*Purpose: Pts with food scarcity often have poor dietary habits which can result in changes in body composition, including increased or decreased body fat depending on the degree of inanition. The relationship between food scarcity and post-transplant weight gain and it’s effect on visceral body fat, which has been associated with increased risk for multiple diseases including metabolic syndrome, cardiovascular disease and diabetes has not been investigated. We studied body fat patterns in a population of inner-city KTRs and looked for association with adverse social determinants.

*Methods: A random sample of 16 stable long-term pts from kidney transplant clinic were studied using the InBody S10 body composition analyzer at a regularly scheduled appointment. Pts were seated and electrodes were attached to the middle fingers, thumbs and below each ankle. Food scarcity was assessed by a standardized survey. Demographic data was collected from EHR.

*Results: Mean age was 52.7±2.2yrs, time since txp 9.73±14.7 yrs. 43% were male (10), 12 (75%) pts identified as black, 2 (12.5%) white and 2 (12.5%) other. The majority (56.3%) had an annual income <$20k. All pts were receiving prednisone and tacrolimus and had stable kidney function. 63% (10) pts had body fat >25% (HIFAT). They did not differ from pts with body fat <25% (6 pts, LOFAT) in time since transplant, race, education or annual income. HIFAT pts had higher visceral fat (14.0±1.3 vs 5.1±1.3, p<0.001), higher BMI (34.8±1.25 vs 27.7±1.7, p=0.002), and body weight (227.1±12.6 vs 180.5±12.1, p=0.010), but no difference in skeletal muscle mass. HIFAT pts were more likely to be male (70% vs 30%, p=.039) and were older (53.9±2.7 vs 43.5±2.5 yrs, p=0.01). Pts with diabetes were more likely to be HIFAT than those without (100% vs 50%, p=.037). 50% of pts in the LOFAT group reported they had cut down or skipped meals because there wasn't enough money for food vs none of the HIFAT pts (p=.018). Additionally, 100% of pts who received food from a bank, church or pantry in the last year were LOFAT (p=.004). There was no difference in SNAP use between the two groups.

*Conclusions: In our population of stable long-term inner-city KTRs: 1. The majority of patients had high total body fat and met the definition of overweight or obesity by BMI. 2. Pts with higher body fat weighed more overall and had more visceral fat but not higher skeletal muscle mass 3. Those with higher body fat were more likely to be older and male and have diabetes. 3. Pts with lower body fat were more likely to report food scarcity and reliance on food pantries and their body composition may not relate to better dietary habits per se. 4. Education regarding lifestyle changes that might improve body composition is important in this population as visceral adiposity may contribute to cardiovascular disease and diabetes which can have deleterious effects in this population.

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