Healthy eating for your kidneys

The kidneys are responsible for filtering our blood, eliminating toxins and keeping the acid-base, water and electrolyte balances in our bodies constant. They also play significant roles in hormone production and synthesizing Vitamin D. Even when they have taken some damage, our kidneys work so diligently that by the time we might feel the symptoms of CKD, they have already been significantly compromised. The upside is that we can make lifestyle and healthy eating choices now that can help to prevent this from happening.

According to ADSA, (the Association for Dietetics in South Africa), people suffering from hypertension and diabetes, and those who are overweight or obese, must pay particular attention to the impact of these conditions, not just on their hearts, but their kidneys too. However, all South Africans can make small lifestyle changes that will help protect their kidneys.

From 5 to 9 September 2022, South Africa celebrates National Kidney Awareness Week, and ADSA spokesperson, Dr Zarina Ebrahim highlights easy ways we can use nutrition to prevent CKD. Dr Ebrahim is a registered dietitian and lecturer at Stellenbosch University, and she says: “Overall, it helps to ensure that you keep your weight in the normal range through healthy eating choices, portion limits and regular physical activity, such as walking, swimming, cycling, running or any other strength and aerobic exercises that you enjoy. If you are diabetic, hypertensive or have heart disease, it is of utmost importance to take your medications regularly and monitor your blood pressure, blood lipids and blood glucose as the ideal control of these values are critical to kidney health. However, even if you are not suffering from any of these health conditions, you can use nutrition to help maintain the health of your kidneys.”

Dr Ebrahim’s tips for healthy eating for your kidneys

• Eat a variety of food: Keep your diet as natural as possible by limiting foods with additives such as processed and convenience foods, for example pies, pastries, polonies, sausages like viennas, burgers, ready packaged meals, take-away foods and packets of soups. Instead, focus on a wide variety of fresh vegetables and fruits, whole grains, small amounts of healthy fats and lean protein.
  
• Fibre is very important for kidney health: Fibre contributes to improving the gut microbiome profile. It increases the healthy gut bacteria and reduces the unhealthy bacteria. Every day aim for at least 2–3 fresh fruit servings (avoid fruit juices) and 2–3 vegetable servings. Increase your intake of legumes such as beans and lentils, as well as wholegrains especially oats, wholegrain breads and cereals.
  
• Reduce salt intake: Limit the addition of salt at the table and to food while cooking. Also avoid salty foods such as chips, biltong, packets of soup and other processed food products. Avoid using salty mixed spices such as BBQ and chicken spice. Rather use natural spices to add flavour to your food, such as cumin, coriander, pepper, turmeric, paprika, chilli powder, fresh garlic, ginger, lemon juice, parsley, celery and other herbs such as origanum, rosemary, thyme mint and basil.
  
• Protein is important, but should be portion-controlled: If you want to prevent kidney disease, be careful not to regularly consume excessive amounts of protein. Choose low-fat protein options such as low-fat dairy, skinless chicken, fish and lean meats. Incorporate more plant-based proteins from beans, lentils, soya, nuts, peanut butter and chickpeas in your family diet.
  
• Focus on food preparation: Avoid take-away meals and ready-made foods that are high in fats and salt. Rather choose healthy cooking methods at home such as steaming, stir-frying, baking and boiling, and don’t fry foods.
  
• Reduce excessive sugar intake: Limit sugar and sugary foods in your diet especially coming from cold-drinks, sweets and chocolates. These contribute unnecessary energy in the diet and may lead to the progression of CKD.

What should you do if you are suffering from CKD?

Registered dietitian, Zama Khumalo, who is also a spokesperson for ADSA, points out that people in any stage of CKD need specialised nutritional support to help them optimally manage their condition. She says: “It is recommended that people suffering from CKD pay attention to the protein, potassium, phosphate and sodium content of the foods they eat. The aim is to support the kidneys by reducing toxins in the blood that can be caused by a high intake of these nutrients in order to slow the progression of the disease. However, it is important to note that patients across the stages of CKD need an individualised approach to their nutrition, based on their health assessments, and there’s no one-size-fits-all solution.”

Generally, elements of the Mediterranean diet may be applied in people with CKD. The focus should be on reducing phosphate intake by avoiding processed foods which usually contain phosphate additives. Whole foods and fibre-rich foods should be increased, regardless of potassium content, unless the patient is hyperkalaemic, which means that you have higher than normal levels of potassium in your blood. In this instance, limit the intake of very high potassium foods. By becoming salt aware and eating fewer processed foods, you can achieve naturally low sodium levels. Aim to eat the right amount and the right types of protein. Too much protein may lead to further damage to kidney function, but not eating enough protein can cause muscle loss and malnutrition. Those receiving dialysis may need a higher protein intake. Better protein sources include beans, lentils, soya, eggs, chicken, lean meat and dairy instead of highly processed meat products, but the appropriate portions will be guided by your dietitian.

Ultimately, people suffering from CKD should have a dietitian as part of their health team to help them optimally manage CKD and to prevent malnutrition, which is associated with progressive kidney disease. Khumalo says: “As the only health professionals specifically trained in nutrition, dietitians help by conducting comprehensive nutritional assessments, evaluating appetite and dietary intake as well as assessing blood results. Your dietitian will calculate your nutritional requirements based on the nutritional assessment and any treatment that you are undergoing. Your dietitian is also able to prescribe nutritional supplements to meet protein and energy requirements where needed, helping to prevent or remedy malnutrition. In a nutshell, your dietitian works with you and your health team to improve quality of life, support your kidneys optimally and slow the progression of CKD.”

To find a dietitian in your area, visit www.adsa.org.za.