Carol Offen and Betsy Crais Broadcast

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A Plant-Based Diet: What Are The Pros and Cons Final

 A Plant-Based Diet: What Are The Pros and Cons?

Introduction

Recently I did a Broadcast on the Urban Health Outreach Media With Dr Blake Shusterman and Dr Shivam Joshi.
https://www.facebook.com/UrbanHealthOutreachmedia/videos/983197005809888/

Dr. Blake Shusterman, the Cooking Doc strongly recommended some version of a plant-based diet. Dr. Blake Shusterman is President and Physician Partner at Carolina Nephrology, a twenty-two provider practice in Greenville, SC. He is also the creator and host of The Cooking Doc (www.thecookingdoc.co), and author of the book The Cooking Doc’s Kidney-Healthy Cooking: A Modern 10-Step Guide to Preventing and Managing Kidney Disease.  You can also subscribe to his newsletter there.

A board certified nephrologist, Dr. Shusterman serves as the medical director at multiple dialysis units. He is a Clinical Assistant Professor at the USC School of Medicine in Greenville and oversees the medical student nephrology rotations. 

He is passionate about home dialysis, patient education and the importance of diet in the management of chronic kidney disease. His interest in diet and kidney disease led him to his role as an ambassador for the American Kidney Fund’s Kidney Kitchen. 

Dr. Shusterman earned his medical degree from The Ohio State University and went on to complete his internal medicine residency and nephrology fellowship at the University of Virginia where he served as chief fellow. He holds a BA in Anthropology from Tufts University. 

"During my years of practice, I have come to realize that many of my patients and their families live equally food-focused lives. So, I understand the furious looks I get from my patients when I tell them to give up their favorite foods.


Thus was born The Cooking Doc. Can you imagine having your doctor right next to you in the kitchen, telling you what delicious foods you need to try? Well, that’s me. I won’t tell you what tasty foods you need to give up, instead I’ll help you find creative ways to use new ingredients and together we’ll make them taste amazing. (Check out this summer squash soup with white wine and leeks)"

Our second nephrologist expert was Dr Shivam Joshi. Shivam Joshi, MD, is an internist, nephrologist, and plant-based physician practicing at NYC Health + Hospitals/Bellevue in New York City. He received his BS from Duke University and his MD from the University of Miami. He completed his residency at Jackson Memorial Hospital/University of Miami and his nephrology fellowship at the Hospital of the University of Pennsylvania. He is also a clinical assistant professor at the New York University School of Medicine with research interests in plant-based diets, fad diets, and nephrology. He has written numerous scientific articles and speaks nationally on these subjects. He is the youngest nephrologist to receive the NKF’s Joel D Kopple award, the highest award in renal nutrition. You can follow him on Twitter (@sjoshiMD).

“Dr. Joshi is incredibly impressive. Though he is still early in his career, he has already made important contributions to the field of renal nutrition and I can’t wait to see what will be next in his career,” said NKF President Dr. Paul Palevsky. “His dedication to patients and understanding kidney disease and its relationship to nutrition is of course evident, but also critical in understanding this disease that touches so many American lives"

What surprised me most about the interview was all of the scientific basis for Plant-based diets for Kidney Patients that exists, and has existed for a long period of time, and yet only recently has this information just begun to surface in the Kidney Community. Even more surprising was the number of views of the Broadcast, indicating a trend towards wide-ranging acceptance of at least some hybrid form of plant-based dieting from actual kidney patients.

That is the reason for this blog. I wanted to put the word out to Kidney Patients everywhere that this deserves their attention and serious consideration.

What Is A Plant-Based Diet?

A standard definition of a plant-based diet would be:

"A plant-based diet or a plant-rich diet is a diet consisting mostly or entirely of plant-based foods. Plant-based foods are foods derived from plants with no animal-source foods or artificial ingredients. While a plant-based diet avoids or has limited animal products, it is not necessarily vegan."
https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760

According to the Harvard Health Blog,

"Plant-based or plant-forward eating patterns focus on foods primarily from plants. This includes not only fruits and vegetables, but also nuts, seeds, oils, whole grains, legumes, and beans. It doesn’t mean that you are vegetarian or vegan and never eat meat or dairy. Rather, you are proportionately choosing more of your foods from plant sources."

What is a plant-based diet and why should you try it?

https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760

Basically, a plant-based diet or some variety of a hybrid of a plant-based diet eliminates in full or in part meat or other animal products. Other versions of a hybrid plant-based diet may include the Mediterranean Diet (incorporates fish & poultry), Pescatarian(includes eggs, diary, fish and seafood, no meat or poultry)and Vegetarian(includes eggs, diary, no meats, poultry, fish or seafood) and Vegan(no animal foods) diets.


What is particularly striking about all of this is that studies have shown that plant-based products have been flying off of the shelves at the grocery while the sales of dairy and meat products may be declining.

A Word of Caution About the Keto Diet for Kidney Patients

In my interview with Drs Shusterman and Joshi, both nutrition expert did not reccommend the Keto Diet for Kidney Patients.

Borrowing heavily from the National Kidney Foundation of Hawaii's article,
To Keto or Not to Keto, https://kidneyhi.org/dietitian-blog/to-keto-or-not-to-keto:

"The ketogenic diet, or “keto diet", is one of a series of trendy low carbohydrate (“low carb”) diets that include the Atkins diet, the South Beach diet and the Zone diet. It was developed at the Mayo Clinic in 1924 as a treatment for epilepsy in children. In recent years the ketogenic diet has made a comeback and today, medical teams are once again using it as a therapy for epileptic kids whose seizures do not respond to medications. The medical ketogenic diet relies on precise ratios of fat to protein and carbohydrates so it requires careful monitoring by a medical team. This is because the diet is not balanced and can lead to nutrient deficiencies among other things.

The "keto diet" got its name from ketones, which are the source of energy that the body uses when it’s burning fat. The goal of the keto diet is to put the patient a state of ketosis through a diet that’s high in fat and ultra-low in carbs with moderate amounts of protein. In simple terms, ketosis occurs when there is a metabolic shift, where the body uses fat as the primary energy source instead of carbs.

The keto diet is NOT a high protein diet. It is a low-carb, high-fat diet typically containing a percentage of total calories as follows: 5% carbohydrates, 75% fat, 20% protein. By contrast, National Health Guidelines suggests intaking 45-65% carbohydrates, 20-35% fat, and 10-35% of protein.

Another Fad?

