"Chronic Kidney Disease Patients Confirm Mediterranean Diet Effectiveness and Safety"
Oct 22, 2024
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A research team led by Professor Lee Ji-won of Severance Hospital's Family Medicine Department, Professor Kwon Yong-jin of Yongin Severance Hospital's Family Medicine Department, and Professor Lee Jung-eun of Kidney Medicine announced on the 22nd that the Mediterranean diet improves metabolic acidosis and protects kidneys without affecting potassium levels in chronic kidney disease patients.
Patients with chronic kidney disease have an increased risk of hyperkalemia as their ability to discharge potassium decreases due to decreased renal function. Hyperkalemia can cause arrhythmia and in severe cases can lead to cardiac arrest. Along with potassium, protein intake also requires caution. Proteins can create nitrogen waste products during metabolism, putting a strain on the kidneys and promoting the progression of renal failure.
Excessive restriction of potassium and protein intake by patients can lead to nutritional imbalances as they eat carbohydrate-oriented meals. With these available nutrients limited, the U.S. Kidney Foundation cited the Mediterranean diet as one of the recommended diets for chronic kidney disease patients in the 2020 Kidney Disease Outcomes Quality Initiative.
The Mediterranean diet is characterized by eating a lot of unsaturated fats such as fruits, vegetables, and olive oil and reducing red meat and saturated fat intake. However, there has been a lack of research on whether high-calorie foods such as melons, bananas, spinach, auk, and potatoes included in the Mediterranean diet are safe.
The research team developed a 'Korean Mediterranean balanced diet' reflecting Korean eating habits and compared the effectiveness with the existing patient diet in patients with renal failure. The research team created a diet that did not deviate from the existing Mediterranean basic principles and reduced sodium, protein, and potassium intake. Sodium intake was reduced and the proportion of protein intake was 0.8g per kilogram, 0.2g lower than that of the existing Mediterranean diet, through methods such as eating Sungnyung instead of soup. Grains, fruits, and vegetables are foods that contain a lot of Mediterranean food, so fruits and vegetables are removed, boiled, or blanched so that dietary fiber can be increased and potassium can be reduced.
Fifty patients with renal failure, whose kidney function decreased by 15-59% compared to normal, were divided into two groups of 25 patients each. The two groups compared changes in kidney function and nutrient intake after 4 weeks of cross-consumption of Mediterranean and conventional patient diets.
Patients on the Mediterranean diet had an increased intake of dietary fat, dietary fiber, and niacin, while sodium and copper intake decreased. Total carbon dioxide levels, which are important for maintaining the body's acid-base balance, have also increased. It can help manage metabolic acidosis commonly seen in patients with kidney disease.
In addition, potassium intake increased slightly after diet intake, but there was no change in potassium levels in serum and urine. The results showed that patients with severe kidney function could safely consume Mediterranean diet. The kidney function of the patients ingested was also well maintained.
Professor Lee Jie-won stated that "Mediterranean diet could be a new breakthrough in the health care of patients with chronic kidney disease" and "'This study, especially with Koreans, will provide an important scientific basis for dietary management of patients with kidney disease.'
Meanwhile, the study was supported by a high value-added food technology development project run by the Agriculture, Food and Rural Affairs Technology Planning and Evaluation Institute under the Ministry of Agriculture, Food and Rural Affairs, and the results of the study were published in the international journal Frontiers in Nutrition.
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