3-10 is the annual World Kidney Disease Day, and 1 in 10 people worldwide has kidney disease! Kidney disease is a chronic disease that may accompany the patient for life until dialysis or death, and the cost and impact of the disease on quality of life are also enormous.
With the improvement of living standards and lifestyle changes, the prevalence of kidney disease in the mainland is also in line with international standards. Not only nephritis can lead to kidney disease, but metabolism-related chronic diseases diabetes, hypertension, obesity, and high uric acid have become the main "killers" of the kidneys. All metabolites will be excreted through the kidneys, and what we eat is closely related to the products of our metabolism, and if the diet is unhealthy, resulting in high blood pressure and obesity, it will also significantly increase the pressure on the kidneys, so the health of the kidneys and eating are inseparable. Seeshi today will talk to you about the "kidney-saving diet" in combination with recent research.
1, kidney disease is not far from us
1 in 10 people suffer from kidney disease, and there are 500 million people with kidney disease worldwide.
1 in 10 people suffer from kidney disease
When you mention kidney disease, you always seem to think of the "kidney protection" in Chinese medicine, in fact, in Western medicine, the kidney is also very important, the kidney here is not a virtual concept but actually exists in our body organs, it is the treatment place for all metabolic waste in the body. Although the kidneys make up only 0.4% of the body's weight, they consume 10% of the basal metabolic rate on a daily basis [1].
The kidneys account for 10% of the metabolism of the whole body
The kidneys filter 180L of fluid every day, which is equivalent to the blood in the whole body passing through the kidneys 60 times a day. When there is no problem with the kidneys, we tend to ignore this important organ, and often when there is a problem, we already regret it.
2, kidney disease may also be eaten
Chronic kidney disease is already a disease closely related to the lifestyle, the proportion of patients with chronic kidney disease dying of cardiovascular disease is significantly higher than that of normal people, and the causes of chronic kidney disease are gradually changing, 10-20 years ago, the main cause of chronic kidney disease in the mainland is nephritis and some urinary diseases, and the data of the past 10 years show that the etiology spectrum of chronic kidney disease in the mainland is similar to other developed countries in the world, which are mainly based on metabolism-related diseases. The main ones are kidney disease caused by diabetes and high blood pressure. Especially in cities with a high standard of living, diabetes and high blood pressure are already half the causes of chronic kidney disease.
Diabetes and high blood pressure already account for more than half of the causes of chronic kidney disease in cities
If a person's diabetes long-term blood sugar is too high, then the blood through the kidney will cause glycosyl oxidation stress and damage to the kidneys, if a person is too fat, then his kidneys will have to do more work than others for a long time will be more tired and more likely to have problems, if long-term hypertension, the kidney blood vessels will also be under the "high pressure" for a long time, and it is easier to get sick over time.
What we eat and drink will enter the bloodstream, and all the blood must be filtered through the kidneys, the waste products in eating and drinking must be excreted through the kidneys, day after day, eating and drinking habits affect the function of the kidneys every day, over time, healthy habits will bring benefits, unhealthy eating habits will also cause damage to the kidneys.
3. How to eat to avoid kidney disease?
High in potassium and low sodium, eat more vegetables and eat less salt
A 20-year systematic review in the Journal of the American Association of Nephrology [2] synthesized data from 104 studies and looked at 2.7 million people without kidney disease and followed them up for many years to try to figure out the relationship between lifestyle and the incidence of kidney disease, including dietary factors, regular exercise, and smoking and drinking. It was found that eating more vegetables and eating more potassium-containing foods could reduce kidney disease by 20%, while eating more sodium would increase the incidence of kidney disease by 20%.
In addition, some studies support that dietary fiber, coffee, dairy products, folic acid, legumes, high-magnesium diets and plant-based proteins in cereals can reduce the incidence of kidney disease while eating more red and processed meat increases the incidence of kidney disease.
How much sodium and how much potassium is present in the diet?
The WHO strongly recommends that the daily potassium intake be increased to 3500 mg, and the sodium intake is less than 2.3 (equivalent to about 5 g of salt), while the latest DIET guidelines in the United States also give adults a daily potassium intake of 3400 mg and a sodium intake of < 2.3 g. So how much sodium and how much potassium do we have in our diet every day?
Intake of sodium
A 2015 study published in jama, journal of the American College of Physicians[3], showed that when sodium levels for eating out were not calculated, In 2002, the average daily intake of salt in Chinese was 11.8g (equivalent to 6.1g of sodium), and in 2010, the daily per capita salt intake of the whole country was 9.2g (equivalent to 5.6g of sodium), of which the north ate more salt than the south, and the salt eaten in Beijing dropped from 11.7 to 7.5g (equivalent to 3.9g of sodium), and overall the amount of sodium we ate decreased slightly, but it was still much higher than the recommended amount.
Potassium intake
In a systematic analysis of the American Journal of Cardiology[4], the daily potassium intake of people over 16 years of age in mainland China was 1417 mg calculated by 24-hour urinary potassium, and the large-scale sodium and potassium intake study PURE in many countries around the world showed that potassium intake in Asian populations generally < 2 g, while the global average daily potassium intake was only 2.6 g. Potassium intake is similar north-south, with the National Health and Nutrition Survey showing that the potassium in our diets is mainly derived from pasta, rice, and potatoes, which are staple foods [5].
How to eat high potassium and low sodium?
Eating more potassium can reduce kidney disease, eating more vegetables can also reduce kidney disease, and vegetables are potassium-rich foods, so the protective effect of eating more vegetables on kidney disease may be related to eating more foods with high potassium.