Because this diet is so restrictive and individualized, it isn’t a healthy option for the general population. You would be missing out on too many essential nutrients and probably experience unpleasant side effects as well. The effects of maintaining ketosis for long periods of time are unknown. There’s a lot of misinformation online about the ketogenic diet. Most people calling their diet a "keto diet" are simply following a low or very low carbohydrate diet. In other words, most keto diets are only keto-like, in that it replaces some of the carbs in a person’s diet with fat and protein. Ketogenic in the clinical sense limits carbs to as few as 10 grams a day. Low carbohydrate diets can be helpful in the short term for weight loss. However, as with the true medical ketogenic diet, most people can’t stick with a very low carbohydrate diet for the long term.

Nutrient Deficiencies

Any time you remove a macronutrient group like carbohydrates, your body is going to be losing some of the essential nutrients that come from that food group (B vitamins, vitamin C, phytochemicals and fiber). Although many people label carbohydrates as "bad", not all carbs are created equal. The key is to choose smarter carbs: sweet potatoes, steel-cut oats, quinoa and fruit rather than white pasta, white bread, white rice, and pastries.

Long Term Effects?

People think, ‘Oh, this diet sounds great - I can eat bacon and cheese and I can still lose weight,’ then they drop pounds quickly and are instantly gratified. It’s true that cutting carbs often leads to rapid weight loss, but in the first week or two much of the loss is water weight, because our bodies store water with our carbs. However over the long term, a diet high in saturated fats increases the risk of heart disease and stroke. Keto diet or not, the fats we should be eating are unsaturated fats, which actually lower the risk of heart disease and stroke. Healthier fats include olive oil, canola oil, walnuts, avocados, and fish.

Kidney stones may also be an issue.  When you compare the annual rate of kidney stones to the annual rate normally found in the general population, the rate in those on the keto diet is 7-8 fold higher than in the general population!

https://pubmed.ncbi.nlm.nih.gov/34070285/#:~:text=Conclusions%3A%20The%20estimated%20incidence%20of,followed%20by%20calcium%2Dbased%20stones.

Sensible Eating is Best

The latest research shows that the ability to stick to a diet is key. If a low carbohydrate diet or keto diet is a practice that works for you and you are able to maintain it for as long as it takes to lose excess body fat and you are meeting your nutritional requirements, then science says that this should be encouraged. As of yet, there hasn’t been enough research into the ketogenic diet to support its use in some medical conditions like Polycystic Ovarian Syndrome, Alzheimer’s, Parkinson’s, and cancer. Eating a well-balanced, keto diet is costly. For most people, following a low carbohydrate diet, rather than a no carbohydrate diet, is much more practical as it will allow for the inclusion of fruit and all vegetables. This represents much better dietary balance and usually leads to people sticking with it for longer.

To Keto or Not to Keto?

As always with weight loss, it all comes down to taking less energy in than you burn. Rather than following a keto-like diet or other low-carb eating plans, focus on smart choices in all of the food groups while paying attention to portion sizes. You will not only be happier, you will be healthier too!

Remember that science involves being inquisitive and skeptical. This means we should all remain open to what high quality scientific research on the keto diet will show in the future, but we shouldn’t be jumping to conclusions that are not available yet. Work with an experienced Registered Dietitian and your medical specialist to help you sort through and make sense of the research and determine the best eating plan for your needs."


Dr. Shusterman in his article, The Keto Diet and Your Kidneys, has said directly:

"While the data is still coming in on the long term effects of a keto diet, I believe there are too many risks and unknowns to safely advise this type of diet for most people with kidney disease. This is especially true for people with Stage 3-5 Chronic Kidney Disease, who already have significant dietary restrictions and who may benefit from a diet that is much lower in protein intake. Additionally, it remains to be seen if people can remain on a keto diet for many years, and this is an important part of any healthy, long term dietary pattern."


Dr. Joshi has written in his article, Why You Should Say No to the Keto Diet,

https://www.forksoverknives.com/wellness/why-you-should-say-no-to-the-keto-diet/:

"Even if you believe the keto diet works for weight loss, there are plenty of other reasons to avoid it. In reviewing the literature of the documented side effects in epileptic children on the diet, I found that patients suffered from no shortage of side effects, including kidney stones, restricted growth, fatal cardiac arrhythmias, pancreatitis, higher cholesterol levels, and many more. The diet seems to be worth utilizing only if one happens to be a child with refractory epilepsy—and even then, children discontinue the diet because of its numerous side effects...

The ketogenic diet has swept the country up with the hope of a miracle diet, but, in the end, it may only bring us down with disappointment. Let food be thy medicine, but not if you need actual medicine to support thy food."

The Pros and Cons of a Plant-Based Diet

There are more Pros than Cons to a plant based diet for Kidney Patients.

Pros

There are numerous positive benefits derived from eating a plant-based diet. A plant-based diet is:

• Rich in vitamins, minerals, fiber, antioxidants found in fruits, vegetables, and whole grains

• Heart-healthy, with lower cholesterol and saturated fats and higher in dietary fiber

• Disease prevention. Overall, plant-based diets are higher in antioxidants, helping to reduce chronic inflammatory diseases such as diabetes. Also, staying away from over-processed foods minimizes our exposure to chemical additives.


• Weight loss. Eating less animal fat and more vegetables, fruits, and dietary fiber keeps calories and fat consumption down and promotes better digestion and your metabolism.

• Contributes positively to the environment. The environmental impact of the livestock industry is affected through the use of chemical fertilizers, pesticides, and antibiotics; and depletion of fossil fuels, methane in the atmosphere.

• Animal preservation and ethics. Eating plant-based foods minimizes the exploitation and cruelty of animals. Those with ethical concerns can “vote” with their dollars and feel they are supporting what’s important to them morally.

• Wide variety of food choices. There are lots of options for what to eat, unlike many other diets where you have to deny yourself certain foods you like or that require you to carry a checklist to the grocery store to make sure you’re purchasing the “right” items.

• Plant-based meals can be prepared more quickly – or just as quickly – as other foods. You can even find them already prepared, for instance, in the grab-and-go sections of grocery stores. Examples include bagged produce like washed leafy greens, and semi-prepared entrees and sides in the produce section.

• Less expensive. While eating fresh foods might seem more expensive – especially if they’re organic – some costs can be offset by eliminating meat, poultry, and/or fish and buying bulk dried foods. Plus, beans, nuts, seeds, and grains are relatively inexpensive and filling. Also, fresh foods go a long way in feeding yourself and your family compared to packaged foods in terms of quantity and price.

