What are Vegetarian and Vegan Diets and How Do They Affect CKD?

Marika Wamback, BSc. R.D.
Registered Dietitian

What are Vegetarian and Vegan Diets and How Do They Affect CKD?

There are a lot of questions about vegetarian and vegan diet use in CKD.  Primarily, can they be safely consumed if there are vitamin and mineral restrictions and do they provide balanced nutrition?  The research is on-going regarding the use of these diets with CKD management. It is important to know what the different types of vegetarian diets are and what a vegan diet is if you want to incorporate them into your lifestyle.

Vegan:

• No animal food products at all.
• All foods are from plant sources.
• Vitamin B12 supplementation is necessary, as vitamin B12 is found only in animal products.

Semi-Vegetarian: 

• No red meat.  
• Chicken, fish, dairy, and eggs are included.

Lacto-Ovo Vegetarian:

•  A vegetarian diet that only includes dairy and eggs as an animal protein source.

Ovo Vegetarian:

• A vegetarian diet that incorporates eggs as the only source of animal protein.

Lacto Vegetarian: 

• A vegetarian diet that only includes dairy as an animal protein source.

Pescatarian: 

• A vegetarian diet that only includes fish and seafood as an animal protein source.

All of these diets incorporate plant based proteins such as soy, beans, lentils, nuts, seitan, and tofu.  Although plant based diets are usually high in fibre, low in saturated fat and cholesterol, and high in antioxidants, it is important to consult with your renal dietitian regarding your diet choice for the following reasons:

Protein:

A well balanced vegetarian or vegan diet contains adequate protein to manage your CKD.  Vegetarian proteins may be sources of phosphorus, potassium, sodium, and calcium, which may be restricted in your CKD diet.  Consult with your renal dietitian about what plant proteins will work for you, especially if you have dietary restrictions.

Vitamin B12:

If you’re following a vegan diet, supplementation of vitamin B12 is necessary.  Consult with your renal dietitian about the amount you should be supplementing.

Essential Fatty Acids:

Essential fatty acids found in plants such as walnuts, algae, and flax are not absorbed as efficiently as EFA’s from animal sources.  Your renal dietitian can advise you on how to get enough essential fatty acids in your diet.

Sodium:

Sodium needs to be restricted in the renal diet no matter which diet and lifestyle you choose to follow.  Be sure to read labels and ingredient lists to look for added sodium and limit your sodium intake to no more than 1500 mg/day.  Buying whole, fresh plant proteins instead of processed ones is a simple way to limit your sodium intake. Purchase dried lentils to make falafel (instead of processed falafel), dried black beans to make black bean burgers (instead of pre-made burgers), and tofu to add to stir-fry.

Phosphorus:

Too much phosphorus in the diet, over time, leads to arterial calcification and cardiovascular disease.  Only 40-50% of phosphorus from natural sources such as nuts, seeds, and legumes is absorbed. However, inorganic phosphorus (found in processed foods such as sodium phosphate) is absorbed at 100%.  Check the ingredient list to see if phosphates have been added. Focus on avoiding foods that contain inorganic phosphorus as opposed to the organic ones. 

Calcium:

Too much calcium in the diet can also affect the cardiovascular system.  You can limit the calcium in your diet (if you have a restriction) by using non-fortified plant based beverages.  They are not fortified with calcium and vitamin D.   Non-fortified rice milk is an easy way to manage your calcium intake while enjoying a non-dairy beverage.  Be sure to follow the recommended portion size by your dietitian.

Vegetarian and vegan diets can be healthy choices for the management of your CKD.  With knowledge, planning, portion size, and consistency you can have optimal health.

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