【Xixi Nutrition】World Kidney Disease Day – How to Eat “Kidney Protection”

3-10 is the annual World Kidney Day and 1 in 10 people worldwide has kidney disease! Kidney disease is a chronic disease that may accompany the patient for life until dialysis or death.

With the improvement of living standards and lifestyle changes, the prevalence of kidney disease in my country is also in line with international standards. Not only nephritis can lead to kidney disease, but metabolic-related chronic diseases such as diabetes, hypertension, obesity, and high uric acid have become the main “killers” of the kidneys. All metabolites are excreted through the kidneys, and what we eat is closely related to our metabolic products. If an unhealthy diet leads to high blood pressure and obesity, the pressure on the kidneys will also increase significantly. Therefore, the health of the kidneys is related to eating. inseparable. Today, Xixi will tell you about “Kidney-Protecting Meal” in combination with recent researches

1.Kidney disease is not far from us

One ​​in 10 people suffer from kidney disease, and there are 500 million people with kidney disease worldwide.

1 in 10 people have kidney disease

When people mention kidney disease, they seem to always think of “protecting the kidney” in Chinese medicine. In fact, the kidney is also very important in Western medicine. The kidney here is not a virtual concept but actually exists in our body. It is the disposal site of all metabolic wastes in the body. Although the kidneys only account for 0.4% of the body weight, the daily energy consumption accounts for 10% of the basal metabolic rate [1].

Kidneys account for 10% of body metabolism

The kidneys filter 180 liters of fluid per day, which is equivalent to the blood passing through the kidneys 60 times per day. When there is no problem with the kidneys, we tend to ignore this important organ, and often regret it when something goes wrong.

2.Kidney disease may also be caused by eating

Chronic kidney disease is already a disease closely related to lifestyle. The proportion of patients with chronic kidney disease dying from cardiovascular disease is significantly higher than that of normal people, and the causes of chronic kidney disease are gradually increasing. Changes are taking place. 10-20 years ago, the main causes of chronic kidney disease in my country were nephritis and some urinary tract diseases. Data in the past 10 years show that the etiology spectrum of chronic kidney disease in my country is similar to that of other developed countries in the world. Metabolic-related diseases are the main ones, the most important being kidney disease caused by diabetes and hypertension. Especially in cities with higher living standards, diabetes and hypertension are already half of the causes of chronic kidney disease.

Diabetes and hypertension already account for more than half of the causes of chronic kidney disease in cities

If a person with diabetes has high blood sugar for a long time, the blood passing through the kidneys will cause glycation and oxidative stress and damage to the kidneys. If a person is too fat, his kidneys will be damaged. If you do more work than others for a long time, you will be more tired and prone to problems. If you have high blood pressure for a long time, the blood vessels of the kidneys will also be under “high pressure” for a long time, and you will be more likely to get sick over time.

What we eat and drink will enter the blood, and all the blood must be filtered by the kidneys, and the waste in eating and drinking must pass through the kidneys to be excreted from the body. Day after day, diet and Drinking water affects the function of the kidneys every day. Over time, healthy habits can bring benefits, and unhealthy eating habits can also cause kidney damage.

3.How to eat to avoid kidney disease?

High potassium and low sodium, eat more vegetables and less salt

A

20-year systematic review in the Journal of the American Nephrology Association[2] combined data from 104 studies of 2.7 million people who did not have kidney disease themselves, followed for many years, and attempted Identify the relationship between lifestyle and kidney disease, including dietary factors, regular exercise, smoking and drinking. It was found that eating more vegetables and potassium-containing foods can reduce kidney disease by 20%, while eating more sodium can increase the incidence of kidney disease by 20%.

Additionally, some research supports that dietary fiber in grains, coffee, dairy products, folic acid, legumes, high-magnesium diets, and plant-based proteins may reduce the incidence of kidney disease while eating more red meat And processed meat increases the incidence of kidney disease.

How much sodium and potassium are in your current diet?

WHO strongly recommendsThe daily potassium intake is increased to 3500mg, the sodium intake is less than 2.3 (equivalent to about 5g of salt), and the latest dietary guidelines in the United States also give an adult daily potassium intake of 3400mg, and sodium intake < 2.3g is recommended. So how much sodium and how much potassium is in our current diet?

Sodium intake

A study published in JAMA in 2015[3] showed that in 2002, the Chinese per capita daily intake of salt was 11.8g ( Equivalent to 6.1g of sodium), in 2010, the national per capita daily salt intake was 9.2g (equivalent to 5.6g of sodium), of which the north consumed more salt than the south, and the salt consumed in Beijing dropped from 11.7 to 7.5g (equivalent to 3.9g of sodium). ), overall we are eating slightly less sodium, but still well above the recommended amount.

Potassium intake

A systematic analysis in the American Journal of Cardiology [4], calculated by 24-hour urinary potassium, The daily potassium intake of people over 16 years old in my country is 1417mg, strong>PURE, a large-scale study of sodium and potassium intake in many countries around the world, showed that the potassium intake in the Asian population is generally less than 2g, while the global average daily potassium intake is only 2.6g. The intake of potassium is similar in the north and south, and the National Health and Nutrition Survey shows that the potassium in our diet mainly comes from pasta, rice and potatoes, all of which are staple foods [5].

How to eat high potassium and low sodium?

Eating more potassium can reduce kidney disease, and eating more vegetables can also reduce kidney disease, and vegetables are foods rich in potassium, so eating more vegetables may have a better protective effect on kidney disease than more vegetables. Eating foods high in potassium is related.