Cons

What could possibly be negative about eating a plant-based diet?

• Fresh produce can be very perishable, so buy just as much as you need to minimize waste.

• Possibly a protein-deficient diet. Animals, milk, and eggs contain necessary amino acids for protein. Plant-based proteins are an incomplete protein source unless properly combined. Make sure you’re eating plants that can supply the appropriate quantity and combination of amino acids.

• Possibly deficient in certain nutrients such as iron calcium, and B12. Plant-based iron is not as bioavailable to the body as animal-based iron, but you can improve your body’s absorption by eating foods containing vitamin C, vitamin A, meat, fish, and poultry during your meals. Getting enough calcium from plants is also more difficult, so pair it with high vitamin D foods like mushrooms which help absorption, and dark leafy vegetables, which contain more calcium. And plants don’t contain Vitamin B12, so you need to add foods fortified in B12, soy, and nutritional yeast to prevent anemia and/or take a B12 supplement. More time for meal planning and preparation – but hey, anyone preparing meals from scratch knows it’s worth the wait. But as plant-based foods become more mainstream, the convenience factor will likely improve.

• If you decide to go vegetarian or vegan, it could be challenging to give up eating animals. But a plant-based diet doesn’t have to exclude animals. Each person can find their happy medium.

According to the experts, the potential big Con is the lack of good protein in a plant-based diet. Dr Joshi in his article, Adequacy of Plant-Based Proteins in Chronic Kidney Disease, https://www.jrnjournal.org/article/S1051-2276(18)30154-7/fulltext,
concludes:

"Concerns regarding protein and amino acid deficiencies with plant-based proteins have precluded their use in chronic kidney disease (CKD) patients. Many of these concerns were debunked years ago, but recommendations persist regarding the use of “high-biological value” (animal-based) proteins in CKD patients, which may contribute to worsening of other parameters such as blood pressure, metabolic acidosis, and hyperphosphatemia. Plant-based proteins are sufficient in meeting both quantity and quality requirements. Those eating primarily plant-based diets have been observed to consume approximately 1.0 g/kg/day of protein, or more. CKD patients have been seen to consume 0.7-0.9 g/kg/day of mostly plant-based protein without any negative effects. Furthermore, those substituting animal-based proteins for plant-based proteins have shown reductions in severity of hypertension, hyperphosphatemia, and metabolic acidosis. Plant-based proteins, when consumed in a varied diet, are not only nutritionally adequate but have pleiotropic effects which may favor their use in CKD patients."


Not only then are there sufficient proteins in a plant-based diet, but the over all effect may be to slow or reverse the effects of Diabetes and High Blood pressure, and therefore, slow or reverse the effects of the number 1 and 2 causes of Kidney Disease.

Dr. Joshi also reccommends that if your blood levels are not being checked, you should consider taking a Vitamin B12 supplement, low dose, daily.

Conclusions

Both experts reccommended that Kidney Patients consider the benefits of a plant based diet/hybrid plant-based diet.

Dr Joshi in the NKF article Plant-Based vs. Animal-Based Diets: The Jury is in!
https://www.kidney.org/newsletter/plant-based-vs-animal-based-diets-jury, states:

It’s been shown that patients with CKD who obtain food from plant sources may actually demonstrate improvement in several of the complications of CKD like hypertension, metabolic acidosis, and hyperphosphatemia...We want the general public to reconsider their stance on plant-based proteins in CKD and know that plant-proteins, when consumed in a varied diet, are a great source of amino acids for patients. These foods are rich in healthy substances, like fiber, antioxidants, phytonutrients, vitamins, and minerals that contribute to improved overall health...  “The renal community has had no shortage of reasons to avoid plant-based foods in the past,” Dr. Joshi said. “However, over the years, we’ve seen these concerns fall by the wayside in response to an ever-expanding body of literatures documenting their safety and benefit for patients with CKD...

“Other disciplines of the health care field have used plant-based diets to their benefit in treating heart disease, diabetes, and obesity,” he said. “Food can be seen as being complementary to pharmacologic therapies for patients with CKD. Instead of running away from these foods, and perhaps incurring harm by doing so, we should be embracing these foods to our collective benefit.”

Both experts recommend if you have CKD, talk to your nephrologist about plant-based protein diets and schedule an appointment with a renal dietitian.

References

1. Dr. Shusterman and Dr. Joshi's Websites

Dr. Shusterman

The Cooking Doc
https://www.thecookingdoc.co/

To Order a Copy of His Book,  The Cooking Doc’s Kidney-Healthy Cooking,  A Modern 10-Step Guide to Preventing & Managing Kidney Disease
https://www.thecookingdoc.co/kidney-healthy-cooking-book/

To Subscribe to His Newsletter
https://www.thecookingdoc.co/

Check out His Blog
https://www.thecookingdoc.co/blog/

Recipies & Videos
https://www.thecookingdoc.co/videos/

American Kidney Fund’s Kidney Kitchen
kitchen.kidneyfund.org

Dr. Schusterman Bio
GET TO KNOW THE COOKING DOC®
https://www.thecookingdoc.co/about/


Dr. Joshi

AFTERNOONROUNDS, Plant-Based Diets in Kidney Disease
https://afternoonrounds.com/2020/04/28/plant-based-diets-in-kidney-disease/

Dr. Joshi on FORKS OVER KNIVES WEBSITE
Plant-based eating simplified.

https://www.forksoverknives.com/contributors/shivam-joshi-md/

Dr. Joshi on Kidney News 360
https://www.kidneynews.org/view/news/careers/perspectives/dr-shivam-joshi-speaks-about-plant-based-diets-and-the-relationship-with-ckd-in-recent-study.xml

THE PROOF IS IN THE PLANTS
https://plantproof.com/nutrition-for-healthy-kidney-function-with-nephrologist-dr-shivam-joshi

Dr. Joshi on Food Is Medicine(Bio)
Plant-Based Diets in Kidney Disease
https://foodasmedicinephilly.com/shivam-joshi


Dr. Joshi Bio on Neph.Org
Shivam Joshi, MD
https://nephu.org/about/team/shivam-joshi/


Nephrologist from NYC Health + Hospitals to Receive NKF's Kopple Award

https://www.kidney.org/news/nyc-health-hospitals-to-receive-nkf-s-kopple-award


Shivam Joshi, MD, on Plant-Based Diets to Treat and Prevent Kidney Disease

https://www.consultant360.com/podcast/nephrology/chronic-kidney-disease/shivam-joshi-md-plant-based-diets-treat-and-prevent

