"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
increases 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 group
were 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 benefit,
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.