Doctor's Note

This is the last of an extended six-part video series on the latest science on diet and kidney health. Check out the rest of the series here:

The problem for most people (98% of American Diets Potassium Deficient) is not getting enough potassium; the problem is that you have to have functioning kidneys to keep you in balance. Too much phosphorus in the blood can also be a problem. Thus, phosphate additives are something we should try to stay away from. See my three-part video series:

If you haven't yet, you can subscribe to my videos for free by clicking here.

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  • HemoDynamic, MD

    Fantastic stuff! Absolutely marvelous! Add another one to my arsenal of eduVideo’s to teach my patients with! I am so grateful! Thank you as always my friendly team!

  • Julie

    In the studies showing a reduction in kidney failure with a low protein vegan diet, how much protein did these subjects consume?

    • EvidenceBasedNutrition

      Really good question!
      The diet contained 0.7g/kg/day of protein.

      Here is the study.

      • Mike Robins

        what about vegetable based proteins or is this just animal protein?

  • Carol

    Awful Video!

    • Jim Felder

      Can you enlighten us on what you found so awful about this video?

      • Tom Goff

        Perhaps Carol is an old fashioned gal (or guy)…. “In the 1300s it originally meant “inspiring wonder” and was a short version of “full of awe”

        • Thea

          Huh. I wonder how the meaning of the word got so very turned around? Here’s my guess: If you are super full of awe, it may be about something that is a bit scary. Ie: That act of God that leveled our town was awe-inspiring. And then I can see how scary/dramatic/traumatic can can turn into modern version of “awful”. Ya think?

          • Joe Caner

            Perhaps, or it could be a conflation of the word “offal” which sounds the same and truly is.

          • Thea

            I would buy that.

          • Wilma Laura Wiggins

            Joe, you are so smart! Bet you play a mean game of Scrabble.

          • Joe Caner

            Thank you Wilma. Actually, as one living with dyslexia, I have always had to concentrate on the the spelling of words so I afraid that I am just an average Scrabble player.

            I am found of the spoken word especially when a transcript is provided, which is just another reason why I appreciate Dr. Greger’s work on

          • Tom Goff

            Yeah, I think so but changes like this are very common. Look at how words like “proof” and “quick” have changed their meaning in relatively recent times. “Proof” really means “test” (eg the proof of the pudding is in the eating) but people now use it to to mean “demonstration of truth”.
            And quick (the quick and the dead) really just means lively or alive but we now use to mean fast or rapid.

          • Thea

            Good points! Language changes can be so interesting I think because it speaks to the human crazy mind.

          • Kitsy Hahn

            See what you started, Carol? :-)

          • Wilma Laura Wiggins

            The one I hate is how they changed “unique” from one of

            a kind to unusual or different. “Unique” was the only word we had that meant one of a kind now we have to say it in full because they have perverted its meaning. I blame advertisers on TV and schools. TV advertisers seem Hell bent on perverting the English language.

  • bibliophila

    Just curious, Carol. Why did you consider this an “awful video”? It seems fact-based to me.

    • mbglife

      (Carol replied below in a new post)

  • Jim

    What about plant based protein instead of animal protein? Is too much protein the problem or just too much animal protein?

    • Nick Presidente

      If you go back and watch some of the previous video in this series you’ll see that its the inflammation that causes the kidney strain. Animal products increase inflammation, which is bad and causes a high kidney load, if people take a inflammation pill it will stop that leakage, but will be bad for you long term. So I think the goal should be to eat a low inflammation diet, which is naturally a whole plant food diet.

      Check his links in notes. But like he says in the video, they need more research to give better options and results.

    • EvidenceBasedNutrition

      Hi Jim,

      In this video, Dr. Greger talks about the high risk of cardiovascular disease in patients with Chronic Kidney Disease.

      He goes on to say, “With heart disease killing more than nearly all other causes combined, decreasing kidney function can set one up for heart attacks, strokes, and death.

      That’s why it’s critical that any diet chosen to help the kidneys must also help the heart. A plant-based diet fits the bill, providing protection against kidney cancer, kidney stones, kidney inflammation, and acidosis, as well as heart disease.”

      Animal protein is a packaged deal and comes along with all the risks involved with consuming these foods, namely, a greatly increased risk of cardiovascular disease.

      Dr. Greger is suggesting that the research points towards a whole foods plant based diet to solve many health issues simultaneously.

      We are just barely scratching the surface here, please feel free to ask any more questions. There are countless videos on this website we can point you towards if you would like to learn more about the science behind nutrition and optimal health.

      to health!

    • Joan E- NF Volunteer

      In the study by Sharon Moe, the control diet composition was 62/16 grams animal/vegetarian protein and the vegetarian study group was 4.1/74.8grams animal/vegetarian protein. The results were a decrease in phosphorus, PTH and FGF23. So, the plant protein appeared kidney protective. Here is the link to the Moe study.

  • spinsbackwards


    We found you from Rich Roll,

    May 1 2016 will be the 1 year anniversary of my wife and I being plantarian’s. We don’t eat meat, dairy, anything processed. We make all our food. This site has been a tremendous help, we rely on “The Original Dr. G.”

    re; kidney stuff. Each year when my wife Renee would go to get a check up her doctor would be concerned about Renee’s kidney numbers. Her doctor would tell her that at some point she’d probably need medication.

    Renee went to her doctor a couple months ago. As her doctor walked into the exam room she was shaking her head in disbelief. Renee was prepared for the worst. When Renee asked what was wrong her doctor looked up and said, “I can’t believe it. Your kidney numbers are perfect. There’s nothing wrong. What are you doing? I’ve never seen this before”.

    Her doctor is in her 40’s, she thinks a lot of herself. Renee isn’t one to waive flags and she didn’t want to have a political discussion with her doctor. Renee just told her, “I changed some things”. Her doctor said, “Whatever you’re doing keep doing it”. Her doctor walked out of the exam room. Her doctor wasn’t near as concerned about Renee as she was being wrong about her prognosis of medication.

    Stick it, doc. Keep your pills and we’ll keep our plants.

    I know this is related to kidney stuff. But Renee also had the same experience with her latest breast exam. Her breasts used to be lumpy. Now, the lumps are all gone.

    Moral of the story? Not sure there is one. What we do know is that since we’ve made the changes to being plant based, no meat, diary, or anything processed, we have both experienced dramatic results.

    Many thanks for the work you do, O.Dr.G!

    • Vege-tater

      Hmm, sounds like your wife and I shared the same doctor! The moral is, I think, to sincerely try a whole food plant based diet for even just one month and see if you don’t have amazing results…even if you aren’t overtly suffering from disease. YET. There are tons of resources online to walk you through the process day by day even, it’s so much easier now with all the people getting on board! Congrats and kudos to Dr G and all the caring doctors and others working so hard to get the message out past the influence of “big business”!


