I had a slip in my GFR in November. I had an gastritis this fall and although I did not take anything, it may have impacted me. I also had fallen away from my diet as we sometimes do in time. I thought it was appropriate for a tune up. I went to see the renal dietician I saw 3 years ago. She is an expert and highly recommended in my area. I took a diary of my food for the last month or so.
She is totally now plant based. She lost a ridiculous amount of weight in the last months, and I think she looked gaunt and frail. She said she did it by eating only 500 calories a day and only plant based. She was honest and said she would not recommend that calorie level for me. (Phew, wasn't going to happen)
But she did have some things to recommend. First of all, she said no fats, none zippo, nada. Well, I agree in principal, there are certain foods and things that need some fat. But I certainly can cut that down. Also no dairy. Yikes, my beloved cheese was on the block. Ok, I can do that. She was basically warming me up to totally no animal products. I still will enjoy my cream cheese "Laughing Cow" product but not every day. NO eggs, even egg whites only. Well, that was going to be a big deal. But, I have stopped for now. And absolutely no milk. I do not drink milk but use Natural Bliss in my coffee. I only have one big cup a day. she recommended almond milk. No Chicken, no fish and no broth, either. I am ok with that for now but my homemade soup is chicken based broth and I am not throwing it out.
She cut my protein level down from 55-70 which was her recommendation 3 years ago to under 47 or lower. The desire was 15% of my intake of calories. Totally doable.
Then it got interesting. She starting recommending foods for me. First up was zucchini. I said no can do, too high in potassium. She disagreed until we looked it up on her computer and I was right. She said eat only a half a cup. Really, why bother? Broccoli was high in protein. Too bad, I thought. Not much else out there in the winter. She listed some other vegetables, and I do consume most of them.
Then she said that oatmeal was fabulous for me. Now this was in complete turn around from 3 years ago. Matter of fact, her recommendation was for everything carb being full on whole grain and bran. Now of course they want you to eat this oatmeal you cook for hours on the stove, but ... not going to happen. Brown rice and whole wheat pasta, which was a no no before, is now good. She again explained about that phosphorous is halved in plant based foods and now they are beginning to do research in the actual amount of potassium absorbed from foods. She said potatoes and some citrus was fine. Not going to take a chance on those with their high potassium. I said I just do not eat them. She said swap them out for other high potassium foods. I said what high potassium foods? I just do not eat them. It was not like I was eating chicken four times a week. She said legumes were great but high in potassium, eat small amounts. Honestly, I was getting a bit frustrated at this point. I was there an hour and half.
We talked more about the fat. She said nuts and nut butters were good for me until I told her I have had diverticulitis and do not eat them. I do not understand how the high fat in nuts is ok, but not olive oil. She said anything that is processed is bad. EVERYTHING. If you do not make it yourself, do not eat it. ( That was ridiculous to some extent. I could see why she lost 50 pounds in 4 months)
And one more good point: Intermittent fasting. I was doing that before and then started eating rice rollers with my coffee in the am. (Rice rollers are a no no because they are processed, even thought they are only rice, and sugar) She said, and I already do this, no food after 6 pm and nothing before 11 or noon. I am back to doing that and its not that hard. I was getting hungry in the am but now I am not.
So I have limited myself even more. Funny thing is I am actually feeling pretty good. She said that often when you change to this diet at first you feel crappy. She said that was because of the toxins being release into you body to eliminate. I will admit that a constipation issue is totally fixed and so that's good. I dropped 2 pounds last week. That's good.
But, and I left her with this. I said, " right now, I am on a short list of longevity. I do not know how long I can go without dialysis, now that my GFR dropped to 13. And we all know how hard that is. So there will be days when food wins. Not every day. But I am not giving up my popcorn with butter on Saturday movie night and I have never met a piece of chocolate cake I didn't love. She agreed that even with her self imposed restrictions that life happens. I wanted to say, but did not, that it is easy to restrict and do a 500 calorie diet if you only do it for 3-5 months. I said this is for life for me.
By the way, 500 calories is what they fed the people in concentration camps.
Wow, she certainly doesn't seem like someone I would be taking any notice of! I am only going on what you have said.
She really is an expert in the renal world. I thin she is swayed because she is now part of the an organization that promotes plant based foods. They provide classes and consultation but it is very expensive. I looked into before. When ever you talk with someone like a dietician, you have to factor in that they are not living your life. These are recommendations, not a prescription.
I do agree that plant based only puts less load on kidneys and the whole body. I gave it a go shortly before starting dialysis and there were huge improvements to all my blood results with the exception of creatinine. But my goodness it was so hard to stick to the diet and I am not sure for me it was sustainable. I do believe that if I had started it when I was at 20% rather than 10% then I could have delayed the need to start dialysis for a long time but by golly you have to have steel will power. But the science behind it is sound. If you think about processing a steak in your body compared to processing a salad then you can obviously see that the salad is going to be easier on our system.
I definitely feel much better eating a modified vegetarian diet than I did the diet I was following before. But, as I just said in my initial reply to this thread, I have to be really careful that I am eating enough protein on a daily basis now. I have been told to aim for 45 grams of protein daily, and that’s a decrease of 15 grams. My dietician told me to both reduce my protein to this level and convert to a modified vegetarian diet. So far so good as far as stabilizing my renal function with an eGFR of 15-17. My kidneys are quiet and stable... However, as we each know, this can change at any time.
Jayhawker
Hi Rabbit,Exactly. What I did not know was how hard milk is on the kidney. The amino acids are tough to process, as bad as red meat, just different. So no milk and very limited if any cheese. I have a friend whose nephrologist was concerned about his weight and told him to drink milk. He was eating enough protein with chicken and salmon. He had raised his GFR from 13 up to 36 over time and then it dropped and stayed pretty much around 24-27. Then he added the milk and boom, right back down. He has stopped the milk and it is back up to 24.
Unfortunately there's so little research and even less understanding about this. For example when I was first diagnosed at about 18% and asked about diet the doctor said it was not going to make any difference and I should go home and just eat normally. Even when I changed my diet and my levels improved the nephrologist dismissed any improvement as an anomaly.
Yes, my first nephrologist was the same with diet. The only dietary changes he had me make were to follow a low potassium diet when my potassium elevated. But nothing about meats or dairy products.
When I finally saw a renal dietician at the transplant center, I learned quite a lot about dietary changes that would support my remaining renal function. The dietary changes I have made have definitely helped a lot. But so frustrating not to have this information sooner when I had about 35% function.
Jayhawker
Yes I totally agree.
Absolutely... I would probably not gotten to the point I have.
I drink only Almond Milk and did find vegan cheese, some made with soy, others not. I do prefer the regular so eat no more than 1 oz serving.
I looked into almond milk and the brand I saw had a lot of additives. But I am going to look for a almond creamer. I know they make it.