fresh-focus-94-lets-talk-kidneys
[Speaker 2]
You are listening to the Fresh Focus Podcast, where VA dietitian nutritionists are serving up health and wellness information for veterans and their families. In addition to being in clinic, chatting over the phone, or using Video Connect, we are increasing your access with this podcast, giving advice and veteran experience on topics that are most important to you.

[Speaker 1]
Welcome to the first Renal Nutrition Fresh Focus Podcast. My name is Morgan O'Hara, and I'm here with Anel Chida, like the animal. We are advanced practice renal dietitians from Buffalo, New York and Orlando, Florida VAs.

If you don't know what renal is, that's okay, because that's what we're here to talk about. Renal is just a fancy term for kidneys, and we're here to talk about kidney nutrition. Right.

Now wait, before you turn this podcast off thinking that you won't need it because you don't have kidney disease, you might want to ask yourself, do you have kidney disease? Because it's possible that you do have it and don't even know about it. Yeah.

According to the Centers of Disease Control and Prevention, the CDC, an estimated one in seven US adults, that's about 35.5 million people or 14% of the adult population is estimated to have chronic kidney disease or CKD. That's a bit shocking to hear those statistics. Yeah.

What's even more scary is that as many as nine in 10 adults with CKD don't even know they have it. And as many as one in three adults with severe CKD also don't know they have it. Unfortunately, I have seen this in practice quite often.

I will have veterans come in to meet with advanced kidney disease to say, stage four, or even those about to start dialysis, who weren't even aware that there was a problem until recently. I know I've seen the same thing here. Let's break this down to why CKD is so prevalent.

And let's let our listeners know to just don't get overwhelmed with this. I think a big part of this is that most people don't have any signs or symptoms of early kidney disease. So it often goes undetected until later stages.

A lot of people may not be even thinking about their kidneys or aware that they could even be a problem. It's always a good idea to understand any lab work and talk to your provider about your risks for developing CKD, especially if you have high blood pressure or diabetes, because these are the two biggest risk factors for kidney disease. I have veterans who are in stage four and didn't realize it, didn't even know they had stages one through three for many years, and then got referred to the dietician and then found out they do have stage four.

And, you know, we're very scared and overwhelmed for sure. You may even be thinking, what do kidneys even do? I know they make urine, but what else?

Kidneys are small, but necessary organs. The kidneys filter and clean blood in the body 24 hours a day, seven days a week, removing waste products and balancing fluids, minerals, electrolytes like sodium and potassium. The kidneys also help to control blood pressure and even make red blood cells for hemoglobin.

All of these things are impacted when you have kidney disease and the kidney function declines. Right. The kidneys are very important for our health.

Early detection and treatment can make your life a lot better and delay the disease. Even though kidney disease isn't reversible, it is treatable. And the earlier it's treated, the better chances of delaying progression.

And that means delaying dialysis. Now, your doctor might prescribe medications to help control blood pressure, blood sugar, and to protect your kidneys from getting worse. Outside of this, there's a lot that you can do, especially with your diet.

I had a veteran the other day who had CKD3. So he was right around the middle stages of chronic kidney disease. We were talking about his sodium, his salt intake, because he had mentioned that, you know, I don't add a lot of sodium to my foods, but his blood pressure was still high.

So what we did is we kind of went through what he ate on a daily basis. And it kind of showed that, even though he's not adding salt to his foods, he was choosing a lot of foods that were already high in sodium. He was getting some fast food, having a lot of convenience-style foods like microwave meals or TV dinners.

So once we actually changed up some of the things that he was eating, his blood pressure started getting better. And his kidney numbers have been stable for, I want to say, maybe six months so far. So yeah, diet does play a huge role in not only managing your chronic kidney disease, but also some of the things that can lead to the progression of the disease like hypertension or high blood pressure.

That is a great story. There are several important ways to manage kidney disease with nutrition. Yeah.

So like I kind of mentioned earlier, decreasing sodium or salt in your diet is very important for your kidney health. Sodium is a mineral in the body. It's involved in fluid balance and blood pressure control.

