Lower Protein Diet Proven to Help Kidney Disease
“Lower Protein Diet Proven
to Help Kidney Disease” Approximately 1 in 7 American adults
have chronic kidney disease, and the prevalence is higher in
those with metabolic risk factors such as high blood pressure,
diabetes, and obesity. That sounds like a job
for plant-based diets, which have demonstrated
significant utility for the prevention and
treatment of all three of those modern-day
scourges of society. Their utility for the treatment
of so many diseases has led to a growing interest in their
applicability for the prevention and treatment of chronic
kidney disease itself. In theory, there are multiple
benefits of more plant-based diets in the management
of kidney disease.
The intake of animal fat
is associated with protein loss in the urine,
and other components related to meat such as
choline and carnitine are converted by bad gut bugs
into TMAO, which is associated with scarring of the kidneys. Plant-based diets carry
a decreased acid load, whereas ingestion of animal-based
foods like meat, eggs, and dairy increase the formation
of acid and ammonia, unlike the favorable alkalization
from fruits and vegetables. The phosphorus in plant-based
protein is less absorbable, which is a good thing if
you have ailing kidneys, especially compared to the
added phosphorus-based preservatives that are often
used in meat processing.
Indeed, you can successfully
lower blood phosphorus levels in kidney disease patients
in as short as one week on a vegetarian diet. Higher dietary fiber intake can
also pull advanced glycation end products out of your system –
those so-called glycotoxins – and prevent constipation, which can cause potassium
overload in kidney patients. A plant-based diet also lessens
the likelihood of exposure to potassium-based additives. A lot of the phosphorus
additives in meat are also potassium additives.
And finally, there may be
favorable impacts on the gut microbiome, leading to
lower generation of uremic toxins. Such “putrefaction” products are
generated by protein putrefying in the gut, but plant-rich
diets may be able to reduce uremic toxins, in part due to increased fiber
and lower protein intake. The lower the dietary protein
intake, the slower the progression toward end-stage kidney disease. And increased risk of progression
to end-stage kidney disease associated with
dietary protein intake appeared to have no threshold, meaning it just seemed
the lower the better. But even if you just drop your protein
intake by just like 10 grams a day, that modest reduction
may decrease the risk of end-stage renal disease
and death by greater than 50%. That’s incredible. It was a randomized
controlled trial. They were trying to get
people down to like 0.6 grams per kg
a day of protein, which is like 40 grams a day,
but could only get people down to about 60
grams a day, which is technically not
even a low-protein diet.
The recommended protein
intake is 0.8 g/kg per day, or like 50 grams a day, but just getting people from
the usual protein intake of like 70 grams
down to 60 cut their risk of dialysis
or death by 77%. Check this out.
By the end of 4 years, more than 25% of those
in the usual diet, the group was either dead or on dialysis
from end-stage disease. In the reduced protein group,
it was less than 10%. A randomized controlled trial
proving massive benefits, yet despite strong scientific
evidence, many doctors are still unconvinced that
a low-protein diet can help patients with
chronic kidney disease.
Why? The reasons for this nihilism
are unclear, but could be related to insufficient
background knowledge, lack of interest in
nutrition and dietetics, and limited familiarity with the
most recent scientific literature.
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