        There’s no shortage of uninformed doctors and PA’s that have absolutely NO idea how the body truly responds to good unprocessed food. My PA is a morbidly obese person who displays NAFLD and Metabolic Syndrome and tells ME that I have to eat high sugar fruits, follow the ADA Diabetic diet and not eat nuts because they are too high in fats!! My lipids are great and have been for a year since I stopped eating wheat products 2.5 years ago, don’t eat any fruits except the low sugar ones in smoothies and use some animal protein as a condiment and not the central part of my meal. I eat some cheese but no other dairy and I do eat eggs. I’ve also lost 75 pounds and my blood sugars are greatly improved with A1cs that run 5.8 to 6.2 which could improve and probably will as I continue down this path. I’m not a vegetarian but I do eat far more plant than animal foods. I also take a benfotiamine supplement (fat-soluble B1 or thiamine research says helps kidney function to improve) daily to help my kidneys and I’m .03 mg/dL on my Creatinine from being normal in kidney function or at least mucho mas mejor in 3 months.

        • 2tsaybow

          Since you are a dietitian and I am just someone who has benefited from a whole food plant based diet, I was wondering why you still eat animal products? They offer no real benefit, as Dr. Campbell’s book, “The China Study” has shown. Other than being tasty, why do you eat the junk? Especially here in the US when our food supply is so messed up and ugly and the cost to our society is so high. Not to mention the animals who suffer and die so that we can live as we please (That’s one billion animals a week who die for us.)

          Here is a perspective that takes the subject away from our health:

          • spinsbackwards

            Many thanks for the great vibe.

            One thing we’ve found in this movement is the people who need it the most aren’t getting it. Rich Roll’s podcast is aimed at the 1%. We live here in the mountains of CO, near Vail and Aspen. In Aspen, there’s all kinds of conferences on health. But guess what? Most can’t go — because they’re working. Or, they can’t afford it.

            My feeling is that more work should be done to bring in poor people or those lower on the socio scale. It’ll be a great day when processed foods are taxed and Kale is subsidized.

            We love this site because T.O.G. (The Original Dr. G.) is putting stuff out there that anyone can learn from. Anyone. And it’s free. The content here is making the world a better place.

            My wife and I support the site. We want others to benefit from this wonderful way of life. For years, I thought I was doing all I can for the environment – I bought solar panels, we composted, ate clean. But then we watched Cowspiracy – We haven’t ate meat, dairy, or anything processed since. And then we found this site.

            A friend who’s way overweight told me he wanted to do this. He’s in CA, I’m in CO. So we’re putting up a few videos a week that him and his wife can watch. They’re a little rough, but they’ll help him.


            Not trying to be a YouTube or blogger star. Just trying to pay it forward. Someone else out there is surely wanting to do this too. Hopefully this will help them.

            I put some videos up when we started, then “being busy” took over. Gong. I can’t be too busy to help others.

          • 2tsaybow

            Thank you! I will take a look at you work!


            You are entitled to your dietary choices. I like a little animal protein in my diet and that is my choice. Dr. Campbell’s study has some flaws in it and he also has ignored the OTHER cultures that are healthy that DO eat animal products. No one dies when I eat cheese or eggs or drink almond milk. When I have some chicken and pork, yes an animal dies for the cause. I grew up on a farm and I’ve plucked more chickens that you have, so what. How much do animals suffer that you have been able to measure on our farm where I lived? You have no idea how we did our butchering and even if our animals suffered. That’s just your opinion and not necessarily accurate in all cases. But the meat was not the center of our meals there either. The veggies were. Veggies have a lot of protein in them which is why I only use the animal as a condiment or supplement. I have no problem with that and if you do, that’s fine with me.

          • 2tsaybow

            I’m sorry if I upset you. Of course your dietary choices are yours and I understand that eating animal protein as a condiment is the way to go if you are going to consume it. But as I stand back and look at the whole way we are treating all other sentient life I just wonder why do it at all if it’s unnecessary. It’s also unsustainable so why eat death to live if you don’t have to.

            As far as Dr. Campbell’s study having flaws, I believe that statement is incorrect. Dr Greger studied at Cornell in order learn from Dr. Campbell and Dr. Campbell offers courses in food as medicine at Cornell.


            You didn’t upset me and that may disappoint you but you’ll recover — we all do. I’m way too old to get upset over your choices being significantly different from mine. My daughter went through a vegan phase and that didn’t upset me either. Everyone is in charge of what they put in their mouth– the good, the bad and the ugly. I just like having discussions about things. Regarding his “The China Study” flaws. I will find the reference to them and post it here for you. Here’s the one that I think is the most accurate and specific. I’ve read her stuff before and think she makes the most sense of the mistakes he made. Do a Google search on “flaws in The China Study” and you may be surprised at how much comes up. The fact that he teaches at Cornell and taught Dr. Greger doesn’t make him or anyone else perfect. There’s a whole history of professors who have been found out to cheat a little or a lot here and there or fudged the numbers for a preconceived notion. I remember when Ansel Keys was wrong also and look how long it has taken to correct that. But those of us who didn’t have Piled Higher and Deeper after our names understood only too well that human breast milk has more cholesterol in it than cow’s milk or eggs and therefore it sounded completely weird that “cholesterol” was the cause of heart disease. Guess what — turns out it isn’t. Lots of people can be wrong.

          • 2tsaybow

            Oh boy, Harriet Hall, she’s not a skep “chick” she’s a skeptic!

            Cholesterol is a factor in heart disease, we should seek to keep our cholesterol as low as possible. Here are a few video’s for you to look at from this website about the subject:

            Here’s n article from on the subject:

            Eggs, milk and other animal products are not good for you. Eat it if you want, but it is not healthy.

            I would not call myself a vegan. I consume a whole food plant based diet. I thought you knew what a WFPB diet was, excuse me for my assumption.


            HH was just one of many, many people who disagree and have found flaws in Dr. Campbells “research” but you will never admit that which is fine. You can be as blind as you choose. It’s not critical to me if you EVER change your stilted, non-cholesterol rich brain at all.

            So you think the cholesterol n our brains is full of heart disease raw material? Interesting, wrong but interesting. I’m well aware of Dr. Greger’s info on it and I don’t agree. Cholesterol is essential in human nutrition, period. It is NOT the cause of heart disease and never was. Arterial plaque is caused by LDL-b which is made from fructose and NOT EVER cholesterol. The reason Ansel Keys identified cholesterol in arterial plaque is we didn’t have the better instruments and knowledge we now have and know a LOT more about cholesterol. The purpose of the plaque he got so torqued about is to maintain laminar flow. The raw material for filing in the pot holes is just that — a hole filler to maintain laminar flow. Our bodies do NOT need cerebral; cholesterol as a raw material depot to give us heart disease. Cholesterol is a perfectly NORMAL part of human nutrition so I hope you eat enough for the production of your cholesterol-based sex hormones.

            I get the forks over knives info all the time but again, disagree with their viewpoint on cholesterol and some other things. I read it but I read a lot of stuff I don’t agree with and am under no obligation to agree with. FOK is really better at and more interested in selling their cooking classes.

