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July 2011: Vegetarian diet fights chronic kidney disease


In the Western diet phosphorus is ingested primarily in the source of meat protein and dairy products, as well as food preservative and/or additive. Individuals with chronic kidney disease (CKD) cannot adequately rid the body of phosphorus and, therefore, must limit its intake as high levels of the mineral can lead to heart disease. While medical guidelines recommend low phosphorus diet for patients with CKD, very often phosphorus content is not listed on food labels. Besides, the patients are advised to follow a phosphate restricted diet but the source of phosphate is rarely considered. In relation to this, the purpose of new medical study was to determine if the dietary source of phosphate (meat/casein or vegetarian/grain) influences mineral metabolism in humans. The study has shown that vegetarian diet has a positive effect on serum phosphorus levels and on the homeostatic response to dietary phosphate intake [1]. As a consequence, eating vegetables rather than meat can help kidney disease patients avoid accumulating toxic levels of phosphorus in their bodies.


Main text:

Disturbances in mineral metabolism may lead to serious health complications. In the case of phosphorus, with excess presence in typical Western diets, it has been shown that increased serum phosphorus is associated with chronic kidney disease [1], and increased cardiovascular events and mortality [2, 3].


Protein sources of phosphate in a diet may be animal or plant in their origin and a study on the effects of vegetarian and meat-based diet on phosphorous levels in patients with kidney disease has recently been conducted by a team of scientists at Indiana Clinical Research Centre [1]. In this study patients were applying a vegetarian or meat-based diet for one week, followed by the opposite diet two-to four- weeks later. In order to determine phosphorus levels, blood and urine tests were performed at the end of each week for both diets.


Despite almost equivalent protein and phosphorus concentrations in the two diets, results have demonstrated that patients had lower blood phosphorus levels and decreased phosphorus excretion in the urine when they were on the vegetarian diet compared with the meat-based diet. The authors consider a lower phosphate-to-protein ratio in a plant-based diet as a possible reason for this difference. Likewise, much of the phosphate is in the form of phytate which is not absorbed in humans.


Since the study indicated the importance of the protein source of phosphate in mineral metabolism after only 7 days of controlled diets, the authors have concluded that dietary counselling of patients with kidney failure must include information on not only the amount of phosphorous but also the source of protein from which it derives.


Although further studies are needed, vegetarian sources of protein are recommended since it has been evidenced that they facilitate phosphorus homeostasis by allowing protein intake without adversely affecting phosphorus levels.


By: Svetlana Obradovic and Luuk Simons


[1] Moe, M. S., M. P. Zidehsarai, M. A. Chambers, L. A. Jackman et. al. (2011). Vegetarian compared with meat dietary protein source and phosphorous homeostasis in chronic kidney disease. Clin J Am Soc Nephrol 6, doi: 10.2215/CJN.05040610



[2] Tonelli, M., F. Sacks, M. Pfeffer, Z. Gao, G. Curhan (2005). Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation 112, pp. 2627–2633.



[3] Narang, R., D. Ridout, C. Nonis, J.S. Kooner (1997). Serum calcium, phosphorus and albumin levels in relation to the angiographic severity of coronary artery disease. Int J Cardiol 60, pp. 73–79.


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