 Podcasts360 · Shivam Joshi, MD, on Plant-Based Diets to Treat and Prevent Kidney Disease

2.  Definition of a Plant-Based Diet

What is a Plant-Based Diet?
https://nunm.edu/2019/04/plant-based-diets/

What Is a Plant-Based Diet? Food List, 7-Day Meal Plan, Benefits, and More
https://www.everydayhealth.com/diet-nutrition/plant-based-diet-food-list-meal-plan-benefits-more/

What is a plant-based diet and why should you try it?
https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760

Plant-Based Diet for Beginners: Your Guide to Getting Started
https://www.eatingwell.com/article/7775696/plant-based-diet-for-beginners-your-guide-to-getting-started/

Vegetable-Based Diets for Chronic Kidney Disease? It Is Time to Reconsider
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627351/

Aleix Cases, Secundino Cigarrán-Guldrís, [...], and Emilio Gonzalez-Parra

What You Should Know About A Plant-Based Diet
https://health.clevelandclinic.org/is-a-plant-based-diet-right-for-you/

General Plant-Based Diet Articles

Ameliorating Chronic Kidney Disease Using a Whole Food Plant-Based Diet

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230354/

Plant-based dietary approach to stage 3 chronic kidney disease with hyperphosphataemia

 https://casereports.bmj.com/content/12/12/e232080

Open Access

Plant-Based Diets in CKD
https://cjasn.asnjournals.org/content/14/1/141

Plant-Based Diets and Kidney Disease
https://kidneyhi.org/dietitian-blog/plant-based-diets-and-kidney-disease

How A Plant-Based Diet Helped Me Restore Kidney Function

https://www.forksoverknives.com/success-stories/beating-kidney-disease-plant-based-diet/

Plant-Based vs. Animal-Based Diets: The Jury is in!
https://www.kidney.org/newsletter/plant-based-vs-animal-based-diets-jury

PLANT-BASED DIET AND KIDNEY HEALTH
https://www.kidney.org/atoz/content/plant-based

3.  Caution on Keto Diets

To Keto or Not to Keto,
https://kidneyhi.org/dietitian-blog/to-keto-or-not-to-keto:

The Ketogenic Diet for Obesity and Diabetes—Enthusiasm Outpaces Evidence
Shivam Joshi, MD1,2; Robert J. Ostfeld, MD, MSc3; Michelle McMacken, MD1
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2737919



Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
Prakrati Acharya et al. Diseases. 2021.
https://pubmed.ncbi.nlm.nih.gov/34070285/

Keto diets are a ‘disease-promoting disaster,’ researchers warn
https://wgno.com/news/health/keto-diets-are-a-disease-promoting-disaster-researchers-warn/

Analysis: Keto diets place pregnant women and kidney disease patients at risk of adverse health effects
https://www.news-medical.net/amp/news/20210803/Analysis-Keto-diets-place-pregnant-women-and-kidney-disease-patients-at-risk-of-adverse-health-effects.aspx

Keto Diet Downsides May Outweigh Benefits, Review Suggests
https://www.everydayhealth.com/ketogenic-diet/keto-diet-downsides-may-outweigh-benefits-review-suggests/

Review finds keto diet ups heart risks, cancer risk, dangers to pregnant women and kidney patients
https://scienceblog.com/524530/review-finds-keto-diet-ups-heart-risks-cancer-risk-dangers-to-pregnant-women-and-kidney-patients/

kidneys

The Super-Trendy Keto Diet Is A Recipe For Bad Health-This Is Why
https://www.theladders.com/career-advice/the-super-trendy-keto-diet-is-a-recipe-for-bad-health-this-is-why

This ‘Popular’ Diet is Doing More Harm Than Good to Your Health, Says New Study
https://www.india.com/health/this-popular-diet-is-doing-more-harm-than-good-to-your-health-says-new-study-4881239/

The popular diet that could lead to seven life threatening illnesses - a new study shows
https://www.express.co.uk/life-style/health/1473843/keto-diet-increase-risk-cancer-diabetes-alzheimers-heart-disease-kidney-failure

Dr. Shusterman's You Tube Video on the Keto Diet
https://youtu.be/wRMooWmj2ZI

4.  The Pros and Cons of a Plant-Based Diet

The Pros and Cons of Plant-Based Diets
https://www.vitruviamd.com/the-pros-and-cons-of-plant-based-diets/

Pros and Cons of a Plant-based Diet

https://crystalgeyser.com/blogs/news/pros-and-cons-of-a-plant-based-diet

Adequacy of Plant-Based Proteins in Chronic Kidney Disease

https://www.jrnjournal.org/article/S1051-2276(18)30154-7/fulltext


5. Conclusions

Plant-Based vs. Animal-Based Diets: The Jury is in!
https://www.kidney.org/newsletter/plant-based-vs-animal-based-diets-jury



 

West Hempstead mail carrier needs kidney transplant

West Hempstead mail carrier needs kidney transplant: Lifelong West Hempstead resident Eric Peluso has earned a reputation as a friendly neighborhood mail carrier in just eight months on the job with the U.S. Postal Service in West Hempstead. Peluso, …

2021 KidneyCAN Pitch

 Introduction

• Hello. My name is Jim Myers. I am speaking to you today on behalf of Kidney CAN and kidney cancer patients everywhere. Thank you very much for taking the time to speak with us today. 


Our Asks For 2021

• To maintain the $50m currently allocated for KCRP for the Fiscal Year 2022;

• To increase the NIH budget by $3.5B for the Fiscal Year;

• To Support the creation of ARPA-H (The Advanced Research Projects Agency-Health) at NIH with an additional $3B;

• To continue to support legislative initiatives that contribute to robust, sustainable funding for medical research;

• To continue to incorporate the patient prospective on legislative policy matters.

Congressional Funding for Kidney Cancer Research


I am here to speak to you about Kidney Cancer Research funding through the Congressionally Directed Medical Research Program (CDMRP) and cancer research funding through the National 

Institute of Health (NIH).


• Many families are confronted with a cancer diagnosis each year. That number tops 73,000 for a kidney cancer diagnosis. Although I am not a Kidney Cancer Patient, I have several friends who are and I have lost several people I know to Kidney Cancer.