            As I said, I don’t drink cow’s milk, I use nut milks for cooking and as a basis for smoothies. Eggs also have choline that helps our bodies to utilize the cholesterol that we need for our brains and other body parts so the eggs are a perfect cholesterol source. And I will continue to eat the animal products I do and I thank you for your permission.

            Vegans do consume ONLY whole food plant based diets. They eat NO animals products at all. So whether you want to be one or not, you fit the designation even if you don’t call yourself one. Perhaps you think the term is negative and therefore don’t like it. Your choice.

          • 2tsaybow

            Vegans don’t wear animal products and have made their dietary choice because of their ethical beliefs. I admire that commitment and do not see it as negative. I made this dietary choice for health reason and I probably consume some animal products when I eat out.

            I am not a fan of Harriet Hall as you seem to be. She has made it a goal to attack Dr. Greger’s work and seems to do so to promote herself.

            Also, when she was approached by a young woman about the persons feelings about how she was bring treated in a group of her skeptic peers, Dr. Hall pretended to be a confidant and then embarrassed the young woman a public forum. Harriet wore a shirt that she was a skeptic, not a skep “chick.” The woman is a self promoting individual who is in need of an ethics class (or a soul). Like I said, I’m not a fan.

            Cholesterol is bad. Maybe you should watch some of Dr. Greger’s videos. This one on arterial acne is very enlightening:


            When human breast milk no longer has MORE cholesterol than cow’s milk and eggs or better yet, NO cholesterol at all and our brains stop being cholesterol, then I will believe there’s probably a reason that cholesterol is left out and is therefore bad for human consumption. Until then, I don’t believe it is bad for human consumption at all regardless of what Dr. Greger’s says in his videos that I have watched. Don’t get all your exercise jumping to conclusions. You may not have enough synapses to do that successfully since;you don’t eat any cholesterol. Bye-bye, it’s been fun exchanging ideas.

          • 2tsaybow

            Have you noticed your need to be nasty to me every time you respond to my answers or to my questions? I have worked very hard to be polite to you. Have you noticed that as well?

            Do you think you’re responding from a higher synaptic response, or maybe it’s your reptilian brain being coaxed by those meat focused bacteria in your gut. What ever it is, I don’t think you should infer that I am stupid because I’m not getting enough eggs. As I said before, human beings can produce our own cholesterol.



          • 2tsaybow

            You’d better just be ignorant about current nutritional science, which is what I assume from your behavior; because if you are a paid shill of the agricultural industry then the RICHO Act applies to you.

            We have interacted enough at this point that the moderators can grab your IP address. That information can and will be used to act against those who intentionally harm people through misinformation.



            Thank you for the threat. Do whatever you think you need to do.

          • Thea

            ohneclue: I would disagree with this statement: “No one dies when I eat cheese or eggs…” The environmental impact of eating diary and eggs is really big. If that impact hasn’t resulted in human death yet, it’s on it’s way big time. Every time you eat cheese or eggs, you not only contribute to the environmental harm from those specific animals, but you encourage the industry to continue down the path of destruction by paying for it. For evidence to support this statement, I would refer you to the documentary Cowspiracy. Just something to to think about since you acknowledge that massive raising of cows (dairy as well as beaf) is so destructive.


            I guess I should have explained that my next door neighbor raises the free-range chickens who lay the eggs who also eat the grasshoppers off our part of the free-range yard. His yard is the Pachanga Place. His goats and couple of small horses have free access to our 2.39 acre yard as well. We do NO watering of anything but he has some collectors for rainfall. I buy my cheese from a local cooperative. I have always felt beef raising at the rate of 8 acres per cow was insane. It’s all food for thought.

          • Thea

            ohneclue: I understand why you feel that way. I still think it would be enlightening for you to see Cowspiracy.


            Thank you.

    • HemoDynamic, MD

      Keep up the great work! I see the results all the time with my patients, and so does John McDougall, MD, Michael Greger, MD, Caldwell Esselstyn, MD, Joel Fuhrman, MD, Neal Barnard, MD, Michael Klaper, MD, Alan Goldhamer, DC, Ron Weiss, MD and the list goes on.

      Only thing is that we are but a few that practice this everyday, but the times are changing and soon more doctors will have to shed their ego’s and do what every person on the planet should do and that is have a ‘Beginner’s Mind.’ We should all be willing to learn new things everyday, but especially if it requires us to educate our patients/friends and colleagues about important issues that have positive life-changing results.

      Good for your for being one of those human beings! And now you get to reap the benefits from such actions!

    • mbglife

      Congratulations to you and your wife. I’m not surprised at your doctor’s reaction as mine has said he wishes that even a tenth of this patients had lab numbers even close to mine (sad, since they could). And, there are lots of morals to the story here.

      Best wishes for continued good health and good annual checkups.
      Mark G.

    • easyout

      If this catches on, how are MD’s going to make a living?

      • Joan E- NF Volunteer

        Good question! But I think we still have a long way to go to convince the general public that WFPB diet is the way to go. :/

        • easyout

          That’s a story in itself. There’s a learning curve in realizing that we have to divert our attention from paying mortgages and what to buy next, to the feeling one gets from being healthy. That’s a tough one that most learn only after they’ve allowed themselves to eat the wrong foods. A Saint once said that human nature is basically weak, and from that one can assume he means lazy. We eat what’s ever available and in that lies the problem, in my opinion.

    • EvidenceBasedNutrition

      Thanks for sharing your story with us!

  • Carol

    It was disorganized. Didn’t state it’s theme up front. It is long without any structure.

    • 2tsaybow

      Well let me give you a synopsis Carol. The title, “Treating Kidney Disease with Food” is the subject and purpose of this video. It’s the sixth video about a Whole Food Plant Based Diet and its ability to help people who have problems with kidney function.
      If you are eating a WFPB diet and believe that you can help direct Dr. Greger’s videos he might be willing to speak to you about your volunteering to help him.
      If you are not eating a WFPB diet and would like to learn this is a great site to start. If you want to look around the internet, here are some links to other sites: has a number of articles about the subject from many contrtibuters. Take a gander at the list of contributers to see how many people are involved in this movement; then look at the website for infomation about specific dietary changes. Thanks for your input, I’m sure the staff here appreciates your well reasoned and well thought out dialog

    • mbglife

      I’m surprised you find it disorganized. I’m a very structured, organized person and I didn’t find it disorganized at all. I thought it did a good job of putting a lot of different points, some with important side-bars, in a very short video. Most videos posted on this site are very short. This was only 6 mins even thought it presented a lot of info. But even so, I’m surprised you couldn’t follow it.

      • Wendy Gretzinger

        Not disorganized at all…but if you buy the Audible book, you will get all of these mini lessons in context. Think these are excerpts from the book…I have the book and Audible presentations…:))

        • Carl

          Why would you want to argue with her or try to qualify matters? Things are pretty clear. You took her bait and perhaps also became fools?