Sodium comes from most of the foods that we eat. In fact, about 70% of sodium comes from outside of the home. So not necessarily the salt that we're putting on our food.

It can be naturally in the foods or added during the processing and cooking of foods. Salt is made of sodium chloride and can be used to season, process, and preserve foods. Seasonings like table salt, monosodium glutamate or MSG, sea salt, and pink Himalayan salt are all forms of salt and sodium.

For kidney health, it's recommended to reduce sodium to less than 2,300 milligrams per day. And I don't know if you've ever tried to add that up, but it's really hard to stick to 2,300 milligrams or less per day if you're eating a lot of convenient style foods. So let's talk more about how we know how much sodium is in the food.

Because like you said, I mean, how do you count up 2,300 milligrams of sodium per day? Great question. All packaged foods and beverages have what's called the nutrition facts label.

This is where a person can read the amount of sodium per serving in that food. So the nutrition facts label has a lot of information on it. I recommend starting at the very top and reading down.

Begin with the serving size of the food product. For example, the food may say a half of a cup is a serving. That means that the rest of the label is based on that half cup serving.

So when you read sodium on the label, it's saying in a half of a cup of this food, there is this amount of sodium. If you eat more than a half cup, let's say a cup, then you'd have to account for that by multiplying the amount of sodium by two. Oh, yes.

That is one of the most common mistakes that I see with reading the nutrition facts label. When following a low sodium diet, I usually recommend choosing foods that have about 140 milligrams of sodium or less per serving because that is what's considered low sodium. If you are looking at the percentages on the label, lower sodium food choices have about 5 to 10 percent daily value per serving.

Generally, foods that have over 300 milligrams of sodium or 20 percent or more per serving are too high in sodium. You can also choose foods that are labeled low sodium or salt free. However, watch out for the term lower sodium because this doesn't necessarily mean low sodium.

This term is only claiming to be lower in sodium than the highest sodium product out there, which might still be really high. Generally, avoiding fast foods and ultra processed foods is a great way to limit sodium in the diet. Also, seasoning foods with as many herbs, spices, and salt free seasoning blends as you like.

Adding acids like lemon, lime juice, or vinegar can add a lot of flavor without using salt. Following these steps will help keep you on a low sodium diet for your kidney health. Another important way to preserve your kidneys is adding plant based foods to your diet.

I recommend adding whole plant based foods and those foods are like beans, unsalted nuts, nut butters, whole grain, soy, and tofu. These foods also have fiber to control blood sugars if you're diabetic and support a healthy gut. Plant based versus animal proteins do not produce the waste products that cause so much stress on the kidneys.

Exactly, so having let's say oatmeal with walnuts for breakfast instead of eggs and bacon would be considered plant based. Also, having a peanut butter sandwich on whole grain bread can replace cold cuts for lunch or a snack. These are some small changes a person can do without completely changing their diet.

Often when I talk about plant based foods, veterans are thinking I'm recommending going 100% vegan or they're also thinking that I'm recommending plant based foods or meatless burgers for example. These are plant based replacements for hamburgers. These types of processed plant based foods are okay in moderation but because they are processed they have more sodium and more chemical additives which are not healthy for the kidney.

So, if you want more help with recommendations for plant based foods and meals, I recommend contacting the nutrition department at your VA to schedule an appointment with the dietician. I'm so glad we were able to talk about this today. I hope it inspires our veterans listening to check in with their primary care teams about their own kidney health to ensure any kind of review of lab values and associated risk factors for chronic kidney disease.

Absolutely, yes. That's the goal to get the veterans with CKD to for one know that they have it and to know what stage they're in and then number two get them into a nutrition appointment sooner to preserve their kidney function. That way they can make sure they are doing everything possible to save their kidneys for as long as possible.

Absolutely, Annelle. I could not agree more. Well, we'd like to thank our listeners for tuning in today.

Be sure to check back for more talks about kidney health.