The principle of high potassium and low sodium is consistent with the DASH dietary recommendation recommended by Sishi before. High potassium and low sodium diet can also prevent and treat hypertension, and it is carried out in many countries around the world. The PURE study also found that high potassium diets also reduced overall mortality

How to have a high potassium, low sodium meal?

* Eating more whole foods and less processed foods is the key to a diet high in potassium and low in sodium. Only 12% of the sodium we eat comes from natural foods, the rest is all processed foods or sodium added during cooking. For example, two slices of ham have 32mmol sodium and only 4mmol potassium, and 1 box of instant noodles contains 48mmol sodium and only 1.4mmol potassium. In contrast, a diet rich in fruits and vegetables is low in sodium and relatively high in potassium, 1 orange contains no sodium but 6mmol of potassium, and 1 bowl of cooked peas contains 0.3 mmol sodium and 9.8 mmol potassium. The survey on Chinese diet shows that most of the potassium in the diet comes from the staple food, which shows that the intake of vegetables and fruits is still insufficient.

Where does 3500mg of potassium come from? Xi Xi mentioned in the previous article that the first thing most people think of when supplementing potassium is “banana”. A medium-sized banana contains 422mg of potassium, which is indeed a lot, but if you only rely on bananas for To supplement potassium, you need to eat 9-10 bananas every day to get enough potassium. It is definitely unrealistic to eat bananas to supplement potassium. Unless we’re all Minions. In fact, bananas are moderately high in potassium. Many other foods are richer in potassium. Below is a list of some common foods.

Skinned potatoes, sweet potatoes, whole grains and legumes are high in potassium, followed by vegetables and fruits such as tomatoes, bananas, oranges, avocados and dried fruit, and seafood for potassium Not low either.

Any nutritional recommendation is not just a simple superposition of numbers, because the role of food and health is very complex and food is not just some numerical values, only what suits you is the best. Here are some potassium supplementation tips to incorporate potassium into a healthier and more individualized diet:

1. Sodium needs to be controlled: The effects of potassium and sodium tend to change. When increasing potassium intake, we should pay attention to the cooking method not to choose high-salt or deep-frying methods, otherwise the health effects of potassium will be affected by high sodium and high oil. offset. Things like fried potato chips or marinated tuna are not suitable.

2. Calories need to be controlled: Weight gain can also cause many problems such as high blood pressure and heart disease. So keep your calories in check while increasing your potassium. Although bananas are high in potassium, their calories are not low. One banana is 105kcal, while spinach with the same potassium content is only 21kcal. Cantaloupe and watermelon with the same potassium content are also lower in calories than one banana, so eat vegetables, other Fruit to supplement potassium is more suitable for people who are in weight control.

3. It is a good way to replace the staple food: Rice and white noodles are not the most nutritious choice as a staple food. One bowl of rice contains 55mg of potassium, and one bowl of dried noodles contains 61mg of potassium. These traditional staple foods lose a lot of minerals and vitamins during processing and refining. Substituting potatoes and beans for staple foods is a good way to supplement potassium and increase dietary fiber intake. In addition 1 bowl of quinoa contains about 300mg of potassium, which is also more than rice noodles

4. A high potassium diet is not suitable for all groups: Finally a high potassium diet is suitable for healthy people and can prevent chronic kidney disease. It is not suitable for patients with chronic kidney disease. When the kidneys are already damaged, the ability to excrete potassium will be greatly impaired. Patients with high blood pressure and diabetes must make sure that there is no abnormal renal function before taking a high-potassium diet.

Meal pattern perspective, healthy diet prevents kidney disease

The latest dietary guidelines in the United States also recommend Meal Patterns for organizing healthy meals. Meal pattern refers to the combination pattern of food, nutrients and beverages, which can better represent a person’s actual eating style, and can take into account the combination of foods and the relationship between nutrients, not just the superposition of simple nutrients. For example, from the perspective of a high-potassium and low-sodium diet, with the current dietary pattern, when a person’s potassium intake exceeds 3500 mg and the sodium intake is less than 2000 mg, the possibility is very low, so the dietary pattern must be changed to achieve the nutrient recommendation. quantity.

Research published last year in CJASN, the Clinical Journal of the American Academy of Nephrology, combined results from 15 cohorts with an average follow-up of 10.4 years, and found that a healthy dietary pattern can reduce chronic chronic diseases by 30%. occurrence of kidney disease. A healthy dietary pattern refers to eating more whole grains, vegetables, fruits, beans and fish, and less red and processed meat, less salt, and less sugar-sweetened beverages. Among them, the Mediterranean diet and the DASH diet are the most studied dietary patterns, and both dietary patterns can reduce the incidence of kidney disease.

Finally, some non-diet lifestyles are also related to the occurrence of kidney disease. More exercise and less smoking can reduce the occurrence of kidney disease.

Finally, I hope Xixi Nutrition can help everyone to eat well and move well, so that everyone can have a healthy body and a happy life.

References

[1] Metabolic rate of major organs and tissues in young adult South Asian women. /Eur J Clin Nutr/ *73,*1164C1171 (2019).

[2] Modifiable lifestyle factors for primary prevention of CKD: A systematic review and meta-analysis/. /Journal of the American Society of Nephrology/ (Vol. 32).

[3] Salt and sodium intake in China. /JAMA – Journal of the American Medical Association/, /315/(7), 703C705.

[4] Twenty-Four-Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta-Analysis. /Journal of the American Heart Association/, /8/(14).

[5] Understanding the patterns and trends of sodium intake, potassium intake, and sodium to potassium ratio and their effect on hypertension in China. Am J Clin Nutr. 2014;99:334C343.< /p>

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