    • Rxshauna

      I will happily await your evidence based video that you will give away for free. I’m sure it will be outstanding.

  • Dr, Chirila cristian

    hello, i would like to know what fruits and vegetables (low in protein as we know its recommended) are to be ate in
    diabetic patients with chronic kidney disease cause i am treating
    diabetic patients. Thank you

    • cafwen

      You can never go wrong with leafy greens! Plus they are of course very low in sugar.


        Yes they are very healthy! There’s a lot of research articles on the addition of B1 or thiamine supplementation that helps to improve diabetic kidney function. It isn’t an overnight thing. I personally take a benfotiamine supplement (fat-soluble B1 or thiamine seems more effective than water-soluble B1) that has improved my kidney function according to my last lab values and I’m now .03 mg/dL from normal Creatinine and I’ve progressed from borderline 3B-4 back to 3A on the GFR scale. While food should never be left out of the equation, supplements are fine for specific problems in my opinion. My next lab work will be due this Friday and I look for increased levels based on my output if you see what I’m telling you. Trying to be polite. I am not a vegetarian but I do eat far more veggies than anything else. My meat is used as a condiment to my veggies, I eat only low sugar fruits in a daily smoothie made from almond milk, kale, spinach, strawberries., cranberries (more for my hubbies AMD that is now better) or other greens, and I eat a lot of zucchini because I like it. I also eat a lot of radishes both oriental Daikon and regular ones in salads plus cooked carrots and all kinds of peppers as well.

    • EvidenceBasedNutrition

      Great question!

      Please refer to this article from NIH/Medline on dietary modifications in Chronic Kidney Disease.

      When eating fruits:
      Choose peaches, grapes, pears, cherries, apples, berries, pineapple, plums, tangerines, and watermelon
      Limit or avoid oranges and orange juice, nectarines, kiwis, raisins or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines

      When eating vegetables:
      Choose broccoli, cabbage, carrots, cauliflower, celery, cucumber, eggplant, green and wax beans, lettuce, onion, peppers, watercress, zucchini, and yellow squash
      Limit or avoid asparagus, avocado, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, avocado, and cooked spinach


        I cannot believe you recommend a dietary source that recommends whipped topping as OK for ANYONE let alone a kidney patient. The first ingredient is water, 2nd is hydrogenated fats and third is high fructose corn syrup! The kidneys should really love that extra glycation from this junk.

        • EvidenceBasedNutrition

          The link is provided as a source for the list of fruits and vegetables I copied and pasted in response to Dr. Chirila cristian.


            Did you tell her only to use the fruits and veggies part or did you just offer it as an article on dietary modifications in Chronic Kidney Disease which includes ALL the recommendations on that document. It is more than just the fruits and vegetables in the list you recommended. It includes the part I thought was very inappropriate for a chronic kidney disease patient. I know of recipes that dietitians promote to kidney patients where they tell them to wash and rewash and rewash the potatoes to remove the potassium and then ADD 1 cup non-dairy creamer and all those chemicals to a kidney patient just to recommend Shepard’s Pie to a kidney patient!! Now they could have done a cauliflower faux mashed potato topping but they didn’t. They wanted all those chemicals in the non-dairy creamer to go through the kidney to bulk up the washed out potatoes!! Just another example (not on this site) of what I find totally incomprehensible as written advice to kidney patients by the health profession that is extremely disappointing.

          • Joan E- NF Volunteer

            You are right, unfortunately. As a dietitian that has worked with dialysis patients for 20 years….that is kind of what we have recommended historically. 20 years ago, it was even worse!! Unfortunately, the focus of the diet was on the reduction of phosphorus and potassium and not the overall health quality of the diet. The renal diet is awful. I can tell you, on behalf of several renal dietitians, that is changing. I am now actively working to turn this around!


            Excellent!! I just love dietitians that think and make changes! Keep up the good work. I’m retired so I can’t do much about it except comment/complain. When I did on the site, the response was they were thinking of not recommending the nondairy creamer because of the high chemical ingredient phosphorous content but were NOT considering the substitution of faux potatoes from a cauliflower topping on the Sheperd’s Pie recipe. I was actually surprised my comment was posted let alone answered. Another poster had actually suggested or asked why they didn’t do the cauliflower thing and the answer was one could do that if they wanted to but NOT that the renal dietitians would change the recipe to include that OR even mention it as a good change to the recipe. Personally, I think what in the world is so great about Shepard’s Pie that you have to include it in the first place. But that’s just me. I know the ADA and Head Dietitians can be real Nazis about stuff like this. That’s why I did an MS and never did the Internship route to my registration.

        • Tom Goff

          That page does NOT recommend whipped topping as you claim. It merely states that it is lower in phosphorous than other dairy foods.


            Actually it does recommend it. “You will need to limit the amount of dairy foods you eat, . . .and nondairy whipped toppings.” all in the same paragraph which means they are saying you CAN eat them as part of the dairy foods (which is certainly isn’t) but you should limit it while you EAT it which is a recommendation that you eat it in smaller quantities or less frequently along with the other DAIRY foods which it simply isn’t. But it does say it has less phosphorus similar to the the other “dairy” products ” tub margarine (really — what cow did that come out of), butter, cream cheese, heavy cream, ricotta cheese, brie cheese, sherbet, and nondairy whipped toppings.” It isn’t a dairy product at all. So, to me, this is a glaring error in including this fake product as a good low phosphorus choice and in a certain aspect, safe to eat because it is a lower phosphorus-containing plastic tub of plastic food and in reality not fit for any one’s kidneys, low phosphorus or not.

          • Tom Goff

            No, it does not RECOMMEND it. I agree we shouldn’t eat it. But my reading is that it says if you insist on eating dairy, these are the lowest in phosphorous.

      • Wilma Laura Wiggins

        I have had only one kidney since my 20’s. I have only been WFP based for the last 3 years. This is the first I’ve heard of this. I don’t and never had kidney DISEASE but do want to protect the only one I have left. Does this apply to me?

        • EvidenceBasedNutrition

          Hi Wilma — Thanks for the question. This article does not apply to you. The article is refering to individuals who have difficulty processing certain foods because of their Chronic Kidney Disease. In your case, you have a healthy kidney. Of course, your WFP based diet will serve your kidney and other organs well!

          Please talk to your physician if you have any concerns about your health to get a clearer sense of what applies to your specific situation.

    • payoung NF moderator

      In general all fruits and vegetables are low in protein as compared to meat and other animal products so are a good choice for anyone with chronic kidney disease. Although many people think diabetics shouldn’t eat fruit, studies have shown that eating fresh whole fruits actually help prevent progression of type 2 diabetes. In this study they found that a higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, cruciferous vegetables or their fiber is associated with a lower risk of type 2 diabetes.


