In the United States, chronic kidney disease continues to be a major problem. One in 10 American adults has some level of chronic kidney disease, and kidney disease is the ninth leading cause of death.[i], [ii]
Much of the cause, at least in the Western world, can be attributed to diet and lifestyle choices. With March as National Kidney Month, it is a great time to review how we can protect our kidneys.
One in 10 American adults has some level of chronic kidney disease...kidney disease is the ninth leading cause of death...
Since the onset of the “industrialization” of the Western diet, the cost of consuming healthier food has increased dramatically compared to more low-cost processed foods. For example, since 1983 the cost of fresh fruit has increased 200% while the cost of sugar has increased by only 30%.[iii]
While the cost of consuming a health-promoting diet may be higher initially, there are considerable savings in the long term when the cost of future medical care is factored in. Still, less than 20% of US adults are consuming the recommended intake of fruits and vegetables.[iv]
Overall, there is little doubt that the typical Western diet, high-stress, and a sedentary lifestyle contribute to kidney disease.
What’s so bad about our “Western” Diet anyway?
Aside from the general increase in processed foods, sugar, animal fat, fried foods, refined grains and the deficiency in vital nutrients, there are several characteristics which specifically cause considerable kidney damage.[v]
What you can do to protect your kidneys
High protein intake: Though this is more of a concern for those who have overt kidney disease (consult your physician on suggested daily protein intake if you do), even in healthy individuals those who consume a high protein diet have a 30% increase in blood flow to and filtration through the kidneys.[vi] This means more “wear and tear” which could spell trouble in the long run. Interestingly, this is only associated with increased consumption of animal protein, not vegetable protein.[vii] According to the American Diabetes Association, those with chronic kidney disease or diabetes should consume 0.8g/kg of their ideal body weight per day in protein which is considerably higher than “normal” for most Americans.[viii]
Consumption of an acid-producing diet: Our kidneys eliminate the acids that our bodies naturally produce and those that we get from our diet. Generally speaking, diets which lead to increased acid production are high in meat products and low in fruits and vegetables. A frequently recommended diet for hypertension (which is strongly correlated to kidney function) is the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet is higher in fruits and vegetables than the typical western diet and has been shown to lead to a 50% reduction in endogenous acid production, making the job of the kidneys considerably easier.[ix]
Low dietary fiber intake: Besides improvements in cardiovascular health, gastrointestinal health, and reductions in cholesterol, increased intake of soluble and insoluble fiber is associated with reductions in kidney disease. Though there are several mechanisms involved, this is in large part due to reduced inflammation, as inflammation plays a central role in chronic kidney disease progression.[x] Fruits, vegetables, and whole grains contain the highest amount of fiber, and you should aim for at least 20g total per day.
Enjoy a Mediterranean Diet: In one study, those who consumed a Mediterranean diet had a 42% lower risk of chronic kidney disease. Compared to those with low adherence, those with medium or high adherence to the diet had a 25% lower overall risk of death. The diet consists of primarily seasonal plant based foods from local sources, whole grains, legumes and nuts. Healthy fats are encouraged, along with various herbs and spices for flavoring (instead of added salt, for example). Red meat is limited, and fish and poultry are eaten in moderation. Red wine (1 glass for women, 1-2 for men) with dinner is encouraged, as well as high quality dark chocolate in moderation. Dairy is eaten but in low volumes, and fresh fruit is the main source of dessert.
Exercise: In combination with diet, a 12-week lifestyle modification program which combines aerobic and resistance exercise has been shown to improve crucial markers of kidney disease.[xi] Speak to your physician about the safety of adding exercise to your treatment plan.
Reduce Stress: As physical and/or mental stress plays a vital role in nearly every disease process, and kidney disease often occurs secondary to many of these diseases (heart disease being most common), including stress reduction techniques may play a role in optimizing kidney health.
As a naturopathic physician, my goal is to educate about prevention as a primary intervention. While there are many options people with kidney disease can try to improve their quality of life, the recommendations above should serve as a foundation for optimal and sustainable wellness. Consult your naturopathic doctor
for recommendations specific to your needs.
Finkelstein EA, Zuckerman L. The fattening of America. Hoboken: John Wiley and Sons, Inc; 2008.
Centers for Disease Control and Prevention (CDC). State-specific trends in fruit and vegetable consumption among adults-united states, 2000-2009. MMWR Morb Mortal Wkly Rep. 2010;59(35): 1125–30.
Hariharan D, Vellanki K, Kramer H. The Western diet and chronic kidney disease. Curr Hypertens Rep.
Ando A, Kawata T, Hara Y, et al. Effects of dietary protein intake on renal function in humans. Kidney Int Suppl. 1989;27:S64–7.
Landau D, Rabkin R. Effect of nutritional status and changes in protein intake on renal function. In: Kopple JD, Massry SG, Kalantar-Zadeh K, editors. Nutritional management of renal disease. 3rd ed. Amsterdam: Elsevier; 2013. p. 197–207.
American Diabetes A, Bantle JP, Wylie-Rosett J, Albright AL, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2008;31 Suppl 1:S61–78.
Scialla JJ, Anderson CA. Dietary acid load: a novel nutritional target in chronic kidney disease? Adv Chron Kidney Dis. 2013;20(2):141–9.
Shankar A, Sun L, Klein BE, et al. Markers of inflammation predict the long-term risk of developing chronic kidney disease: a population-based cohort study. Kidney Int. 2011;80(11):1231–8.
Yamamoto-Kabasawa K, Hosojima M, Yata Y, et al. .Benefits of a 12-week lifestyle modification program including dietand combined aerobic and resistance exercise on albuminuria in diabetic and non-diabetic Japanese populations. Clin Exp Nephrol. 2015; [Epub ahead of print].