As you know, I have been a PKD patient for over 40 years and a Kidney Advocate for over a decade. I was diagnosed at the age of 25 with polycystic kidney disease, on dialysis at 58, transplanted at IU Health at 62. My five year anniversary will be April 27th. I have lost 5 members of my family to PKD including my Dad.


Relevant Numbers


More than 200 diseases that we call “cancer” take a tremendous toll on our nation. It is estimated that almost 1.7 million people in the United States will be diagnosed with cancer this year. Cancer 

kills nearly 600,000 Americans every year, and almost every family in the United States has felt its impact or faced the loss of a loved one to cancer. Perhaps you have had a loved one or know 

someone who has been diagnosed with cancer?


More than 76,080 Americans will be diagnosed with kidney cancer this year or 200 people a day, and almost 14,000 died from the disease in 2020. That translates to almost 40+people every single day. Kidney Cancer is the 8th most prevalent cancer. Kidney Cancer is the 10th most prevalent cancer in women. Men are twice as likely as women to develop kidney cancer, and it is more common in African Americans and American Indian/Alaska Natives.


As you know appropriations for Kidney Cancer are not automatic and must be requested every year, for example in 2016, $0 were appropriated for Kidney Cancer in 2016, where $50M was appropriated in 2021.


For the last 50 years, almost every major medical breakthrough in cancer can be traced back to the NIH and National Cancer Institute (NCI) and medical research funding. 


Because of the previous investment in cancer research, more than 15.5 million American cancer survivors are alive today. But we still have over 600,000 cancer deaths a year in the U.S.


Last year Congress increased funding for the NIH by $1.2 billion and the NCI by $460 million in FY’21. 


Kidney Cancer in the State of Indiana


In our home state of Indiana:


• 37, 940 people have been diagnosed with cancer this year;

• 13, 630 deaths from cancer will result this year;

The economic impact of cancer research in Indiana is striking:


• $324M was awarded from the NIH in Indiana research awards;

• 5,732 Indiana jobs are supported by NIH awards;

• $890M dollars in economic activity was generated in Indiana as a result of cancer research;

• 58, 018 Indiana Jobs are supported in biotech by cancer research;

• 1, 730 Indiana businesses are supported in biotech by cancer research.

Examples of Awards for Kidney Cancer Research in Indiana Includes:

• $630,000 To Robert Pili from Indiana University Indianapolis, who received the Idea Development Award- Established Investigator in 2017



The Department of Defense Congressionally Directed Medical Research Program (CDMRP) Plays a Vital Role in Kidney Cancer Research. 


In addition to the NIH, the kidney cancer community recognizes the value of the Department of Defense CDMRP (Congressionally Directed Medical Research Program) in supporting innovative high risk/high reward, life-saving cancer research. The Department of Defense Congressionally Directed Medical Research Programs have played a vital role in Kidney Cancer research.


• Congress approved $50 million specifically for Kidney Cancer in FY’21, via the Kidney Cancer Research Program (KCRP). The program is having a significant impact and providing increased hope for our military and veteran patient community. It is also an economic driver and job creator –

creating laboratory research jobs and creating robust growth from young investigators entering this 

field of medicine. To date, 83 grants have been awarded totaling $41.5 M.


The CDMRP funds high-impact research for cancer prevention, detection, treatment, and survivorship to support current Service Members, their dependents and families, our veterans, and the American public at-large. 


Almost every major medical breakthrough in cancer can be traced back to the NCI and NIH over the last 50 years. Dr. William Kaelin, Jr. and Dr. Gregg Semenza, two 2019 Nobel Prize awardees, received an NIH grant for study of von Hippel-Lindau (VHL) disease. Their research has led to a dozen new drug treatments for kidney cancer as well as other cancers. More than 15.5 million American cancer survivors are alive today because of this research.


Congress approved $50 million specifically for Kidney Cancer research through the CDMRP in FY ’21 via the Kidney Cancer Research Program (KCRP).


Dr. Andrew Smith, from the University of Alabama (Birmingham), is a recent KCRP grant awardee. His breakthrough imaging platform has greatly improved scanning and monitoring of kidney cancer as well as all solid tumors. This research grant has led to the incubation of a startup company in the state of Alabama, several patents, and the imaging platform is pending FDA approval.


Drs. Tykodi and Akileesh, from the University of Washington are recent KCRP grant awardees. Their research on a T-Cell therapy for RCC is remarkably interesting. In blood cancers, T-Cell therapies are leading to cures. This partnership grant is allowing the University of Washington team to explore ways this exciting technology can be used to overcome challenges of targeting solid tumors and to cure kidney cancer.


As highlighted above, the KCRP/CDMRP programs are an economic driver and job creator – generating laboratory research jobs and producing robust growth from young investigators entering this field of 

medicine.


Funding of the KCRP/CDMRP through the Department of Defense helps fund high-impact research for cancer prevention, detection, treatment, and survivorship to support Service members,their dependents and families, our veterans, and the American public at-large.


There is No Duplication of Grant Awards


THIS IS VERY IMPORTANT TO NOTE!

There is no duplication of grant awards between the NIH and the CDMRP. NIH and CDMRP compare and cross-reference grant applications against existing NIH and CDMRP research data bases to confirm no duplication throughout the award process.


Money Should be set aside for both the NIH and the CDMRP


• The two funding sources do not compete or overlap. There are review committee safeguards to

ensure no duplication exists.


• The NIH and CDMRP undertake significant cancer research. 


• The NIH grant process, in general, requires more preliminary data to prove the concept drawn up in the grant application. 


• Research done through the CDMRP is generally more “High-Risk for High-Reward” in concept and has a requirement for military relevance. Although the ideas and concepts are scientifically-based, they are considered by some to be more aggressive and therefore riskier. 


• The medical research funding avenues of the NIH and the CDMRP are different yet complementary.


The Risk of Kidney Cancer to Service Men & Woman is Significant


Service men and women are at higher risk of kidney cancer due to a possible link of cancer and water contamination on military bases, ammunition dumping, and subsequent clean up compounds and exposure to some flame-retardant materials, like Agent Orange, that are linked to Kidney Cancer.


The Military Needs to Complete Research on Kidney Cancer


Service men and women may be exposed to cancer causing agents during active service. Those effects may not appear until later in life. Some studies have shown veterans have a higher 

incidence of kidney cancer than their U.S. civilian counterparts.


• There are studies that show kidney cancer is linked to smoking. Historically, many of our military personnel smoke. 


Result


The CDMRP/KCRP program is having a significant impact and providing increased hope for our military and veteran patient community. To date, 83 grants have been awarded totaling $41.5 million.