        They outlined the specific fruits and vegetables that are the best. The high sugar fruits do continue the on-going higher, longer glycation of all cells of the diabetic patient as well as the rest of us. Diabetics shouldn’t eat the high sugar fruits such as bananas that are 91% sugar/starch and 7% fiber. That small amount of fiber really gets worn out trying to modify something that is 13 times larger. And the berries are the best because of the combination high% of calories as fiber AND lower sugars for the fiber to slow down and modulate. Gestational diabetes and pregnancy outcome has been better when the mothers ate MORE vegetables than fruits. Sugar is sugar is sugar and less of it is better for everyone including but not limited to diabetics.

        • payoung NF moderator

          I agree that lower intake of sugar regardless of the source is better. The point I was trying to make is that diabetics are often advised not to eat fruit and as the paper I cited points out, that is not necessarily good advice. As you pointed out, Chart 5 compared studies analyzed when participants ate plant FIBER, and chart 4 compared studies when participants ate fruit FIBER. But if you look at Table 3 which highlights the results in ALL the categories that this study examined you’ll see that the relative diabetes risk when participants ate WHOLE FRUIT ONLY vs. WHOLE VEGETABLE ONLY was exactly the same (91%). Also notice that relative risk in both these categories were less than FRUIT & VEGETABLE or FRUIT or VEGETABLE FIBER alone. Perhaps the antioxidant/phytonutrient properties of the WHOLE fruit or vegetable has protective properties. As you stated they did find that the berries were particularly protective but berries are particularly high in antioxidants and phytonutrients so perhaps the nutrients trump the sugar. An interesting study would be to compare eating berries alone to eating berries with bananas and see if there is any difference in diabetes risk.
          In any case my view and advice to patients is to eat a WIDE VARIETY of fruits and vegetables in their whole unprocessed state whether diabetic or not.


            I agree on wide variety of veggies but absolutely not on the fruits. There’s far too many that are sugar bombs that do little else but fuel glycation and that’s not good for anyone, diabetic or not. Statistically when the sugar calories and fiber calories are compared in each fruit, the % of calories as fiber is significantly lower in ALL fruits than in ALL vegetables except the high starch ones. If fiber is going to play any part in reducing or helping to modulate glycation, then the vegetables, nuts and beans lead the way with fruit being far less important above and beyond this evaluation of multiple studies. So if the whole fruit only and whole vegetable only was exactly the same, that doesn’t support the idea that whole fruits are superior to whole veggies at all. This conclusion is tied up in their math evaluation of the many studies (chart 3) they tried to equate and lay out on an even playing field. I don’t know of anyone who ever recommends that diabetics NEVER eat fruit but I DO know and fully understand why a lot of them recommend eating only the lowest in sugar and highest in fiber berries-type fruits and unripe bananas because the ripe bananas are glycation killers in yellow coats and that’s not what diabetics or anyone else for that matter need at all. As we no longer need or use as much personal energy as we did even 50 years ago, the entire energy needs equation is really hard pressed to justify the 279 carb grams recommended in the ADA Diabetic Plan. That represents 1,116 calories of carbs alone when the main goal for diabetics should be weight reduction to reduce the fat that constantly interferes with the metabolism and doesn’t really get much of a chance at reducing the visceral fat clogging the pancreas, especially given the problem that first fat (visceral fat in the pancreas and other internal organs) has the greatest initial effect on diabetes/pre-diabetes. Higher carb intake also hijacks the daily energy cycle and that interferes with weight reduction, keeps that diabetic medicine coming though. Also, that same 279 carbs can be the “advice” for a 1200 calorie diabetic client and very top heavy on breads that can raise blood glucose more than a large Snickers bar. That doesn’t leave much room for calories for other nutrients needed BEYOND energy needs when the gas tank is overflowing to begin with. Totally meshuge.

    • Paul

      Eat the F/V you like. Then you will be motivated to continue eating them. You can branch out later to other F/V you’ve never tried or believe you may not have enjoyed in the past.

  • Carol

    My advice is to state the problem, review or summarize what you are going to say, state it again, show how and then go on with the longer message. Make it short. 3 minutes or less for the summary.

    • John

      I think he did that, but it was a bit longer, I think, because people on this site put his useful information into practice. I think everything was about the topic.

    • mbglife

      Most of his videos are under 3 minutes. And even if they weren’t. It’s not long. I think you’re just being picky, not to mention missing the point.

      • Paul

        I love that about his videos. Personally I’m not motivated to sit and watch a video longer than about 5:00. Not because I don’t have the attention span but because I’m too busy.

    • Dave

      I thought it was informative and put together well. Do you have videos up on the Internet using your format?

    • NFModeratorRonda

      Hi Carol, This video is actually the last of an extended six-part video series on the latest science on diet and kidney health. If you look under Dr. Greger’s doctors notes you will see a list of the videos in the series. This might shed some light on misunderstanding and you will better able to follow the video. You can click on the link and it will take you directly to the videos.

      I hope this clarify it for you.

    • Thea

      Carol: Thank you for the clarification on what you are thinking. Not everyone may agree with your analysis and preferences, but it really is helpful to see what issues you had. My opinion is that we don’t want NutritionFacts to be a site where people can’t offer constructive criticism.

      FYI: My thinking is that you just can’t please everyone. There are definitely going to be people like you who want super-short videos. And if you’ve been around a while, you will note that Dr. Greger’s videos used to average about 3 minutes. More recently, I’ve noticed that the videos tend to go longer. However, for me, I *greatly* appreciate the added information that Dr. Greger can include in say a 6-8 minute video over what can be covered in 2-3 minutes. When we had the shorter videos, there were many, many questions that came up that the videos did not have time to answer. Now the videos can cover some background information and give more details.

      As I said, that won’t please everyone. And I personally appreciate your second post which has details on what your preferences are. Thank you for sharing. That’s something to think about.

    • EvidenceBasedNutrition

      One thing I do — and I certainly recognize this is not for everyone — I watch the videos in double speed by clicking the gear icon on the bottom right of the YouTube window and increasing the playback speed. This is the best of both worlds for me — 3 minute video + more detailed content.

  • Rodrigo Cardoso
  • Sidney

    Walter Kempner, M.D. cured his patients of CKD (and many other diseases including diabetic retinopathy) by putting them on rice and fruits only diet. Literally just white rice and fruits, with some vitamins to supplement. The patients also lost significant weight and lowered insulin resistance. No fat or animal proteins. This was done 70 years ago at Duke University.

    • 2tsaybow

      There are several mentions of him here on the website, but I think that we have plenty of proof that the addition of whole foods, including whole grains, spices, fruits, nuts, and vegetables add all of the nutrients and fiber we need in our daily diet. Really the healing part of Kempner’s diet was the fruit, while he removed the poison in his patients diet by taking away the animal products. White rice is tasty, but not the best nutrient wise.

    • Rebecca Cody

      According to a recent talk by Dr McDougall, if Dr Kempner’s patients’ diets exceeded 5% protein he gave them WHITE SUGAR to lower the protein content! Yikes! But despite this, his diet worked for many.

