Diet and Your Organs: We’re Not Kidney You

When was the last time you thought about your kidneys? Unless you’re one of the 37 million people in the US with some form of chronic kidney disease, you probably haven’t given them much thought.

Make two fists with your hands right now. Don’t worry if you’re in a public space, pretend like you’re stretching.

Did you know that those two fist sized organs under your ribcage on either side of your spine filter 200 quarts (that’s 50 gallons if you’re counting) of blood a day? You might recall someone reminding you to drink 8, 8-ounce glasses of water a day and finally you know why! Only 2 quarts of the 200 quarts a day is sent out as waste (again, for you mathematicians that’s exactly 64 ounces, or 2 quarts).

Here’s some other things your kidneys do:

Unsplashed / Robina Weermeijer
  • Hormone production for your blood
  • Converts vitamin D from a non-usable source like the sun into a usable form. Vitamin D helps retain calcium and phosphorus which builds bones, reduces inflammation, and reduces tumor growth!
  • Filters out minerals your body doesn’t need to maintain healthy blood

We would submit to you that poor access to healthy food, a reality for 1 in 5 food insecure individuals in Arkansas, leads to many diet-related illnesses that have seriously negative consequences for the health of their kidneys, and ultimately their lives.

Your kidneys are important. Lose even a portion of their function and life gets hard. So, what inhibits the correct function of these fleshy powerhouses?

Unsplashed / CDC

Without getting too scientific, your kidneys filter toxic and unnecessary minerals out of your body to maintain healthy levels in your blood. When there is an overwhelming amount of something in your bloodstream, your kidney must work harder to process it, leading to kidney disease.

Diabetes is the leading cause of chronic kidney disease (1). A person with diabetes either lacks the insulin to process sugar or their blood rejects insulin, so sugar builds up in the blood, damaging the filters in your kidneys.

High blood pressure is kidney killer number two. High amounts of sodium in your diet cause your body to retain more water. More blood flowing in your veins, higher blood pressure. The extreme force of blood pumping through your kidneys can cause damage to its tiny blood vessels and lead to kidney disease or failure over time.

There is no single reason why certain communities in Arkansas are more at risk for kidney disease, but food insecurity plays a huge role for many rural and minority communities. 

African Americans are 4 times more likely to develop kidney disease, while Hispanic people and Native Americans are at 1.3% and 1.2%, respectively (2). Much of their risk is due to their risk for diet-related illnesses like diabetes and hypertension (high blood pressure)

Our mission is deeper than simply providing healthy food. Diet is the major determinant of our participants wellbeing, but empowerment and education are vital to see change.

Good news is kidney disease is reversable. With the correct diet, help from a nutrition or doctor, a support system, and a good nutritional plan, a kidney disease patient can return to good health in time.

Check your kidneys health here and find resources to avoid or manage kidney disease here.

What is… Biological Determinants of Health

What determines our health?

Dr. Bortz likes to explain it using the life of a car. “The life of a car depends on 4 elements: design, accidents, maintenance, and aging. If the car is a “lemon,” is involved in many accidents, or is poorly maintained, it will not have the chance to grow old. (1)” Our bodies work similarly. This is called the biological determinants of health.

What are biological determinants of health? For the purposes of simplification, biology is the study of the vital processes of life. For humans, that encompasses things we do that keep our body functioning correctly, or in contrast, what can deteriorate it faster. Internal factors such as how much or what we put in our body and how much exercise we do and don’t get, even factors outside our control like what genes we’ve inherited and external factors including bacteria and viruses, can significantly impact our health and quality of life. These are the biological factors that determine our health.

Some of these we can control. We can determine, to a certain point, our diet, whether we smoke or drink alcohol, and how much exercise we get. Other parts of our biology, paired with careful actions, can result in positive health outcomes. For example, someone with type 2 diabetes in their family history can reduce their risk of becoming diabetic through healthy regulation of their diet and exercise (2). There are biological determinants that are out of our control such as the deterioration of our body’s vital processes with age, but even as we age, how we treat our body can influence how fast our body ages and how resistant our body is to disease and harm.

This is where Well Fed is set up to make the most impact. We are focused on biology and behavior. We work in underserved communities where diet-related illness affects many people’s daily lives. The choices they make often determine their health outcomes. Some struggle to change bad habits and choose a healthy diet and as a result their diabetes or hypertension gets worse. Others will develop illnesses because they do not change their current lifestyle. However, we recognize the barriers they face which make choosing to cook and eat healthy difficult and sometimes out of reach.

Phinehas Adams / UNSPLASH

This brings us to the social determinants that drive health outcomes. These are the conditions in which a person is born, grows, lives, works, and ages that contribute to their health (3). The governmental policies, cultural values placed on health, your socioeconomic status— who you are in society as far as your income, occupation, education, ethnicity, and gender impact your health. Even psychological factors like if you have a healthy relational support network or have stressful living circumstances can all govern your ability to live and eat healthy.

