Inflammation and Chronic Kidney Disease: The Dietary Fiber Connection
Low dietary fiber intake is a chronic problem in most Westernized diets. Our love of refined grain products, juices instead of fresh fruit, processed and fast foods, sweets and salty snacks, limited vegetable intake and narrow use of whole grains, beans, nuts and seeds has resulted in a fiber intake around 10 to 14 grams of fiber a day. In comparison, the Institute of Medicine recommends 14 grams for each 1000 calories, which is around 25 grams for females, 38 grams for males and 19 to 25 grams for children each day.
The Renal and Urology News article cited a recent analysis published in Kidney International that looked at fiber and inflammation data from over 14,000 participants from the third National Health and Nutrition Examination Survey (NHANES). C-reactive Protein (CRP), a marker that indicates a person’s degree of system-wide inflammation, was compared to dietary fiber intake from a 24-hour diet recall. In patients with chronic kidney disease and glomerular filtration rate (GFR) below 60, for each 10 grams of increased fiber intake there was a 38% decreased chance of having elevated CRP (above 3 mg/L). In other words, higher fiber intake is associated with lower inflammation. In non-CKD participants there was an 11% decrease chance of having elevated CRP. The CKD group also had lower mortality with higher fiber intake.
Some reasons suspected that higher fiber intake may reduce CRP and inflammation are:
- Fiber may lower the glycemic load of carbohydrates that are digested and absorbed rapidly.
- Adiponectin, a hormone made in fat cells, helps regulate glucose and fat metabolism, and has anti-inflammatory properties. A high fiber intake has been linked to higher levels of this hormone in the blood.
- Bacteria in the gut produce toxins such as phenols, indoles, and amines that can contribute to inflammation. People with kidney disease have higher levels of these toxins because the kidney is no longer excreting them. A high fiber diet may decrease the amount of these toxins produced and absorbed into the bloodstream.
- Fruit and vegetable provide a source of alkali and may help decrease a condition called acidosis, often seen in dialysis and CKD patients.
Despite following a kidney diet, you can still find ways to increase fiber in your diet. Be sure you eat the suggested number of fruit and vegetables recommended in your meal plan. Include an apple with the peeling. Look for a breakfast cereal that contains at least 4 grams of fiber. Snack on unsalted popcorn. Try high-fiber white bread. Ask your dietitian for suggestions on ways you can increase fiber intake.
Try some of my favorite higher fiber, kidney-friendly recipes:
Kidney diet resources from DaVita.com
- Review and rate recipes
- Discussion Forums
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- DaVita Diet Helper
- Phosphorus ChallengeTM
- Food Analyzer
- DaVita Cookbooks