  • geos

    At the risk of repeating myself in these forums, I will state that CKD is easily reversable on a WFPB diet such as Dr McDougall’s. I had CKD as well as a lot of other chronic issues as part of my Metabolic Syndrome. I not only stopped my declining eGFR but dramatically increased it well into the normal range in a year of following this diet and I have the numbers to prove it.

    And I kept a one year journal recording everything I did and ate every single day for the whole year if anyone is interested to see just how easy it was to do:

    Oh and the kicker to all this…I only have one kidney (donated kidney to sister that had Type 1 diabetes)…so despite the CKD and having only a single kidney I was still able to dramatically improve and normalize my kidney function.

    • payoung NF moderator

      That’s phenomenal Geos, you’re a real inspiration!

  • heathfan

    Off topic —
    A few questions

    I am trying to find easy and convenient ways to improve health & diet with nutritionally dense foods integrated almost daily.

    1 – Can anyone point me to a list of healthy smoothie recipes?
    I am interested in green smoothies.
    I would like to add any healthy ingredients Dr. Greger discusses.

    2- What are some creative ways to get more tumeric, ginger, green tea, flax, amla, etc?

    3- What other ingredients am I missing? Garlic, cinnamon

    Thank you!!!

    • payoung NF moderator

      Here are 11 great smoothie recipies you can try. A few of them contain ginger, flax and many other healthy ingredients. I’ve found the site to be an excellent site for ideas and plant based recipes.
      Congratulations on taking steps to improve your health naturally, keep it up!

      • heathfan

        Thank you!

    • Nick Presidente

      For me, I hide these things often into a lot of the one pot meals I make. Yesterday I made a tempeh/kidney bean chili with lots of flax, tumeric, ginger, garlic, nutritional yeast mixed in. The flavours are strong and bold and any additions generally will be covered up well. Tonight I made a red lentil sloppy joe, and I have a lot of the same ingredient in there, sometimes I make a red lentil curry, again you can put that stuff in and not taste it, keeping all your dishes unique.

    • Cathleen_NF_Moderator

      I just realized I answered your question as a new comment (right above yours) rather than as a reply. Hope it’s helpful!

    • As a corollary, is there a way to mask the taste of amla? I’ve tried it and frankly to met the taste is wretched.

      • heathfan

        a friend mentioned that he blends amla with clove — I personally can’t imagine how the two can comibine well as they both have such strong flavors. But my friend says it works for him… and clove is also quite high in anti-oxidants, etc.

  • Cathleen_NF_Moderator

    It’s great you’re working on improving your health and nutrition! Here are videos in which Dr. Greger talks about smoothies: I’ve also found pinterest to be a great source for recipes, you just want to be careful about ingredients with lots of sugar (i.e. those with a juice base or lots of sweetener). Many of the ingredients you mention can be blended into a smoothie (although I’m not sure how garlic would be…). One tip I have for getting more greens into smoothies–buy lots of greens all at once, wash them and then blend very fine with a little water. Freeze in ice cube trays. This way you don’t have to worry about your greens going bad so quickly. These cubes are also great for adding to soups, stews, etc. I’m sure you’ll be getting more tips from others here soon. Best wishes with your health journey!

    • Thea

      Cathleen: For a twist on your “greens, blend and freeze”: I just put the leaves in a big bag directly into the freezer without any blending. After freezing, I pull it out and squish the bag. The leaves crumble. So it’s like minced greens without the added water and blender step, and it still gets fairly compact. I find this works pretty well for myself. Especially since I hate trying to mince greens and this process is more fun. :-) Similar idea, just thought I would share my twist.
      Either way, it works great for making sure greens don’t go to waste as you say. There are a lot of recipes that may say only call for 1/4 cup of chopped cilantro. But I have to buy them by the little bundle… The really wise person would grow it themselves I think and just harvest what is needed each time. I’m just not that wise.

      • Cathleen_NF_Moderator

        Great tip, Thea. Thanks! Wish I had the green space and time (and yes, wisdom) to grow my own as well. We need more community gardens in big cities.

    • heathfan

      Great idea, thank you!

  • Matthew Smith

    More fruits and veggies for kidney function. Niacin can strip cholesterol from the arteries. Lysine and Vitamin C, from the Pauling therapy, to declog arteries in the kidneys. I hope more people live longer on kidney therapy. A kidney diagnosis sounds like a death sentence.

    • Alan

      I am just wondering – Do you sell supplements for a living ???

      • Matthew Smith

        No, thank you. I read many books about the use of vitamins to cure disease and found it is insatiable. You can put almost any disease into the internet followed by the world vitamins and come up with a meaningful treatment. Take hemorrhoids. They are common and extremely painful. I think in some cases they can be treated by Silicon or stinging nettle. I was surprised by joy by Orthomolecular Medicine which treats my mental illness. Stunned really. Dr. Pauling said an elemental deficiency is at the root of every disorder. Even anxiety can be treated by Selenium. Mental illness, Nitrogen from Niacin. There is a book Orthomolecular Medicine for Everyone which lays out the treatment of any disease by vitamins. I wish to spread the word. Vitamins as a treatment paradigm for the sick could save billions of dollars and much pain and shame. In at least many cases, a vitamin is the right thing to use.

        • Alan

          A whole food plant based diet will do the same thing, without the added cost and not taking the chance of causing an imbalance with the added supplement. Also do you know of anyone that has actually used those protocols and gotten any benefit from them.

          • Matthew Smith

            Vitamins are remarkable for their repeated results. Compliance is very low with the vegan diet. Dr. Greger has really shaped up America and gotten us to eat huge amounts less of meat. I do not think imbalances are a frequent outcome from vitamin supplementation, with the possible exception of taking too much Zinc (Copper levels lowered) . Dr. Greger is chipping away at mount improbable. I am incredulous at what he has achieved. I would ask if he gets threats from the meat industry. Most whole food is processed. Eating a single bit of chickweed from your lawn might be very curative, as it could not be processed. I believe most foods are heated, soaked, polished, rinsed, based, milled, and acidified, on top of being grown on damaged soils. This is very damaging to food. Lots of nutrition is lost from food. I do not know if a whole food plant based diet would as quickly cure you as would taking the right vitamin for the right disease. The work of these vitamin experts right now is being lost and it is at our peril. Drugs prove a poor solution to health problems compared to vitamins. Yes, I agree with you. If you were at a doctor, there response to most disease would be to eat more beans or more vegetables. It to me, seems to be half of the answer.

          • Alan

            In response to your last 2 sentences. I do not go to doctors because i eat a plant based diet and do not over eat, exercise and work hard, get plenty of sunshine and fresh air, drink plenty of water get adequate rest and trust in Divine power, which helps keep stress to a minimum. When i did go to doctors i never had any to tell me to eat more beans and veggies. I used to take vitamins and never could tell that they helped me. But each to their own.
            Also you failed to answer the question of do you know of anyone that has actually gotten help taking vitamin?

