DASH Diet For Kidney Disease: Does it Work? (Part 1 of 2)

Should you tweak the popular DASH diet if you have kidney disease

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Managing chronic kidney disease (CKD) usually takes a 2-pronged approach. There is what the physician does with the tests and the fancy schmancy pills, but then there is what you do at home. And what you do at home is perhaps equally if not more important that what the nephrologist does for you in the office.

Here is what I tell my patients to do at home:

  1. Watch your blood pressure
  2. Eat a kidney-friendly diet

    I have described dietary guidelines for kidney disease patients at other forums, and here and here. I want to take a moment to talk about the popular DASH diet eating plan that is probably the most recommended diet plan for people with high blood pressure. But is it applicable if you also happen to have kidney disease? 

    WHAT IS THE DASH DIET EATING PLAN?

    Alarmed at the increasing incidence of high blood pressure (hypertension) in the US, the National Institutes of Health (NIH) conducted a multi-center study in 1992 to see how diet influences blood pressure, and what diet plan might be best for keeping blood pressure controlled. It compared typical American diets of the day to other diets including the so-called DASH diet. In a nutshell, the study found that people who ate the DASH diet showed a significant lowering of their blood pressure in as little as 2 weeks.

    The DASH acronym stands for Dietary Approaches to Stop Hypertension.

    The approach emphasizes intake of fruits, vegetables, and low fat dairy; while limiting intake of sodium, sugar, and red meat. It is low in saturated and trans fats, and high in calcium, potassium, magnesium, fiber, and protein.

    Here is how you should be getting your daily calories if you stick to the DASH plan

    (for a 2000-calorie diet. Table courtesy National Heart, Lung, and Blood Institute- http://www.nhlbi.nih.gov/health/health-topics/topics/dash):

    Total fat27% of calories
    Saturated fat6% of calories
    Protein18% of calories
    Carbohydrate55% of calories
    Cholesterol150 mg
    Sodium2,300 mg
    Potassium4,700 mg
    Calcium1,250 mg
    Magnesium500 mg
    Fiber30 g

    UNDERSTANDING DASH DIET IN PLAIN ENGLISH

    As you might imagine, just because you have knowledge about the DASH diet does not mean you can put a meal plan together. What you need at this point is knowledge of portion sizes, which can help the average person understand what to eat and in what quantities. Enter your friendly dietitian, who will put it together for you. Here is what it should look like, based on different levels of calorie intake:

    Food Group1,200
    Cal.
    1,400
    Cal.
    1,600
    Cal.
    1,800
    Cal.
    2,000
    Cal.
    2,600
    Cal.
    3,100
    Cal.
    Grains a4–55–6666–810–1112–13
    Vegetables3–43–43–44–54–55–66
    Fruits3–4444–54–55–66
    Fat-free or low-fat dairy products b2–32–32–32–32–333–4
    Lean meats, poultry, and fish3 or less3–4 or less3–4 or less6 or less6 or less6 or less6–9
    Nuts, seeds, and legumes3 per week3 per week3–4 per week4 per week4–5 per week11
    Fats and oils c1122–32–334
    Sweets and added sugars3 or less per week3 or less per week3 or less per week5 or less per week5 or less per week≤2≤2
    Maximum sodium limit d2,300 mg/day2,300 mg/day2,300 mg/day2,300 mg/day2,300 mg/day2,300 mg/day2,300 mg/day

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