The President's Proposed ARPA-H Funding


Our last Ask concerns the Proposed ARPA-H Funding. (Advanced Research Projects Agency for Health )

Recent advances in biomedical science—from immunotherapy to treat cancer, to the highly effective COVID-19 vaccines—demonstrate the strengths and successes of the U.S. biomedical enterprise. Such advances present an opportunity to revolutionize how to prevent, treat, and even cure a range of diseases including cancer, infectious diseases, Alzheimer’s disease, and many others that together affect a significant number of Americans.


To improve the U.S. government’s capabilities to speed research that can improve the health of all Americans, President Biden is proposing the establishment of the Advanced Research Projects Agency for Health (ARPA-H). Included in the President’s FY2022 budget as a component of the National Institutes of Health (NIH) with a requested annual funding level of $6.5B, ARPA-H will be tasked with building high-risk, high-reward capabilities (or platforms) to drive biomedical breakthroughs—ranging from molecular to societal—that would provide transformative solutions for all patients.


The Kidney Cancer community supports this possible legislation. We feel that

ground-breaking research is critical to finding a cure for all cancers. 

Funding for the Advanced Research Projects Agency - Health (ARPA-H) will 

allow researchers across multiple fields to create innovative projects that will 

lead to breakthroughs to prevent, detect, and treat cancer as well as other 

diseases that aict the US population. Research funding for kidney cancer 

also has the possibility for cross-over care for other cancers. Treatments 

uncovered for kidney cancer has the potential to help other cancers and vice 

versa.


Summary of Our Asks:


The Kidney Cancer Community is asking Congress to: 

• Maintain the $50 million currently allocated for KCRP for FY ’22. *

• Increase the NIH budget by $3.5 billion for fiscal year FY ’22. **

• Support the creation of ARPA-H (the Advanced Research Projects at the with an additional $3 billion. 

• Continue to support legislative initiatives that contribute to robust, sustainable funding for medical research;

• Continue to incorporate the patient perspective on legislative policy matters.

Conclusions:


Together, we can do so much with a robust and sustained investment in medical research. Americans are getting older and chronic diseases consume most of our health care dollars. We can 

meet these challenges head-on, but to do so, medical research funding must be a strong national priority.


Thank you for your time. If you have any questions or ever require information on kidney cancer, we would be happy to be a resource.

Shane Blanchard Broadcast

 Did you miss the live Broadcast? Catch the Instant Replay Here:

Shane Blanchard Tells His Kidney Story 

https://facebook.com/UrbanHealthOutreachmedia/videos/541800810403549/…

Rough Draft: A Plant-Based Diet: What Are The Pros and Cons?

 A Plant-Based Diet: What Are The Pros and Cons?

Introduction

Recently I did a Broadcast on the Urban Health Outreach Media With Dr Blake Schusterman and Dr Shivam Joshi.
https://www.facebook.com/UrbanHealthOutreachmedia/videos/983197005809888/

Dr. Blake Schusterman, the Cooking Doc strongly reccommended some version of a plant-based diet. Dr. Blake Shusterman is President and Physician Partner at Carolina Nephrology, a twenty-two provider practice in Greenville, SC. He is also the creator and host of The Cooking Doc (www.thecookingdoc.co), and author of the book The Cooking Doc’s Kidney-Healthy Cooking: A Modern 10-Step Guide to Preventing and Managing Kidney Disease.  You can also subscribe to his newsletter there.


A board certified nephrologist, Dr. Shusterman serves as the medical director at multiple dialysis units. He is a Clinical Assistant Professor at the USC School of Medicine in Greenville and oversees the medical student nephrology rotations. 

He is passionate about home dialysis, patient education and the importance of diet in the management of chronic kidney disease. His interest in diet and kidney disease led him to his role as an ambassador for the American Kidney Fund’s Kidney Kitchen. 

Dr. Shusterman earned his medical degree from The Ohio State University and went on to complete his internal medicine residency and nephrology fellowship at the University of Virginia where he served as chief fellow. He holds a BA in Anthropology from Tufts University. 


"During my years of practice, I have come to realize that many of my patients and their families live equally food-focused lives. So, I understand the furious looks I get from my patients when I tell them to give up their favorite foods.


Thus was born The Cooking Doc. Can you imagine having your doctor right next to you in the kitchen, telling you what delicious foods you need to try? Well, that’s me. I won’t tell you what tasty foods you need to give up, instead I’ll help you find creative ways to use new ingredients and together we’ll make them taste amazing. (Check out this summer squash soup with white wine and leeks)"


Our second nephrologist expert was Dr Shivam Joshi. Shivam Joshi, MD, is an internist, nephrologist, and plant-based physician practicing at NYC Health + Hospitals/Bellevue in New York City. He received his BS from Duke University and his MD from the University of Miami. He completed his residency at Jackson Memorial Hospital/University of Miami and his nephrology fellowship at the Hospital of the University of Pennsylvania. He is also a clinical assistant professor at the New York University School of Medicine with research interests in plant-based diets, fad diets, and nephrology. He has written numerous scientific articles and speaks nationally on these subjects. He is the youngest nephrologist to receive the NKF’s Joel D Kopple award, the highest award in renal nutrition. You can follow him on Twitter (@sjoshiMD).


“Dr. Joshi is incredibly impressive. Though he is still early in his career, he has already made important contributions to the field of renal nutrition and I can’t wait to see what will be next in his career,” said NKF President Dr. Paul Palevsky. “His dedication to patients and understanding kidney disease and its relationship to nutrition is of course evident, but also critical in understanding this disease that touches so many American lives"


What surprised me most about the interview was all of the scientific basis for Plant-based diets for Kidney Patients that exists, and has existed for a long period of time, and yet only recently has this information just begun to surface in the Kidney Community. Even more surprising was the number of views of the Broadcast, indicating a trend towards wide-ranging acceptance of at least some hybrid form of plant-based dieting from actual kidney patients.


That is the reason for this blog. I wanted to put the word out to Kidney Patients everywhere that this deserves their attention and serious consideration.


What Is A Plant-Based Diet?

A standard definition of a plant-based diet would be:


"A plant-based diet or a plant-rich diet is a diet consisting mostly or entirely of plant-based foods. Plant-based foods are foods derived from plants with no animal-source foods or artificial ingredients. While a plant-based diet avoids or has limited animal products, it is not necessarily vegan."
https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760

According to the Harvard Health Blog,

"Plant-based or plant-forward eating patterns focus on foods primarily from plants. This includes not only fruits and vegetables, but also nuts, seeds, oils, whole grains, legumes, and beans. It doesn’t mean that you are vegetarian or vegan and never eat meat or dairy. Rather, you are proportionately choosing more of your foods from plant sources."

