inflammation or rather the nature of foods that are high in fiber.
Two possible reasons why fiber intake is so powerful:
1. Dietary fiber sustains and modulates the gut microbiome,
as fiber is essentially “fuel” for the good bacteria in the
gut.
2. Fiber-rich food groups may contain antioxidant and anti-
inflammatory properties.3 Some kidney-friendly sources
of dietary fiber include many fruits and vegetables.
Legumes and whole grains are also a great source of fiber
although may be higher in potassium and phosphorus.
They can fit into many renal diet regimens, but patients
should discuss adding these with their renal dietitian. The
following table is a list of food substances that are good
sources of fiber and lower potassium and phosphorus
options.
Food Item
Amount
Fiber (g)
Potassium
(mg)
Phosphorus
(mg)
Apple 1 medium 4 195 20
Blackberries ½ cup 4 117 16
Pear 1 small 5 172 16
Raspberries ½ cup 4 93 18
Green beans 1 cup 4 183 36
Green peas ½ cup 4 88 62
Chickpeas ½ cup 5 83 65
Black beans ¼ cup 5 167 62
Barley ½ cup 4 77 61
Omega 3 fatty acids/fish oil
Supplements of omega 3 fatty acids or fish oil have shown
promising anti-inflammatory effects in some recent research.4
These effects on inflammation are likely due to the ability of
these fatty acids to combat oxidative stress and downregulate
pathways of inflammatory cytokines.4 Both supplements and
diet have been shown to be effective. Fatty fish are a great
source of dietary omega 3’s and include: salmon, mackerel,
herring, trout, and tuna.
Prebiotics and Probiotics
Prebiotics and probiotics may have anti-inflammatory effects,
according to some studies, presumably due to their actions of
modulating the gut microbiome. 1 Prebiotics are the fibers that
are food for the good bacteria in your gut. Probiotics consist
of supplements containing the actual bacteria that are good
for your gut. Currently, there isn’t much conclusive evidence
of the benefits of prebiotics/probiotics for CKD patients.
However, one study has shown reduced inflammation with
probiotic supplementation in animal models. This leads us to
believe there would be little harm, and possibly some benefit,
to supplementing with a probiotic food.1 We need more
data!
Physical Activity
Physical activity has a multitude of benefits in healthy and CKD
populations. Experts suggest that in patients with pre-dialysis
CKD, 6 months of regular walking exercise (30 minutes per day
5 days weekly) has anti-inflammatory effects.1 Therefore, an
evening walk around the neighborhood may be a great step
toward reducing inflammation and slowing the progression of
CKD.
Knock out that Fire!
Taking small steps to reduce inflammation in your lifestyle can
pay dividends. Increasing fruit and vegetable intake, eating
more fish, and getting exercise can be important lifestyle
habits. Talk with your dietitian and physician about ways to
incorporate more diet, lifestyle, or supplement approaches to
decrease inflammation.
1.
Oleh, A. Frederick, K. Update on Inflammation in Chronic Kidney Disease. Blood Purification.
2015;39:84-92
2.
US Department of Health and Human Services. Glomerular Diseases. National Institute
of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-
information/kidney-disease/glomerular-diseases. April 2014. Accessed January 18, 2018.
3.
Vidya, R. Guo, W. Bradley, C. et al. High dietary fiber intake is associated with decreased
inflammation and all-cause mortality in patients with chronic kidney disease. Kidney
International. 2012;81(3):300-306
4.
Kelei, L. Tao, H. Jusheng, Z. Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on
C-reactive Protein, Interleukin 6 and Tumor Necrosis Factor a: A Meta-Analysis. PLoS ONE 9(2):
e88103.
5.
http://www.scielo.br/scielo.php?pid=S0482-50042012000300009&script=sci_arttext&tlng=en
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