Fast Food Nation: A Reason for Chronic Kidney Disease

McDonald’s. Taco Bell. Burger King. Kentucky Fried Chicken. You name it. A stroll through Baltimore’s Charles Village may only feature a small sampling of the well-liked fast-food joints, but the Hopkins nest is an anomaly when contrasted to the dining habits of the rest of our nation. I admit, I have indulged in the occasional French Fry; however, for a majority of lower-class Americans, indulgence is not an incentive for dining out. In many neighborhoods, McDonalds, Taco Bells, Burger Kings, and KFCs supersede grocery stores as a cheap solution for a daily meal.

The reality is, though, that consuming processed and fast foods frequently augments the risk of contracting diabetes, high blood pressure, obesity, and cardiovascular diseases. In the simplest terms: inexpensive junk food is a Public Health nightmare.

Most of these processed foods are manufactured with additional phosphorous, an elemental mineral that is naturally present in dairy products, peanut butter, and beans. While phosphorous itself appears as a vital supplement for osseous growth and ATP production, it is also a contributor to the rising incidence of Chronic Kidney Disease (CKD) in the United States. Aggravated by diabetes and high blood pressure, CKD slowly paralyzes the excretory system’s function in removing the excess mineral wastes from the body. 2004 data from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates 11.5% prevalence (about 23 million adults in the United States) of CKD, defining this medical issue as a primarily Public Health concern. Yet how do fast-food, phosphorous, CKD, and Public Health correlate? A recent study explores this question, with an epidemiologic approach.

Observing both the social and scientific side of Chronic Kidney Disease, Journal of the American Society of Nephrology had found a trend in the high incidence of CKD in black individuals in comparison to other ethnicities. Additive phosphates in cheap foods (to extend shelf-life) are known to increase the risk of other chronic diseases in CKD patients, yet the racial trends were incongruous.

The Chronic Renal Insufficiency Cohort Study (CRIC) featured 3,612 racially, ethnically, and socioeconomically diverse CKD patients. Contradicting previous observations, CRIC revealed that the blood phosphate levels in both black and white patients of a lower socioeconomic status were significantly high.

CRIC followed the observational and non-invasive counting, comparing, and concluding methodology of a cohort study. A common exposure was deduced, and multiple outcomes were linked to the multiple exposures successfully. But cohort studies can be limiting. The follow-up duration and the expense of conducting this study is restricted by the resources available and the impracticability of attaining a large or diverse enough group without the influence of bias. I cannot be completely convinced that CRIC was the most effective study; prescribing a suggestion (either extending the duration or increasing the studied population) may not be feasible because of the inherent weaknesses of cohort studies.

My occasional guilty pleasures in fast food are over (for the most part). But for people within impoverished communities who simply cannot afford the best organic vegetables or agave nectar sweeteners, fast food seems to be the only pleasure. How can we create Public Health policy and structural change to provide access to all?

The vicious cycle continues: our fast food nation is to blame.