What is a plant-based diet and why should you try it?

https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760

Basically, a plant-based diet or some variety of a hybrid of a plant-based diet eliminates in full or in part meat or other animal products. Other versions of a hybrid plant-based diet may include the Mediterranean Diet (incorporates fish & poultry), Pescatarian(includes eggs, diary, fish and seafood, no meat or poultry)and Vegetarian(includes eggs, diary, no meats, poultry, fish or seafood) and Vegan(no animal foods) diets.


What is particularly striking about all of this is that studies have shown that plant-based products have been flying off of the shelves at the grocery while the sales of dairy and meat products may be declining.


A Word of Caution About the Keto Diet for Kidney Patients

In my interview with Drs Schusterman and Joshi, both nutrition expert did not reccommend the Keto Diet for Kidney Patients.

Borrowing heavily from the National Kidney Foundation of Hawaii's article, to Keto or Not to Keto, https://kidneyhi.org/dietitian-blog/to-keto-or-not-to-keto,
https://kidneyhi.org/dietitian-blog/to-keto-or-not-to-keto:


"The ketogenic diet, or “keto diet", is one of a series of trendy low carbohydrate (“low carb”) diets that include the Atkins diet, the South Beach diet and the Zone diet. It was developed at the Mayo Clinic in 1924 as a treatment for epilepsy in children. In recent years the ketogenic diet has made a comeback and today, medical teams are once again using it as a therapy for epileptic kids whose seizures do not respond to medications. The medical ketogenic diet relies on precise ratios of fat to protein and carbohydrates so it requires careful monitoring by a medical team. This is because the diet is not balanced and can lead to nutrient deficiencies among other things.


The "keto diet" got its name from ketones, which are the source of energy that the body uses when it’s burning fat. The goal of the keto diet is to put the patient a state of ketosis through a diet that’s high in fat and ultra-low in carbs with moderate amounts of protein. In simple terms, ketosis occurs when there is a metabolic shift, where the body uses fat as the primary energy source instead of carbs.


The keto diet is NOT a high protein diet. It is a low-carb, high-fat diet typically containing a percentage of total calories as follows: 5% carbohydrates, 75% fat, 20% protein. By contrast, National Health Guidelines suggests intaking 45-65% carbohydrates, 20-35% fat, and 10-35% of protein.


Another Fad?


Because this diet is so restrictive and individualized, it isn’t a healthy option for the general population. You would be missing out on too many essential nutrients and probably experience unpleasant side effects as well. The effects of maintaining ketosis for long periods of time are unknown. There’s a lot of misinformation online about the ketogenic diet. Most people calling their diet a "keto diet" are simply following a low or very low carbohydrate diet. In other words, most keto diets are only keto-like, in that it replaces some of the carbs in a person’s diet with fat and protein. Ketogenic in the clinical sense limits carbs to as few as 10 grams a day. Low carbohydrate diets can be helpful in the short term for weight loss. However, as with the true medical ketogenic diet, most people can’t stick with a very low carbohydrate diet for the long term.


Nutrient Deficiencies


Any time you remove a macronutrient group like carbohydrates, your body is going to be losing some of the essential nutrients that come from that food group (B vitamins, vitamin C, phytochemicals and fiber). Although many people label carbohydrates as "bad", not all carbs are created equal. The key is to choose smarter carbs: sweet potatoes, steel-cut oats, quinoa and fruit rather than white pasta, white bread, white rice, and pastries.


Long Term Effects?


People think, ‘Oh, this diet sounds great - I can eat bacon and cheese and I can still lose weight,’ then they drop pounds quickly and are instantly gratified. It’s true that cutting carbs often leads to rapid weight loss, but in the first week or two much of the loss is water weight, because our bodies store water with our carbs. However over the long term, a diet high in saturated fats increases the risk of heart disease and stroke. Keto diet or not, the fats we should be eating are unsaturated fats, which actually lower the risk of heart disease and stroke. Healthier fats include olive oil, canola oil, walnuts, avocados, and fish.


Sensible Eating is Best


The latest research shows that the ability to stick to a diet is key. If a low carbohydrate diet or keto diet is a practice that works for you and you are able to maintain it for as long as it takes to lose excess body fat and you are meeting your nutritional requirements, then science says that this should be encouraged. As of yet, there hasn’t been enough research into the ketogenic diet to support its use in some medical conditions like Polycystic Ovarian Syndrome, Alzheimer’s, Parkinson’s, and cancer. Eating a well-balanced, keto diet is costly. For most people, following a low carbohydrate diet, rather than a no carbohydrate diet, is much more practical as it will allow for the inclusion of fruit and all vegetables. This represents much better dietary balance and usually leads to people sticking with it for longer.


To Keto or Not to Keto?


As always with weight loss, it all comes down to taking less energy in than you burn. Rather than following a keto-like diet or other low-carb eating plans, focus on smart choices in all of the food groups while paying attention to portion sizes. You will not only be happier, you will be healthier too!


Remember that science involves being inquisitive and skeptical. This means we should all remain open to what high quality scientific research on the keto diet will show in the future, but we shouldn’t be jumping to conclusions that are not available yet. Work with an experienced Registered Dietitian and your medical specialist to help you sort through and make sense of the research and determine the best eating plan for your needs."


Dr. Schusterman in his article, The Keto Diet and Your Kidneys, has said directly:

"While the data is still coming in on the long term effects of a keto diet, I believe there are too many risks and unknowns to safely advise this type of diet for most people with kidney disease. This is especially true for people with Stage 3-5 Chronic Kidney Disease, who already have significant dietary restrictions and who may benefit from a diet that is much lower in protein intake. Additionally, it remains to be seen if people can remain on a keto diet for many years, and this is an important part of any healthy, long term dietary pattern."


Dr. Joshi has written in his article, Why You Should Say No to the Keto Diet,

https://www.forksoverknives.com/wellness/why-you-should-say-no-to-the-keto-diet/:

"Even if you believe the keto diet works for weight loss, there are plenty of other reasons to avoid it. In reviewing the literature of the documented side effects in epileptic children on the diet, I found that patients suffered from no shortage of side effects, including kidney stones, restricted growth, fatal cardiac arrhythmias, pancreatitis, higher cholesterol levels, and many more. The diet seems to be worth utilizing only if one happens to be a child with refractory epilepsy—and even then, children discontinue the diet because of its numerous side effects...

