Eating well to support kidney health

The first week of September is Kidney Awareness Week in South Africa. It’s an important reminder to give our kidneys a second thought and see if there are a couple of lifestyle tweaks that could provide better support. High blood pressure, diabetes and obesity, all of which are prevalent throughout the country, tax the kidneys hard and can lead to chronic kidney disease (CKD) and renal failure, which may require dialysis or a kidney transplant when the condition becomes severe.

Working with a dietitian on your health team helps to determine healthy eating plans that reflect your food preferences, family life and household budget, as well as your health needs.

Advances in nutrition science have led to revised nutritional guidelines for those at risk or living with CKD. ADSA (Association for Dietetics in South Africa) spokespersons, Dr Zarina Ebrahim, a registered dietitian and lecturer at Stellenbosch University, and Lynette Cilliers, a registered dietitian at Groote Schuur Hospital, collaborate to champion nutritional support and care for patients living with kidney disease. In the past, people living with CKD faced a range of stringent dietary restrictions. Cilliers says: “The liberalization of the dietary guidelines for CKD patients is now a sparkle of sunshine in a previously doom-and-gloom approach.”

She explains: “We have moved away from outdated ‘do’ and ‘don't’ lists to a more balanced approach of whole foods. This is important because people living with CKD must avoid malnutrition and enjoy a good quality of life. So, we’ve gone back to the basics of healthy balanced dietary intake, keeping it simple and natural by favouring the inclusion of foods such as whole grains, vegetables and fruit, and limiting ultra-processed foods with additives. This transformative approach can benefit entire households and improve the physical, psychosocial, and financial health of a family affected by the risk factors for developing kidney disease.”

While these dietary guidelines are good for anyone aiming to protect their kidney health and those at risk, Dr Ebrahim notes that those living with CKD must have individualised nutrition guidelines that take into account the stage of disease, their current health assessments and treatments. She says: “The aim for CKD patients is to reduce the burden on the kidneys through nutrition, which means paying attention to the protein, potassium, phosphate and sodium content of the foods they eat. Working with a dietitian on your health team helps to determine healthy eating plans that reflect your food preferences, family life and household budget, as well as your health needs.”

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What’s important to note is that the dietary guidelines for people living with CKD, are sound advice for all. Dr Ebrahim says: “Overall, you want to maintain a healthy weight. Your nutrition focus should be on eating a variety of healthy foods to provide you with the right balance of energy and protein. Choose lean sources of protein such as skinless chicken, fish and low-fat dairy. Include plant proteins such as beans and lentils. Whole grain foods such as wholewheat breads, brown rice and oats are good choices as they provide fibre as well as energy. Avoid foods with added salt.

"Choose whole foods where possible by limiting foods with additives such as processed and convenience foods, for example pies, pastries, polonies, sausages like viennas, crisps, packet soups and takeaways. Additives contain potassium and phosphate salts which are absorbed much quicker in your bloodstream than from natural food. This is problematic when your kidney function is deteriorating since the kidney struggles to excrete these minerals. You can flavour your meals with herbs and spices rather than salt. Make sure that you limit or completely avoid alcohol.”

Lynette and Zarina’s top tips for looking after your kidney health are:

• Enjoy what you eat: Experiment with different recipes and ingredients to make healthy and interesting meals.

• It's not the ‘sometimes’ decisions that change the course of your health and wellness, it is the small everyday commitments that alter our lives: Making healthy food choices ‘most days’ is how you change your dietary patterns.

• Move. Exercise is not a punishment; it celebrates that your body is able to move: Make it fun. You don't have to hit a gym, dancing in your living room or gardening is also movement.

• Choose your liquids wisely: Consider how much sugar or additives are in your drink of choice. Are you hydrating appropriately for your body's needs? Clean, safe water should be your first choice.

• Stop smoking: Your kidneys don't like it.

• Look out for specials on healthy food items, either online or instore. Plan your meals in advance, it will make shopping and cooking much easier and more economical.

• Pack in healthy meals for work rather than buying take-outs.

• Manage your stress: Physical and emotional stress influences our overall health and sleep and has a knock-on effect on how we choose foods.

• And lastly, know your numbers: Get regular check-ups on your blood sugar levels, blood pressure and weight. Early diagnosis and management of high blood pressure or diabetes can prevent the progression of kidney disease.

To find a dietitian in your area, visit www.adsa.org.za.