The Fruit and Veggies for Kidney Health Study: A Prospective Randomized Trial

Area of Science:

• Community-based health interventions
• Nephrology and cardiovascular disease prevention
• Nutritional science and public health

Background:

• Elevated urine albumin-creatinine ratio (ACR) is a marker for chronic kidney disease (CKD) and cardiovascular disease (CVD) risk.
• Previous studies demonstrated that fruits and vegetables (F&Vs) can reduce ACR and slow CKD progression in healthcare system patients.
• Lower-income African American communities face disproportionately higher rates of CKD and poorer health outcomes.

Purpose of the Study:

• To evaluate a community-based strategy for identifying African Americans with elevated ACR in lower-income settings.
• To assess the efficacy of a 6-month F&V protocol, with and without cooking instructions, on reducing ACR.
• To test the hypothesis that adjuvant cooking instructions enhance the kidney-protective effects of F&Vs.

Main Methods:

• Prospective, randomized, parallel 2-arm study design.
• 142 African American adults with ACR >10 mg/g creatinine were randomized to receive F&Vs only or F&Vs with cooking instructions.
• Participants received 2 cups of F&Vs daily for 6 months, with outcomes assessed at 6 weeks and 6 months.

Main Results:

• 71% of participants were retained at 6 months, with high adherence to F&V distribution.
• The F&V + Cook group showed a significant 31% lower ACR at 6 months compared to the F&V Only group (P=0.02).
• Combined F&V intake increased significantly, and biometric variables improved across both groups.

Conclusions:

• The study demonstrates the feasibility of identifying and engaging community-dwelling African Americans at risk for CVD and CKD.
• A 6-month F&V protocol is effective in improving kidney outcomes and CVD risk factors.
• Preliminary evidence suggests that incorporating cooking instructions alongside F&V provision is crucial for further reducing ACR.