The ketogenic diet has swept the country up with the hope of a miracle diet, but, in the end, it may only bring us down with disappointment. Let food be thy medicine, but not if you need actual medicine to support thy food."

The Pros and Cons of a Plant-Based Diet

There are more Pros than Cons to a plant based diet for Kidney Patients.

Pros

There are numerous positive benefits derived from eating a plant-based diet. A plant-based diet is:


• Rich in vitamins, minerals, fiber, antioxidants found in fruits, vegetables, and whole grains


• Heart-healthy, with lower cholesterol and saturated fats and higher in dietary fiber


• Disease prevention. Overall, plant-based diets are higher in antioxidants, helping to reduce chronic inflammatory diseases such as diabetes. Also, staying away from over-processed foods minimizes our exposure to chemical additives.


• Weight loss. Eating less animal fat and more vegetables, fruits, and dietary fiber keeps calories and fat consumption down and promotes better digestion and your metabolism.


• Contributes positively to the environment. The environmental impact of the livestock industry is affected through the use of chemical fertilizers, pesticides, and antibiotics; and depletion of fossil fuels, methane in the atmosphere.


• Animal preservation and ethics. Eating plant-based foods minimizes the exploitation and cruelty of animals. Those with ethical concerns can “vote” with their dollars and feel they are supporting what’s important to them morally.


• Wide variety of food choices. There are lots of options for what to eat, unlike many other diets where you have to deny yourself certain foods you like or that require you to carry a checklist to the grocery store to make sure you’re purchasing the “right” items.


• Plant-based meals can be prepared more quickly – or just as quickly – as other foods. You can even find them already prepared, for instance, in the grab-and-go sections of grocery stores. Examples include bagged produce like washed leafy greens, and semi-prepared entrees and sides in the produce section.


• Less expensive. While eating fresh foods might seem more expensive – especially if they’re organic – some costs can be offset by eliminating meat, poultry, and/or fish and buying bulk dried foods. Plus, beans, nuts, seeds, and grains are relatively inexpensive and filling. Also, fresh foods go a long way in feeding yourself and your family compared to packaged foods in terms of quantity and price.

Cons

What could possibly be negative about eating a plant-based diet?

• Fresh produce can be very perishable, so buy just as much as you need to minimize waste.


• Possibly a protein-deficient diet. Animals, milk, and eggs contain necessary amino acids for protein. Plant-based proteins are an incomplete protein source unless properly combined. Make sure you’re eating plants that can supply the appropriate quantity and combination of amino acids.


• Possibly deficient in certain nutrients such as iron calcium, and B12. Plant-based iron is not as bioavailable to the body as animal-based iron, but you can improve your body’s absorption by eating foods containing vitamin C, vitamin A, meat, fish, and poultry during your meals. Getting enough calcium from plants is also more difficult, so pair it with high vitamin D foods like mushrooms which help absorption, and dark leafy vegetables, which contain more calcium. And plants don’t contain Vitamin B12, so you need to add foods fortified in B12, soy, and nutritional yeast to prevent anemia and/or take a B12 supplement. More time for meal planning and preparation – but hey, anyone preparing meals from scratch knows it’s worth the wait. But as plant-based foods become more mainstream, the convenience factor will likely improve.


• If you decide to go vegetarian or vegan, it could be challenging to give up eating animals. But a plant-based diet doesn’t have to exclude animals. Each person can find their happy medium.


According to the experts, the potential big Con is the lack of good protein in a plant-based diet. Dr Joshi in his article, Adequacy of Plant-Based Proteins in Chronic Kidney Disease, https://www.jrnjournal.org/article/S1051-2276(18)30154-7/fulltext,
concludes:

"Concerns regarding protein and amino acid deficiencies with plant-based proteins have precluded their use in chronic kidney disease (CKD) patients. Many of these concerns were debunked years ago, but recommendations persist regarding the use of “high-biological value” (animal-based) proteins in CKD patients, which may contribute to worsening of other parameters such as blood pressure, metabolic acidosis, and hyperphosphatemia. Plant-based proteins are sufficient in meeting both quantity and quality requirements. Those eating primarily plant-based diets have been observed to consume approximately 1.0 g/kg/day of protein, or more. CKD patients have been seen to consume 0.7-0.9 g/kg/day of mostly plant-based protein without any negative effects. Furthermore, those substituting animal-based proteins for plant-based proteins have shown reductions in severity of hypertension, hyperphosphatemia, and metabolic acidosis. Plant-based proteins, when consumed in a varied diet, are not only nutritionally adequate but have pleiotropic effects which may favor their use in CKD patients."


Not only then are there sufficient proteins in a plant-based diet, but the over all effect may be to slow or reverse the effects of Diabetes and High Blood pressure, and therefore, slow or reverse the effects of the number 1 and 2 causes of Kidney Disease.


Conclusions

Both experts reccommended that Kidney Patients consider the benefits of a plant based diet/hybrid plant-based diet.


Dr Joshi in the NKF article Plant-Based vs. Animal-Based Diets: The Jury is in!

https://www.kidney.org/newsletter/plant-based-vs-animal-based-diets-jury, states:


It’s been shown that patients with CKD who obtain food from plant sources may actually demonstrate improvement in several of the complications of CKD like hypertension, metabolic acidosis, and hyperphosphatemia...We want the general public to reconsider their stance on plant-based proteins in CKD and know that plant-proteins, when consumed in a varied diet, are a great source of amino acids for patients. These foods are rich in healthy substances, like fiber, antioxidants, phytonutrients, vitamins, and minerals that contribute to improved overall health...  “The renal community has had no shortage of reasons to avoid plant-based foods in the past,” Dr. Joshi said. “However, over the years, we’ve seen these concerns fall by the wayside in response to an ever-expanding body of literatures documenting their safety and benefit for patients with CKD...


“Other disciplines of the health care field have used plant-based diets to their benefit in treating heart disease, diabetes, and obesity,” he said. “Food can be seen as being complementary to pharmacologic therapies for patients with CKD. Instead of running away from these foods, and perhaps incurring harm by doing so, we should be embracing these foods to our collective benefit.”


Both experts recommend if you have CKD, talk to your nephrologist about plant-based protein diets and schedule an appointment with a renal dietitian.