A recent study highlights the benefits of a food-centered strategy in managing chronic kidney disease (CKD). According to researchers, this approach can not only slow the progression of CKD but also help reduce the risks of heart attacks and strokes.
Significant Highlights:
- The study revealed that adding a few more servings of fruits and vegetables to daily meals significantly improved kidney function and addressed heart disease risk factors, such as high blood pressure, in individuals with CKD.
- These positive effects appear to be linked to the body’s reduced acidity levels.
- By lowering acidity, the kidneys experience less strain as they are responsible for filtering excess acid from the blood through urine.
Recent research suggests that incorporating a few extra servings of fruits and vegetables into daily meals may slow the progression of chronic kidney disease (CKD) while significantly improving blood pressure and other risk factors associated with heart attacks and strokes. The study underscores the benefits of a plant-based diet in lowering body acidity, which can have a positive impact on both kidney and heart health.
The research provides a fresh perspective on managing CKD and heart disease by highlighting the importance of dietary changes, particularly a food-first approach, instead of relying solely on medication. The study’s lead investigator, Donald E. Wesson, MD, professor of internal medicine at the Dell Medical School at the University of Texas in Austin, emphasizes the need to place fruits and vegetables at the forefront of treating hypertension, a condition closely linked to both kidney and heart disease.
A Food-First Approach to Managing Hypertension
“Fruits and vegetables should be foundational in the management of hypertension, with medications added as needed,” says Dr. Wesson. “In our study, participants given fruits and vegetables had lower blood pressure, better kidney health, and better heart health while taking lower doses of blood pressure medications than those participants not given fruits and vegetables.”
This insight challenges the traditional approach to managing high blood pressure, which often prioritizes medication over dietary changes. According to Wesson and his team, the evidence suggests that a plant-heavy diet can not only complement but also reduce the need for medications in managing conditions like CKD and heart disease.
The Role of Acidity in Kidney Disease
One of the key aspects of the study was investigating how reducing the body’s acidity levels could influence kidney health. When people consume animal products, such as meat, their bodies become more acidic. On the other hand, the digestion of most fruits and vegetables makes the body more basic, or alkaline. Dr. Wesson explains that basic foods neutralize acidity, which in turn reduces the strain on the kidneys.
The kidneys play a crucial role in maintaining the body’s pH balance by filtering out excess acid from the blood and expelling it through urine. As kidney function declines in individuals with CKD, the ability to filter this acid becomes compromised, leading to further damage. The study was designed to determine if a diet rich in fruits and vegetables, which reduces acidity, could help lighten the load on the kidneys and improve overall health.
Trial Design and Methodology
The trial involved individuals with high blood pressure but no diabetes, all of whom had severe chronic kidney disease marked by high levels of macroalbuminuria, a protein found in urine that indicates kidney damage. Participants were randomly assigned to one of three groups:
- Those instructed to add two to four cups of fruits and vegetables to their diet daily.
- Those prescribed sodium bicarbonate (baking soda) twice a day to reduce acidity.
- A control group that received standard medical care.
Participants in the fruit and vegetable group reported eating approximately two additional cups of produce per day by the end of the trial. The researchers tracked participants’ health over five years, with the fruit and vegetable group showing notable improvements in kidney health as well as reductions in heart disease risk factors, such as lower blood pressure, cholesterol, and body mass index (BMI). Interestingly, they also required less blood pressure medication than the other two groups, suggesting that a plant-based diet could naturally alleviate the need for pharmaceuticals.
Long-Term Success of Dietary Changes
Christopher Gardner, PhD, a professor of medicine at Stanford University and director of nutrition studies at the Stanford Prevention Research Center, comments on the study’s findings, noting that they align with standard recommendations for people with kidney disease to eat more plant-based foods. “It makes sense that lowering acid by consuming either plant foods or sodium bicarbonate would benefit kidney health,” says Gardner. He adds that subjects in the fruit and vegetable group also likely saw heart health benefits due to the increased fiber and reduced intake of saturated fats from animal products.
“What is really impressive about this study is that the follow-up was for five years, not simply five weeks or five months,” Gardner continues. “These were long-term dietary changes that were made and maintained, with long-term health benefits.” This highlights the sustainability of such dietary adjustments, which are not only practical but also manageable over extended periods.
Gardner also points out that medical professionals often receive limited training on nutrition during their education, which can leave them feeling underprepared to counsel patients on dietary changes. However, he believes studies like this one can encourage more physicians to incorporate nutrition advice into their practice. “This is not a complicated strategy — eat more plants — and hopefully study findings like these will encourage more physicians to take advantage of this strategy and combine it with the other tools they use to treat and prevent disease,” he says.
The Importance of Adding, Not Eliminating, Foods
One of the most intriguing aspects of the study was its approach to dietary recommendations. Instead of advising participants to eliminate specific foods, the focus was on adding healthy options, particularly fruits and vegetables. This approach not only made the changes easier to adopt but also led to participants naturally reducing their intake of less healthy foods.
“My dietitian colleagues have taught me over the years that it is best to make recommendations on what to eat, rather than what not to eat,” says Dr. Wesson. He believes that focusing on positive additions to a diet can be a more effective and sustainable way to encourage healthy eating habits.
Wesson also notes that participants in the study, when told to add more fruits and vegetables to their diet, often substituted them for the more expensive and less healthy processed meats they had previously consumed. “Our dietary surveys done before and after the study showed that they substituted the provided fruits and vegetables for the most expensive elements of their previous diets, which were often processed meats. This taught us that when we focus on telling patients what we want them to eat, they will typically substitute these foods for the foods that we do not want them to eat,” he explains.
Conclusion
This study offers valuable insights into the benefits of a food-first approach in treating chronic kidney disease and managing related conditions such as high blood pressure and heart disease. By focusing on adding nutrient-dense, plant-based foods to their diets, patients can experience significant improvements in both kidney and heart health, often reducing their dependence on medications. The findings reinforce the importance of dietary changes as a sustainable, long-term strategy for better health outcomes, and suggest that physicians should prioritize nutrition in their treatment plans for CKD and hypertension patients.
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