There are organizations that hold an important role in working hard to influence policy and the conditions in which people live. Well Fed is in some of those conversations, but our expertise and where we can help the most is with the biological determinants that are causing poor health, hospitalizations, and death among under-represented communities in Arkansas.

We empower families to make healthy choices by providing them with consistent cooking and nutrition education. We’re giving them the tools so that they can construct a healthy lifestyle for themselves.

Each conversation about how to cook a particular vegetable and its related nutritional benefits is a step forward in real behavioral changes.

They see the importance and simplicity of cooking healthy. 1) We give them fresh fruits and vegetables so they can access it, because many of our participants have physical restrictions to healthy food access. They may live in a food desert (link), they could be disabled, or their transportation could be inconsistent. 2) Our participants can use the food we give to make the recipes they get from our education segment. 3) The healthy food we give them adds vital nutrients to what they already make!

The statistics in Arkansas are not good. In previous blogs we wrote about the devastating effects in the Natural State in regards to the obesity rates, rate of food insecurity among adults and children, and the risk of diabetes, hypertension, and heart disease. The social determinants need addressing, however, as Dr. Bortz explains (4),

it is evident that the biological factors are more proximate determinants than the socioeconomic contributors, which are upstream and ultimate in their role.

What goes into our bodies has the closest impact on our health outcomes! Although it may be a daunting task to impact behavior and biology in a way that heals people living in underserved communities in Arkansas, through the cooperation of our partners and our community, we can begin to change the future health of communities one person at a time.

Food Insecurity Won’t Be Fixed In Just a SNAP

SNAP (Supplemental Nutrition Assistance Program), formerly known as the Food Stamp Program, is a government program that provides food assistance to qualifying low-income individuals in order to mitigate food insecurity. In 1933, as a way to alleviate the struggle farmers were having selling excess crop supply, the Federal government purchased these commodities and distributed them among under-nourished communities.

The program today has certain requirements for those who can receive SNAP benefits and Arkansas’ are among the highest. These barriers prevent many eligible Arkansans from accessing the important nutrition they need. What these barriers are, how SNAP participants actually feel about the program, and how organizations like Well Fed that specialize in healthy food access are necessary while the system changes, will be answered in this blog.

Arkansas uses one of the strictest allowable asset limits for SNAP eligibility according to a report done by one of our local partners, the Arkansas Hunger Relief Alliance. They teamed up with local medical research organizations such as the Office of Community Health and Research at the University of Arkansas for Medical Sciences (UAMS) and the Center for Science in the Public Interest (CSPI) to interview SNAP participants and representatives from SNAP-focused organizations across Arkansas.

Their motive was to gather first-hand testimonies from actual SNAP stakeholders to learn the barriers to success in the program and come up with tangible strategies based on these stakeholders’ opinions and stories.

Mael BALLAND / Unsplash

Arkansas’ SNAP program provides assistance to over 330,000 individuals and has 2,808 authorized SNAP retailers. And although 330,000 is 11% of all Arkansans, only 66% of eligible residents accessed SNAP in 2018, compared to 82% nationally.

With 34% of eligible Arkansans living in need but not accessing government assistance and food insecurity levels in Arkansas climbing 5.2% since the pandemic started, the AHRA and UAMS set out to discover why.

For the 34% eligible, what are the barriers? As stated above, Arkansas has one of the strictest allowable asset limits for SNAP eligibility. That means they either can’t save in order to qualify for the program or they use their savings on food. Participants surveyed said this discourages saving among eligible participants.

Some other barriers mentioned by SNAP community stakeholders were the child support enforcement requirements (which research suggests only harms the children who wouldn’t receive the food), difficult application process, and negative stigma against SNAP users.

The amount of food and frequency of when participants receive it was a concern for participants, too. One SNAP stakeholder said:

When you got to stretch [your benefits] you will buy the cheapest thing. It’d be bologna, hot dogs, you know, a lot of processed foods […] because you’re trying to stretch your stamps out for the end of the month.

The current SNAP benefits could be indirectly encouraging unhealthy eating habits and, ultimately, the high percentage of diet-related illnesses in Arkansas. No one is causing it specifically, however, participants feel like the only reasonable method to make their government assistance last is to purchase unhealthy, cheap food.

Interviewees brainstormed ideas to solve it; increasing the amount of allocation and frequency was mentioned, however, passing such legislation would be difficult and without an accompanying education component, their diet is unlikely to change, they concluded.

There are parts of the program that encourage eating healthy. The Double Up Food Bucks program incentivizes participants by matching up to $20 for every dollar spent on FFV (Fresh fruits and vegetables) at participating locations. Participants did express opinions that the program needs to be more widely advertised because not everyone knows it exists.