          • Matthew Smith

            People argue from experience, not evidence. My experience with vitamins was profound and very pleasurable. Dr. Hoffer treated 5,000 persons with mood disorders effectively with vitamins. Do you have a specific health concern? Nitrogen is the basis of every neurotransmitter. Nitrogen in the raw form used to make neurotransmitters comes from Niacin. It is very good for the mood. If you are not sick, then more power to you. I had many deficiencies going into my 30s. People estimate their is sickness coming from food processing as the supplementation program is reaching less. It’s poor medicine to use vitamins, which is why everyone would want it but no one can get it. I would love to know how to use vitamins as medicine. I would be the only one left! The Orthomolecular doctors have all died or retired. A few new converts? To be an Orthomolecular doctor is very filled with prestige.

          • Matthew Smith

            To answer your question specifically, you could see an orthomolecular doctor. They put you on every vitamin, at its highest dosages. They can dose high levels of vitamins. They know what the highest doses are. There strategy works miracles. They might be people who have Autism or ADHD, but if you developed a list of vitamins, all of them, and their highest dosages, you would have their program to perfect health. It is a brilliant approach, a craft lost to the world, from which their minds can part the true problem. They are scientists, doctors, experts, healers. You would search forever for the joy. The list a man very much like me was B complex, 3 grams Vitamin C, Niacin 2 grams a day, 3 grams Omega three, Zinc 50 mg. Their work is magic. They are never surprised it works. You could even teach people how to put them on every vitamin at large doses. They then take every vitamin (these and others) every day to treat the world. They are all gone. We are getting sick without them. I think Dr. Greger is eating every food for us. I hope health can be gleaned from these approached.

  • Clarence

    Not so fast, Dr. G! in you said: “Now baking soda is sodium bicarbonate, so this would add about a gram of
    sodium to our daily diet but sodium bicarb doesn’t seem to have the
    same effect of sodium chloride, or table salt. In this study those
    drinking the baking soda water had no change in blood pressure, and in
    the other study actually enjoyed a significant improvement in their
    blood pressure, but your physician will want to keep an eye on it.” Now, you seem to be changing your tune since you say: “sodium bicarbonate (baking soda), has sodium; so, doctors may be just adding another problem.” So, is baking soda a problem or not? If so, perhaps I should find a different way to DE-gas my beans and give up Irish soda bread. By the way, even though my eGFR is low, my blood pressure is perfect. The doctor wanted to give me a CT scan after an ultrasound didn’t show anything wrong with my kidneys. I opted for a MRI instead since I didn’t want to glow in the dark, and it found my kidneys to be normal. Could it be that my exercise routine suppresses my estimated flow rate by increasing creatinine at my advanced age?

    • Tom Goff

      I don’t see a contradiction here. Dr G hasn’t changed his tune. He quite clearly said, according to your quote, ” doesn’t seem to have the same effect of sodium chloride, or table salt.” in one video and “doctors may be just adding another problem” in the second video. Yet you are implying, incorrectly, that he categorically said it isn’t a problem in one video and categorically that it is in another. He is merely alerting us to potential issues.
      Baking soda isn’t a food so in principle it’s probably not a good thing to consume. However, if you are using it to “de-gas” beans you should be thoroughly rinsing the beans after soaking anyway and that will get rid of the baking soda.

      • Clarence

        The first quote by Dr. Greger indicates that baking soda is not harmful to blood pressure, while the second quote says that it is. Hence, the contradiction.

        • Tom Goff

          No. Read them again – it is there is black and white in your own quotes…….. “seem” and “may”.

      • easyout

        Nice clarification Tom. We as listeners can’t and shouldn’t get over accurate about food science. The body is still and probably will always be if we believe the good Lord doesn’t want us to figure out HIs creation, way to complicated to have exact science. Sure we can get close, but the listeners have to understand that even though science is supposed to be exact, we can only rely on these studies that aim for clarification but there will always be to many variables. The studies are also biased on the money side. There are certain positives, like we know what a salt is, but there are way different modes of operation with different salts on the body with the body being in different states of toxicity, and different detox pathways running at all times to be able to have any exact science on any particular individual, let alone all the other pathways, so how can there be any exacting effects, and therefore why Dr.’s have to use the words “seem” and “may”.

    • Dr.Jon_NF Volunteer

      Good question you raise, Clarence. Sodium bicarbonate is a good acid buffer, so it will reduce the acid load to the kidneys, which will improve kidney function (see Dr. G.’s other videos listed in the Doctor’s Note, above), and better kidney function is helpful for maintaining a healthy blood pressure. However, over the long term, increased sodium (of any type) causes a slow increase in blood pressure. So, why not just eat a healthy plant-based diet, which will reduce acid load to the kidneys, AND add little to no extra sodium?

  • Kevin MacArgel

    I guess everyone is entitled to their own opinion …………… is mine , I think Dr. Greger is part of what the world needs with his truth and caring about his fellow man/woman enough to spend his time pumping this information out there so we can make radical decisions about how we take care of ourselves and the ones we care about……………. the radical part is the departure from the environment of lies and betrayal from those we thought we could trust with our health OUR VERY LIVES!! Dr. Greger is true to the oath ……… Do No Harm!!! The Doc is RIGHTEOUS as he shows us the way through……….amongst the wicked with their drugs and scalpels they have as their answers to everything ………….. THANK YOU Dr. Greger YOU ROCK!!

  • Kaivay

    I was always a vegetarian and I loved cheese, but I started to realise how cruel milk production was but I still couldn’t give up cheese. But i was able to much more easily change to of a plant based diet when I found out the enormous health benefits of such a diet.

    So at heart, my diet is because of ethical reasons, but wow, it turns out to be so good for you!

    • Cathleen_NF_Moderator

      I have a similar story, Kaivay. I was never really a meat eater, but cheese? Delicious. Thinking about the ethical implications of animal products definitely helps. Thanks for your comment.

  • Charlene Harryman

    What about food combining? Does it make any difference in our health?

    • NFmoderatorStephanie

      Charlene, can you please be more specific regarding your question of food combining? Yes, foods usually are eaten in combination (I don’t know anyone who regularly eats only one food at a time). I always tell people a meal should contain at least 3 out of the 4 food groups (veg, fruit, legumes, whole grains) in order to be well-rounded and provide necessary nutrients. Overall, your daily food intake should be a balanced combo of all 4 food groups. Check out the PCRM power plate for a visual representation and more detailed info. Does that answer your question?

    • Wade Patton

      Combine your fruits and vegetables and greens and grains and nuts and seeds and everything will be o.k.

      It’s just about that simple. Don’t buy into anything more complicated. There’s no need. More animal products nearly always bring more problems.

  • Alan

    The key to good health and halting all diseases is in the produce market or our own backyard gardens.

  • June Ribaldi

    Your doing Great work Your Book is sensational Thank you for writing it .

  • Lori

    Is there a connection with the acid producing diet and respiratory rate? My meat eating, veggie hating, husband has a respiratory rate of 16-18 when he’s sound asleep. Isn’t that too fast? His mom died of congestive heart failure. I think it’s all connected. What is your opinion?

