Whole Foods and Kidney Disease

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Stephanie Legin, RD, LDN

Renal Dietitian

What is a “Whole” Food? 

A whole food is defined as a “food with little or no refining or processing and contains no artificial additives or preservatives; natural or organic food”.

Real, whole food is the key to a healthy diet and overall good health; processed food is not.   When you eat whole foods, you’re consuming food in its natural state, intact, with all of the fiber, vitamins, minerals, essential fatty acids, phytochemicals and other nutrients that are in the food.  Basically, it’s the healthy unadulterated food, rather than the bits that remain after refinement and processing.   Processing includes any alteration of a food from its natural state such as peeling, slicing, cooking, dehydrating, preserving, frying, freezing and roasting.   The harder it is to tell what the food looked like when it came out of the ground, the more likely the food is highly processed.

For individuals with chronic kidney disease, focusing the diet around whole foods most of the time, may help to preserve kidney function by reducing blood pressure, controlling blood glucose (for individuals with diabetes), and helping to reduce inflammation.

Risk Factors That Impact CKD

High Blood Pressure –high blood pressure damages blood vessels in the kidneys, reducing their ability to filter extra water and waste products. High blood pressure is the second leading cause of kidney failure in the United States.

Hyperglycemia (high blood sugar)–uncontrolled diabetes injures small blood vessels in the kidneys reducing the kidney’s ability to regulate and filter water and waste products. Diabetes is the leading cause of kidney failure in the United States. One in 4 individuals with diabetes will develop kidney disease.

Chronic inflammation—uncontrolled, chronic inflammation results in structural kidney damage which significantly contributes to CKD.

Health Advantages of a Whole Food Based Diet

  • Whole, unprocessed foods are naturally very low in sodium, which helps to control blood pressure, reducing the risk for heart and kidney disease.
  • Whole foods contain heart healthy fats known to help reduce cholesterol and reduce the risk for heart disease.
  • Whole foods are higher in fiber, and have a lower impact on blood sugar compared to refined, processed carbohydrate sources, and assist with better blood sugar control.
  • Whole foods are rich in phytochemicals – naturally occurring compounds found in plants. Some antioxidant phytochemicals, such as flavonoids, carotenoids, and lycopene, are powerful nutrients found in plant foods that are known to protect cells against damage and reduce inflammation.
  • The combinations of nutrients in whole plant foods act synergistically to protect us from disease.

Health Disadvantages of a Heavily Processed Diet

  • Heavily processing  whole, simple foods into commercial products takes away the natural health benefits and typically adds in sodium, added sugar, and saturated and trans-saturated fats, unhealthy additives, preservatives, and chemicals that can contribute to chronic disease.
  • Added sodium is found in nearly all processed foods which contributes to high blood pressure and heart disease and contributes to the progression of kidney disease.
  • Many processed foods can be loaded with hidden added sugar. For diabetics, uncontrolled blood sugar can lead to damaged blood vessels in the kidneys.
  • Processed foods may contain artery clogging hydrogenated oils.
  • Processed foods may contain hidden allergens posing a threat to people with food allergies.
  • High calorie, low fiber processed foods contribute to overeating and weight gain because you don’t feel full as quickly as with high fiber whole foods.

How to Choose Whole Foods

Choose whole/minimally processed fruits and vegetables

Fresh fruits and vegetables

Pre-washed/pre-cut produce

“No salt added” canned or frozen plain vegetables

“No sugar added” canned, dried or frozen fruits,

100% fruit juice

Choose minimally processed sources of protein

Include minimally processed, whole protein foods like dry beans, lentils and peas, fish/seafood, poultry, red meat, pork, eggs, dairy foods, , and “no salt added” canned beans.

Choose whole or minimally processed grains

100% whole grains such as dry brown rice, quinoa, millet, whole wheat berries, and barley. These are the “whole seeds or kernels” of their respective plants, and retain all three parts: bran, endosperm, and germ.

Look for the word “whole” as the first word on the ingredient list. For example, “whole wheat flour” or “whole brown rice flour”.  This indicates that the whole grain has been minimally processed (up to 5% of the seed is removed to help improve the shelf life of the product) but still retains much of the original grain and most of its fiber and nutrition.

Use the Food Label

A good rule of thumb is shopping for groceries with six ingredients or less. The more ingredients the food has in it, the more it has been processed.  

Just because it comes canned, pre-packaged or in the frozen aisle doesn’t necessarily make it off-limits. Look for the food claims on label packaging like, “no-salt added”, “no added sugar”, “no preservatives”.


  • Any canned food with salt
  • Any canned food packed in heavy syrup
  • Pre-made items like frozen dinners, meatballs, chicken nuggets, etc.
  • Canned vegetables with salt
  • Anything salted or cured: pickles, olives, sauerkraut, deli meats, beef jerky, hotdogs, bacon
  • Processed cheeses
  • Instant rice, noodle, pasta mixes with seasoning, flavoring or gravy packets
  • Premade salad dressings
  • Salted or sugary snack foods
  • Sugary beverages (soda, Kool-Aid, etc.)
  • Fast foods

Fresh is Best!  Shop and purchase foods from the perimeter of your grocery store or farmers markets where the freshest, most unprocessed items are available.   Explore your fresh produce, seafood, meat, and dairy sections and select a variety of whole foods to create healthy, unprocessed meals.  Moderation is key; however, as it is unrealistic to expect all the foods and meals you consume to be from whole foods.  The goal is to decrease the number of processed foods you eat and increase the proportion of healthy whole foods.   Always be sure to speak with your nephrologist or renal dietitian about how to safely include these items in your individualized meal plan.

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.


Moe SM, Zidehsarai MP, Chambers MA, et al. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol. 2011;6(2):257-264.









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