The principle of high potassium and low sodium is consistent with the DASH diet recommended by Xi xi before, and high potassium and low sodium diet can also prevent and treat high blood pressure, and PURE studies conducted in many countries around the world have also found that high potassium diets can also reduce overall mortality
How can I have a high potassium and low sodium diet?
* Eating more whole foods and eating less processed foods is the key to a high-potassium and low-sodium diet. Only 12% of the sodium we eat comes from whole foods, and the rest is all processed foods or added to cooking. For example, two slices of ham have 32 mmol sodium, only 4mmol potassium, and 1 box of instant noodles contains 48mmol sodium and only 1.4mmol potassium. In contrast, the dietary sodium content rich in fruits and vegetables is very low, while the potassium content is relatively high, 1 orange contains no sodium and contains 6 mmol of potassium, and 1 bowl of cooked peas contains 0.3 mmol sodium and 9.8 mmol of potassium. Surveys of Chinese diets show that most of the potassium in diets comes from staple foods, which indicates that the intake of vegetables and fruits is still significantly insufficient.
Where does 3500mg of potassium come from? Xi Xi mentioned in the previous article that most people first think of potassium supplementation - "banana", a medium-sized banana contains 422mg of potassium, it is indeed quite a lot, but if you only rely on bananas to supplement potassium, you have to eat 9-10 bananas a day to get enough potassium, and it is certainly unrealistic to eat bananas to supplement potassium. Unless we're all minions. In fact, bananas are medium to high in potassium, and many other foods are more abundant in potassium, and the potassium content of some common foods is listed below.
Peeled potatoes and sweet potatoes and whole grain legumes have a higher potassium content, followed by vegetables and fruits such as tomatoes, bananas, oranges, avocados and dried fruits, and the potassium content of seafood is not low.
Any nutritional recommendation is not just a simple superposition of numbers, because the role of food and health is very complex and food is not just some values, only suitable for their own is the best, here are some potassium tips, can make potassium into a healthier and more individual diet:
1. Sodium amount needs to be controlled: the role of potassium and sodium often goes on and on, while increasing potassium intake, we must pay attention to the cooking method can not choose high salt or frying, otherwise the effect of potassium on health is offset by high sodium and high oil. For example, fried potato chips or pickled tuna are not suitable.
2. Calories need to be controlled: weight gain can also cause many problems such as hypertension and cardiovascular disease. Therefore, while increasing potassium, it is necessary to control heat. Although bananas have a high potassium content, but the calories are not low, 1 banana 105kcal, while the same potassium content of spinach is only 21kcal, the same potassium content of cantaloupe and watermelon calories are also lower than 1 banana, so eating vegetables, other fruits to supplement potassium is more suitable for people who control weight.
3. Alternative staple food is a good way: rice white noodles as a staple food is not the most nutritious choice, 1 bowl of rice contains potassium 55mg, 1 bowl of noodles contain potassium 61mg, these traditional staple foods in the process of processing and refining lost a lot of minerals and vitamins, with potatoes, beans instead of staple food function can supplement potassium and increase dietary fiber intake is a good way, another bowl of quinoa contains potassium about 300mg or so than rice white noodles
4. Not all people are suitable for a high-potassium diet: Finally, a high-potassium diet is suitable for healthy people and can prevent chronic kidney disease. But not suitable for patients who have suffered from chronic kidney disease, when the kidneys have been damaged, the ability to excrete potassium will be greatly impaired, and the potassium eaten into it will not be able to cause serious problems such as arrhythmias, for patients with perennial hypertension and diabetes, we must make sure that the kidney function is not abnormal and then carry out a high-potassium diet.
From the perspective of dietary patterns, healthy diets prevent kidney disease
The latest dietary guidelines in the United States also recommend organizing healthy meals in a dietary manner. Dietary pattern refers to the combination of food, nutrients and beverages, which is more representative of a person's actual way of eating, and can take into account the interrelationship between foods and nutrients, rather than just the superposition of nutrients. For example, from the perspective of a high-potassium and low-sodium diet, with the current dietary pattern, when a person's potassium intake exceeds 3500mg while the sodium intake is less than 2000mg, the possibility is very low, so it is necessary to change the dietary pattern to reach the recommended amount of nutrients.
The study, published last year in the American Society of Nephrology Clinical Journal CJASN, combined results from an average of 10.4 years of follow-up in 15 cohorts, found that healthy dietary patterns reduced the incidence of chronic kidney disease by 30 percent. A healthy dietary pattern refers to eating more whole grains, vegetables, fruits, legumes and fish, eating less red and processed meats, eating less salt and eating fewer sugary drinks. Among them, the Mediterranean diet and the DASH diet are the most studied dietary patterns, both of which can reduce the occurrence of kidney disease.
Finally, there are some non-dietary lifestyles that are also related to the occurrence of kidney disease, and more exercise and less smoking can reduce the occurrence of kidney disease.
Finally, I hope that Xixi Nutrition can help everyone eat well and move well, so that everyone can have a healthy body and a happy life.
bibliography
[1] Metabolic rate of major organs and tissues in young adult South Asian women. /Eur J Clin Nutr/ *73,*1164–1171 (2019).
[2] Modifiable lifestyle factors for primary prevention of CKD: A systematic review and meta-analysis/. /Journal of the American Society of Nephrology/ (Vol. 32).
[3] Salt and sodium intake in China. /JAMA - Journal of the American Medical Association/, /315/(7), 703–705.
[4] Twenty-Four-Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta-Analysis. /Journal of the American Heart Association/, /8/(14).
[5] Understanding the patterns and trends of sodium intake, potassium intake, and sodium to potassium ratio and their effect on hypertension in China. Am J Clin Nutr. 2014;99:334–343.