  • Bob Shields

    I recently began a modified renal, vegetarian diet and am having trouble getting enough protein since the usual sources, such as lentils, are off-limits due to the high potassium or phosphorus. Any suggestions? I am in stage 3B CKD and trying hard not to go into stage 4!

    • DrAlex

      Bob, Dr. Greger pointed to 2 articles in his video about potassium and phosphorus from plant sources (and, yes, beans count). The first article talked about phosphorus and the fact that when it comes from plant sources the phosphorus is absorbed at only about half the rate when compared to animal sources. The secondary article mentioned potassium, and he stated the alkalinizing effect of a plant-based diet helps you to excrete potassium more easily. Given that you are at Stage IIIB, I’m assuming that you are not having to take specific mediations to lower your phosphorus or potassium levels. Usually that happens with progression to Stage IV or V. Since you are wanting to avoid progression, I would highly advise going to an all plant-based diet, and honestly, I think in the realm of plants you should be allowed to eat whatever you want…lentils/beans and all. I’m a family physician and not a nephrologist so you may want to get your nephrologist’s thoughts if one is following you. If you are not seeing a specialist, consider talking with your primary physician. I hope this helps. Good luck to you.

  • Kat Kamp

    I have a friend who has PKD, it runs in her family. Her sister and mom died from it, and she’s on dialysis. Her nephew also has it, but he’s only 20 – her, her mom, and sister, all went on Dialysis in their 40’s. Would a vegan diet help him delay dialysis or would it even make a difference in this sort of inherited kidney disease?

  • Sabin

    Six years ago, at the age of 26, I was diagnosed with a renal artery stenosis caused by fibromuscular dysplasia. I was rushed to the ER and my BP was 247/174 and I had a minor stroke that luckily resulted in no long term affects. I am on a mountain of hypertension drugs that have my condition under control for now. I always assumed I would end up on dialysis in my 40’s. I have recently started a WFPB diet, While I have not been on the diet long enough to know if there are any positive results, anecdotally, I feel much better. Perhaps there IS some light at the end of the tunnel.

    Is there any reason to believe FMD may be reversed or controlled on a vegan diet, or am I one of the few people that may be on hypertension medication for life?

  • Jon Travis

    Does NutritionFacts have a diet recommendation for people with modest hyperkalemia (5.3 mmol/L)? Elevated blood potassium is one indication of the beginning of chronic kidney disease. Mine is ostensibly due to BPH and natural aging. I have mostly been a low-SOS vegan for about 2 yrs, but many vegetables and fruits are high in potassium and it would be difficult to remove those foods from the diet. Dr McDougall has a short article on diet and kidney disease in one of his Newsletters (July 2007, Vol 6, No 7), but the article is too short and ambiguous to be of much help.

    • Thanks for your comment Jon.

      Although this question requires an individualised diet. According to the Manual of Dietetic Practice:

      “Hyperkalaemia becomes increasingly common as GFR falls. Dietetic advice to treat hyperkalaemia can allow ACE inhibitors or ARBs to be continued, facilitating the optimal treatment of hypertension and proteinuria (NICE, 2008a). However, as potassium levels at the lower end of normal are not advisable, it is important to ensure that the diet is not too restrictive. The lowest mortality risk may be between 4.1 and 5.5mmol/L (Korgaonkar et al., 2010). The aim of a low potassium diet is to control serum potassium levels within an acceptable range whilst encourag- ing a well balanced diet. The level of potassium restriction should be individualised according to dietary intake, blood levels and medical treatment, but intakes of approximately 1mmol/kg of IBW may be required. In practice, this involves limiting or avoiding those foods with high potassium content. Non-essential foods should be limited or avoided first, e.g. coffee and chocolate. Fruit, vegetables and potatoes contain significant amounts of potassium, but as the latter are important components of most diets, they should not be restricted unnecessarily. Cooking methods may need to be adapted, e.g. boiling potatoes and vegetables lowers their potassium content. There is evidence that some people have been found to have low serum vitamin C levels on a low potassium diet (Pollock et al., 2005). Nowadays, people should be able to consume up to five 80-g portions of fruit and vegetables daily, but should also be provided with appropriate education on limiting or avoiding those that are particularly high sources of potassium, e.g. bananas and dried fruit.”

      On the other hand, PCRM also has some useful information on Nutrition and Renal Disease that you can read.

      Hope this answer helps!

  • Noah99

    Dear Dr.Greger (or anyone else who is kind enough to help),

    My mother has always had issues with her kidney. Yesterday her doctor told her, that her kidney is calcified. The Doctor told my mom, that she has to watch her potassium intake now and gave her a list with all kinds of foods, all kinds of meat, veggies, fruit, nuts and grains. The list contains the amount of potassium each food has.

    Basically, she is allowed to eat everything that has less than 400 mg of Potassium per serving, so she can’t eat potatoes, broccoli or spinach anymore, including many more health foods.

    She is basically on a vegan diet, and having to watch her potassium intake that much is really limiting her diet. She can only eat rice with a limited amount of veggies and some fruit.
    Obviously she is really upset about it and scared that if she eats too much, she is going to damage her kidneys. This makes me worry real bad, because I don’t think she is getting the right amount of nutrition this way.

    So my question is, even with calcified kidneys, does she really have to watch her potassium intake that much? I mean can’t she even eat health foods like broccoli, potatoes and beans anymore, because they have more than 400mg of potassium?

    I would really, really appreciate an answer, as like I said, I’m really scared about her mental and physical health.
    Thank you.

    • DrAlex

      Noah99, I appreciate your concern as I hear this frequently from patients. First, I’m a family physician, not a nephrologist so I would run anything I say by your mother’s nephrologist for their thoughts. The reason potassium is such a concern with kidney disease is not that the potassium hurts the kidney itself, but it’s that the kidneys don’t function properly to be able to get rid of potassium that is eaten and a high potassium in the blood stream is very dangerous, so that’s where the concern lies. Might I suggest two things to look at. 1) Look at a list of low-potassium vegetables that she can eat and enjoy and 2) look into the process of “leaching”, a way to help rid some vegetables of some of their potassium they have so that she can enjoy a little more of them. Both of these items are addressed on the National Kidney Foundation’s webpage at the following link: Potassium and Your CKD Diet. I hope this helps a little. Best to you and your mother!

      • Noah99

        Thanks! I will definitely look into your suggestions.
        Thanks again!

  • joe marvin

    muy bien

  • Barbara

    I have Polycystic Kidney Disease (PKD). I’ve been on blood pressure medications for a few years now and I’m only 30. I’ve been told that PKD can raise my blood pressure. I know the importance of keeping my blood pressure as low as possible as to not do more damage to my kidneys. But I haven’t been able to find anywhere in my research that PKD actually causes high blood pressure. I’m currently vegetarian and working towards a more vegan/plant based diet. I would love to get off of my blood pressure meds using a plant based diet. But I’m afraid that with my PKD I would need to take these meds all my life. Any advice?

  • Javed Hussain

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