Healthy diets could help our kidneys and the environment too
Diet is crucial to general health and well-being, but to what extent can we use food to treat and prevent kidney problems? At WCN‘22, this will be the question addressed by Peter Stenvinkel, professor and senior lecturer in the department of renal medicine at the Karolinska Institutet, Stockholm, Sweden.
Professor Stenvinkel and colleagues are conducting two studies looking at the effects of diet: the HELPFUL study in CKD4 patients on the impact on quality of life and potassium levels of three weeks of eating baskets of healthy food composed by a nutritionist; and a national randomized controlled trial, INITIATE, examining the effects of eating broccoli for 12 weeks on metabolic control in type 2 diabetic CKD4 .
“We already know that a suboptimal diet is responsible for more deaths globally than any other factor including tobacco smoking,” he says. “Epidemiological studies show that plant-based food reduces the risk of incident chronic kidney disease and retards the progression of kidney disease.
“The aim of ‘food as medicine’ is the generalized application of personalized nutrition, supported by solid scientific evidence. Bioactive nutrients targeting inflammation, oxidative stress, nitric oxide, and gut biodiversity look promising. Bioactive nutrients may also reduce the negative effects of drug treatments, such as proton pump inhibitors, phosphate binders, and antibiotics, on gut biodiversity.”
Evidence suggests that eating a lot of red meat can be detrimental to kidney health. Professor Stenvinkel says his group has preliminary data indicating that a diet low in red meat and high in fish may decrease the risk of death and slow the rate of disease progression so that renal replacement therapy can be initiated at a later stage.
“Accumulation of gut-derived uremic toxins, such as TMAO, promote renal fibrosis and early vascular aging. TMAO is produced from food rich in choline and L-carnitine. Red meat, which is particularly high in L-carnitine, reduces the ability of kidneys to excrete TMAO. Skewing towards a more carnivorous diet has resulted in a dietary association with the of aging.”
He concludes: “As food production is responsible for more than 25% of all greenhouse emissions and 70% of all freshwater use, it is the single strongest lever to optimize human health and environmental sustainability. A radical transformation of the global food system is urgently needed to adhere to the Paris agreement to keep the rise in global temperatures to no more than 1.50 C. In general, healthy diets are also environmentally sustainable.”
Professor Peter Stenvinkel: “Food as Medicine – Can it Link the Gut to an Improved Renal Phenotype?” Gut to Kidney in Experimental and Clinical CKD session, Friday 25 February, 21.30-22.30 hrs Kuala Lumpur (Malaysia) time: https://cm.theisn.org/cmPortal/searchable/WCN2022/config/normal#!sessiondetails/0000015370_0
