Starfruit: The Forbidden Fruit for Individuals with CKD

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Stephanie Legin RD, LDN
Registered Dietitian

Starfruit: The Forbidden Fruit

Individuals living with Chronic Kidney Disease (CKD) know the renal diet is one of the most complex diets to follow.  Depending on your level of renal function and lab results, your diet can be extremely restrictive, having to avoid or limit portions of many foods and beverages.  On occasion, however, your doctor and dietitian may give you some flexibility with food choices. There is one food that your renal care team will never grant you an exception to consume—that is the Starfruit (Carambola).

What Is Starfruit?

The Starfruit is a tropical fruit originating from Indonesia, Philippines and Malaysia.   A popular fruit in most East Asian countries, it is becoming increasingly popular and more available in grocery stores in North America.  Tropical parts of North America are cultivating and growing Starfruit to make it more accessible.  

Why Can’t You Eat It if You Have Impaired Kidney Function?

Unfortunately, if you have kidney issues, you cannot try or enjoy Starfruit.  It is toxic and can be lethal if eaten.  

Oxalates

  • Starfruit or Starfruit juice, contain significant amounts of oxalates.   Impaired kidneys are unable to filter the excessive amounts of oxalates found in the fruit.  If eaten, oxalate crystal obstructions can form in the kidneys, further damaging them and worsening your kidney function.

Caramboxin

Starfruit also contains caramboxin.  Caramboxin is a neurotoxin. Impaired kidneys cannot filter out this toxin.  If ingested, the toxin accumulates and remains in your body, especially the brain, causing neurotoxicity that can lead to a variety of serious health issues including:

  • mental confusion
  • seizures
  • coma
  • insomnia
  • lethargy
  • agitation 
  • nausea
  • vomiting
  • hiccups
  • death

Once Starfruit is consumed in any form, these negative physical and mental symptoms can occur rapidly.

What If You Don’t Have Kidney Disease?

If you don’t have impaired kidney function, Starfruit is a wonderful citrus fruit, that, when cut, looks exactly like a yellow star.  The entire fruit is edible. It’s low in calories, full of fiber, and is a great source of vitamin C and other antioxidants such as polyphenols.  

Living with kidney disease has many challenges.  Learning about and following the many facets of the renal diet requires a fair amount of persistence, dedication, and lots of will power.  Even though the renal diet may be limited in what you can eat, there are still many wonderful fruits that can be eaten. Starfruit is not one of them.  Be sure to read food packaging information, Nutrition Facts Labels and ingredient lists on foods such as fruit salad, fruits pizzas, fruit cocktail, etc. to ensure they do not contain Starfruit.  It’s imperative that all individuals with kidney disease know about the dangers of eating Starfruit or Starfruit juice.  

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. KidneyChef urges you to seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. KidneyChef advises you to never disregard professional medical advice or delay in seeking it because of something you have read on the Website.

If you think you may have a medical emergency, call your doctor or local emergency service immediately. KidneyChef does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the website. KidneyChef does not guarantee the accuracy of information on the Website and reliance on any information provided by KidneyChef is solely at your own risk.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683968/

https://phys.org/news/2013-11-sweet-poison-star-fruit-neurotoxin.html

https://www.kireports.org/article/S2468-0249(17)30253-X/fulltext

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