Many FFV vendors are at farmers markets, which helps the local economic growth, but can be a barrier for participants who can’t go to these markets, feel embarrassed to use EBT (Electronic Benefits Transfer), or don’t feel like they fit in with the clientele of the market. There are thoughts on expanding eligible locations to supermarkets and even pick-up or delivery to eliminate this barrier.

SNAP is a very important program to help people in need and Well Fed was never meant to replace it, simply compliment it. The AHRA did this study intentionally to improve on a system that needs a refresh. Until legislation can improve SNAP benefit access, distribution, and improve incentives for eating healthy, Well Fed will be in communities in Arkansas where SNAP eligible participants live.

52% of our mobile market participants in low-income communities are not accessing SNAP benefits and 80% of our participants in a post survey said they needed continued assistance to access the healthy food they need.

Oh, snap! Clearly there is still a great need and we will be there for years to come to help supplement their diets with highly nutritious food and compliment the food assistance programs some currently use.

This blog is a synopsis of the whole article that you can find here.

If you or someone you know would like to apply for SNAP Benefits, please go to the Divisions & Shared Services website to learn more.

Cover photo by Pascal Bernardon

What is… Covid-19’s Impact On Low-Income Communities

If asked what the trending health issue has been the last two years there’s no doubt the answer would be Covid-19. The economic impact proceeding the lockdowns and the aggregated number of hospitalizations and deaths has affected many Americans on a personal level, not to mention the global impact it has had on the supply chain, health, and travel. There is a portion of the population, however, whose high health risk has put them in greater jeopardy during the Covid-19 pandemic: Low-income communities.

The prevalence of diet-related illnesses in low-income communities has been a leading comorbidity issue, the simultaneous presence of two or more diseases in a patient, among Covid-19 patients. In this article I will give some background concerning diet-related illness in these communities, what are the main factors that lead to diet-related illnesses, how the emergence of Covid-19 has been worse for communities prone to these illnesses, and what solutions can be offered.

The Covid-19 pandemic has only perpetuated health risks associated with diet-related diseases that have been present among low-income households with food insecurity for decades. A study done in the early 2000’s among low-income households in counties across Arkansas, Louisiana, and Mississippi found that food insecure individuals have 2.4 times higher risk of diabetes and hypertension. And since the 70’s, mortality rates connected with cardiovascular disease (CVD) have declined, however, about 659,000 people in the United States still die from heart disease each year—that’s 1 in every 4 deaths [1]. Communities on the south side of Chicago (where the majority of the population represented is low-income African-Americans) made up “more than 50% of Covid-19 cases and nearly 70% of Covid-19 deaths [in Chicago city limits]…” Why were infection and mortality rates in low-income communities so high?

First, the concept known as “social determinants of health” needs to be defined and addressed for us to arrive at an informed conclusion. Boiled down it is the “view that health and illness are not randomly distributed throughout human society neither are the resources to prevent illness and its effects [2].” Where you are born, live, work, your age, and the systems around you that are in place to deal with illness determine health outcomes.

Before the pandemic began, socioeconomic circumstances made it less likely for them to have access to healthy food whether it’s because they live in a food desert (we have written about this before), have a disability, or less income due to unemployment.

 Furthermore, they may have learned poor health behaviors or have a poor social support system which contributes to stress and poor health.

These factors naturally cause or perpetuate food-related illnesses. Now add in the effects of a pandemic like unemployment, increase in cost of healthy food, decreased public transportation, and fear of going to hospitals or clinics (one study found a decline in “food related disease diagnosis during the pandemic without the indication of a fall in prevalence of these conditions [3]”).

The risk is substantial. Early on, researchers began developing studies that showed a substantial increase in risk of 2-to-3 fold for infection and hospitalization among patients with diabetes and CVD.

What can be done? We agree with Michael Thomsen, a professor of agricultural economics and agribusiness at the University of Arkansas, when he said, “COVID relief should place more focus on food assistance [4].”

We believe food-related disease comorbidity among Covid-19 patients is addressable with proper food access and education, especially among low-income and underserved communities.

Access to proper nutrition is the powerhouse that fuels a healthy immune system, fights diabetes, hypertension, and CVD, and is the best long-term solution to keep people from hospitalization. And nutrition and cooking education empowers and equips families to cook and eat healthy.

Since Well Fed’s mission focuses on food access and nutrition education, our goal is that, through providing healthy food and nutrition education, underserved individuals and families will have the good health, energy, and motivation to focus on other important areas of their lives such as acquiring a job or maintaining their mental health. They cannot focus on these fundamental steps in life while they remain at high risk for Covid-19 comorbidity. There is hope for these communities battling Covid-19 and it starts with healthy food, it starts with organizations like ours. Will you join us?