"Plant-Based Diet for Treating and
Reversing Stage 3 Kidney Disease" Is it possible to ameliorate
chronic kidney disease using a whole food,
plant-based diet? In my last video
on kidney disease, I talked about how randomizing
people to cut just around 10 grams of protein from their
daily diet could cut their risk of dialysis and death
by a whopping 77%. That was cutting protein
across the board. But while animal-based
protein ingestion — meat, dairy, and egg white
protein ingestion — promotes an acidic environment
in the kidneys, inflammation, and stresses the kidneys to what's
called hyperfiltration mode, plant-based protein can be
alkaline-producing and anti-inflammatory and contain
kidney-protective properties.
So, what if you have kidney patients
eat a plant-dominant low-protein diet, abbreviated adorably as PLADO,
I guess for plant-dominant. If you fashion up a plant-based diet
index score where you get points for healthy plant foods and get points deducted
for eating animal foods, those with serious kidney disease
with higher scores were found to have lower systemic inflammation. But does that actually translate
into living a longer life? Apparently so. Even a 10% increase in the
proportion of plant-based protein was associated with a significant
reduction in all-cause mortality. Even just eating more servings of
fruits and vegetables, like two a day compared to two a week,
is linked to living longer. Without fully functioning kidneys, there are concerns about
phosphorus and potassium overload, though, on a plant-based diet. But the phosphorus in plant-based
foods is not as much of a problem as the phosphorus additives
in processed and animal foods. And the risk of potassium overload
from plant-based diets appears overstated and not supported
by the evidence.
But you don't know about
ameliorating chronic kidney disease using a whole food, plant-based
diet until you put it to the test. Here's a case report of a 69-year-old
man with type 2 diabetes, high blood pressure, and
stage 3 chronic kidney disease, resulting in elevated phosphorus
and potassium in the blood, Interested in changing his diet
to improve his medical condition. That's my kind of patient! He was on 12 different medications,
eating a diet that may actually be slightly better than
the average American: some whole grains and beans, but then his doctor advised to try
eating whole food, plant-based. So, oatmeal with fruit and flax,
beans and greens, whole wheat spaghetti and
veggies, fruit as snacks.
Counselled to eat as much as he
wanted from whole healthy foods; no carb counting, no calorie counting,
no portion size restriction — improving the quality of food rather
than restricting the quantity of food. He adopted the whole food,
plant-based diet, packed with carbs, yet rapidly reduced his insulin
requirements by more than 50%, and subsequently saw
improvements in weight, blood pressure,
and cholesterol. Because eating healthy
can have such a rapid effect on improving your body's
insulin sensitivity, immediate adjustments
in insulin dosing were made. Within four days, his insulin dose
was able to be reduced from roughly 210 units of insulin
a day down to 70 units daily, and an oral blood-sugar lowering
medication had to be stopped due to rapidly improving blood sugar. He also was able to stop his
carvedilol, the hydrochlorothiazide, amlodipine, sitagliptin
within the first two months due to improving blood pressure
and blood sugars.
His insulin dose was
steadily titrated downward. His pravastatin dose was cut in half,
and he lost about 50 pounds. Okay, so what happened
to his stage 3 kidney failure? He was no longer in
stage 3 kidney failure! Doctors watching this will understand
what all these numbers mean. Here's a graph of his GFR, which
is a measure of kidney function, declining for years before shooting
up after he started eating healthy. He experienced an increase
in estimated GFR of 73%, suggesting that the improvement
in estimated kidney function was greater than what would be
expected from weight loss alone. For example, lose about 60 pounds
from bariatric surgery, and you only get
about a 12 to 15% boost. Bottom line: for individuals
with chronic kidney disease, especially those with obesity,
hypertension, or diabetes, a strict, all-you-care-to-eat
whole food, plant-based diet may confer significant benefit. I mean, apart from the
kidney-specific outcomes, overall mortality is significantly
lower among kidney patients who eat more plants.
And that's critical because most
kidney patients don't even make it to dialysis because they die first, most often from
cardiovascular disease. Let's hear from the patient. "At the outset, it seemed like
this was going to be a difficult and restrictive way to eat, but I began feeling different
almost immediately and we had to decrease
my insulin after ONE day. It seemed like almost overnight I had
more energy than I'd had in years. Weight I'd been trying to lose for
a decade began dropping off. As the weight came off, I felt lighter,
and more able to move my body again. This lifestyle change has been
the greatest gift I've ever received.
I am off most of my medications,
I've lost over 70 pounds, and I've regained control
over my health. I feel empowered
by this lifestyle change, and I finally feel like I'm
in charge of my health, not just an unlucky victim shuffling
from one specialist to the next. My only regret was that
I didn't know about this sooner.".
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