Plant Based Eating: What It Is And How It Applies To CKD

Marika Wamback, BSc. R.D.
Registered Dietitian |

Plant Based Eating: What It Is and How It Applies To CKD

Plant based eating has been growing in popularity.  There is an increasing amount of plant based foods available for consumers.  As the awareness of plant based foods grows, so does the confusion and questions about what a plant based diet really is.  Although there is no definition of ‘plant based eating’, it has been described as a diet comprised mostly of plant based foods with small amounts of animal proteins, or substituting all animal proteins with plant based proteins. 

 A vegetarian diet is a loose term that encompasses different kinds of vegetarian diets.  Typically, if you follow a vegetarian diet, you may choose to include eggs and dairy (lacto ovo), or you may choose to include fish (pescatarian).  If you choose to follow a vegan diet, you avoid consuming any animal products.

How Does A Plant Based Diet Fit Into Your CKD Diet?

The renal diet is a plant based diet (whereas stage 5, ESRD, is more protein based due to protein needs for dialysis).  Why? Fruits, vegetables, and grains are all foods that are plants. If you are on a renal diet, you are encouraged to fill ½ of your plate with vegetables/fruits, ¼ of the plate starch, and ¼ of the plate protein.  Snacks are allotted, if needed, and they usually contain a plant (fruit, vegetable or grain) and a protein. That means that 75% of your plate at all meals is plant based.

The foods you are allowed from each food group are dictated by your level of kidney function.  This is determined by routine lab work. Working closely with your renal team can help you identify which foods fit your dietary needs the best. The following information reviews common nutrition needs of CKD patients that may be addressed by your renal team.

Protein

Meeting protein needs with CKD management is important no matter the stage of CKD.  Plant based proteins can be used in place of animal proteins with consultation from your renal dietitian.  Plant based proteins such as beans, nuts, lentils, and tofu can be nutritious choices when used appropriately and with the proper portion size.  For example, three-quarters of a cup (175 ml) of lentils or beans can be substituted in place of 75 grams (or 2.5 ounces) of cooked animal protein.

Phosphorus

Phosphorus is a mineral found in animal and plant based proteins but not in other plants like fruits and vegetables.  Recent research suggests that the phosphorus in plant proteins may not be absorbed like phosphorus from animal proteins, thus lowering the risk for hyperphosphatemia.  Prolonged hyperphosphatemia can be a serious risk for cardiovascular disease. If you are on a phosphorus restriction, consult with your renal dietitian about how to safely consume plant proteins in your renal diet.

Potassium

Legumes, nuts, seeds, and many fruits and vegetables all contain various amounts of potassium.  To keep your potassium in a healthy range, consume fruits, vegetables, grains, and plant proteins recommended by your renal dietitian.

Sodium

Sodium is a natural preservative that is used to prevent food spoilage.  Too much sodium can affect the cardiovascular system and kidneys by increasing blood pressure, thus increasing the workload on these systems.  Read product labels and ingredient lists to check for added sodium. To manage your CKD, it is recommended to keep your sodium intake to no more than 1500 mg/day, no matter the source of sodium.

Fibre

Fruits, vegetables, and many plant based proteins provide fibre which is essential for regular bowel function, lowering cholesterol, hunger satiety, and maintaining healthy gut bacteria for digestion and nutrient absorption.  The recommended fibre intake for adults is between 25-35 grams/day.

Prepackaged/Prepared Plant Based Foods

A growing number of prepackaged and prepared plant based foods are available at the grocery store.  These items may not be as healthy as they portray themselves to be depending on how processed they are.  Processing can decrease their quality of nutrition, protein and fibre content, and they may contain increased amounts of added sodium, phosphates, and other additives.  Read their Nutrition Facts Labels and their ingredient lists to be sure they are a nutritious choice for you.

With some planning and consultation with your renal team, your renal dietitian can help you optimize your choices, advise you on cooking methods, and suggest recipes/cookbooks for a delicious, nutritious, and balanced plant based renal diet.

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