (CKD stage G3a) and 1.6% had eGFR <45 mL/min/1.73m² (CKD stages G3b/G4/G5). MyPlate awareness was lower among persons with CKD compared with those without CKD (19.6% versus 26.4%, p<0.001) and was lower among persons with more advanced CKD stages: 20.8%, 18.2%, and 16.3% in persons with CKD stages G1/G2, G3a, and G3b/G4/G5, respectively (trend p<0.001). Among persons aware of MyPlate, a numerically higher proportion with CKD attempted to follow My Plate recommendations (43.9% versus 32.3%, p=0.10); the proportion was highest among persons with moderate-to-advanced CKD (41.9%, 42.9%, and 56.9% among persons with CKD stages G1/G2, G3a, and G3b/G4/G5, respectively (trend p<0.001). Perceived and objective dietary quality (the latter based on concordance with the Dietary Approaches to Stop Hypertension diet) were slightly higher among persons with CKD relative to those without CKD.

Conclusions: Adults with CKD have lower MyPlate awareness than adults without CKD. Enhancing diet education to persons with CKD could improve diet quality and potentially ameliorate CKD-associated complications.