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A diet low in salt, sugar and saturated fat can help delay kidney damage, writes Meera Murugesan
EATING habits are like a second skin and the most challenging lifestyle habit to shed.
We develop a taste for certain foods in childhood and it becomes a hurdle to change those habits as adults, even when we know they are unhealthy.
Many of us procrastinate and rarely take steps to address our eating patterns. But isn’t it better to change before we are forced to do so?
TACKLING THE TONGUE
If you like salty food, you’re probably reaching for the salt shaker without even being aware of it or pouring ketchup on your food before tasting it.
If deep-fried food is your weakness, you’re likely to find meals prepared in any other way unappealing no matter how well-flavoured they are.
Foods high in salt, sugar and saturated fats are the biggest stumbling blocks. Not only do we consume such food when eating out but such items also find their way into our kitchen cupboards.
The end result is rising levels of diabetes and hypertension in the country — two leading causes of chronic kidney disease (CKD).
CKD is present in about 10 per cent of the adult population worldwide and is a major public health hazard, says Professor Dr Joel Kopple, professor of medicine and public health at the David Geffen School of Medicine UCLA and UCLA School of Public Health in Los Angeles.
Globally, more than 500 million individuals or one in 10 adults has some form of CKD. In Malaysia, about 50-60 per cent of CKD cases are due to diabetes and hypertension.
Kidney disease impairs the kidney’s ability to eliminate bodily waste which then remains in the system and can reach fatal toxic levels.
If left untreated, CKD can cause total kidney failure and patients have to go on dialysis to stay alive.
Even with this, patients are 20 times more likely to succumb to heart attacks, heart disease and stroke. More than four million Malaysians are at risk of chronic kidney failure.
Do we really want to wait till it’s too late before attempting a change in our eating habits?
EATING RIGHT
The problem today is not only what people are eating but that they are eating way too much of everything, says Dr Maria Chan, senior renal dietitian at the faculty of medicine, University of New South Wales, Australia.
She explains that, like many other developing countries, Malaysia is becoming more affluent and people have money in their pockets to enjoy good food. We no longer eat just for nourishment or to overcome hunger. Eating is now a form of relaxation.
The downside is that people eat way too much, way too often and look for taste rather than nutritional content. When this is coupled with physical inactivity, obesity rates bloom and non-communicable diseases flourish.
But Chan says, change must happen, even if it happens gradually. And we should start in our kitchens.
AVOID OVER FLAVOURING
Use less salt when preparing meals and gradually, our tongues will become used to the natural flavours of food.
Add fresh herbs and spices, lemon juice or even home-made broth to enhance the flavour of dishes instead of reaching for bottled sauces.
“There is no one particular food that’s good or protective for the kidney. Rather, it’s our whole eating pattern that plays a key role,” says Chan.
While it’s not wrong to add traditional flavouring agents such as soya sauce or fish sauce in our food, we should be careful of how much and how often we use these.
PICK WISELY
When purchasing canned or packaged food, it’s important to read and understand the labelling in order to avoid those high in saturated fat, sugar and salt.
Chan says canned food is convenient and we do need it in our busy lives today but it’s important to choose wisely.
For example, a can of baked beans is high in fibre and good for the body but ensure that the salt content in it is not high. Similarly, canned lentils are a good source of protein and can be used in a variety of ways to make different healthy meals and canned tuna is a good accompaniment for rice or noodles.
However, instant noodles are often high in salt and saturated fat, so these are not a wise choice as regular meals.
Chan says when buying canned or pre-packed food, consumers should look for labels that clearly state “no added salt”. This means there is no additional salt added to the product. It only contains the natural sodium in ingredients.
On the other hand if a product label says “salt reduced”, it’s not necessarily a good thing. “Salt reduced can mean reduced from a very high level, so it’s still really bad. It’s a term that can be quite misleading,” she adds.
Dr Kopple says many people in Asian countries may be getting more sodium than needed because of the frequent use of flavouring agents during meal preparations.
“Years ago, the highest prevalence of hypertension was in the northern islands of Japan because they loved soya sauce but the Japanese government embarked on a long progressive campaign to lower sodium intake and it is working.”
WESTERN WOES
Another problem in developing countries is that growing affluence means people consume a Western diet more regularly. This has contributed to obesity, another risk factor for CKD.
Chan says the traditional Asian diet is a good example of a healthy balanced meal with carbohydrate- based foods like noodles and rice, some of which are also high in fibre and plenty of fruit and vegetables.
Protein is usually a medium-sized serving to complement the rice, fruit and vegetables.
However, today, more Asians are eating large chunks of salty, fatty meat. Meat is no longer a complement but the main portion of the meal like in a western diet while fruit and vegetables have been significantly reduced.
Dr Kopple agrees. He says in America, obesity and diabetes was at one time extremely uncommon among the native American Indians in New Mexico and Arizona but today it’s a raging epidemic.
This happened because not only did they switch to a Western diet when they became affluent but they also stopped their traditional daily activities which required physical movement.
“It’s a situation that’s killing them, not to mention what it’s doing to the quality of their life,” says Dr Kopple, adding that while many people with CKD do progress to end stage kidney failure and eventually require dialysis, most people don’t.
They actually die much earlier from other causes, usually from various forms of heart disease. They don’t even live long enough to need to go on dialysis.
This further highlights the tragic consequences of a lifestyle that, with education and early exposure, can be prevented.
NEVER TOO LATE
WHILE making dietary changes is important for those who want to remain healthy and avoid kidney disease, it’s equally crucial for those who have already been diagnosed with the disease.
Renal dietitian Dr Maria Chan says that when a person has been diagnosed with early stage kidney deficiency, diet can play a major role in slowing down the progression of the disease.
At the onset, the kidneys may still be able to function reasonably, so a kidney-friendly diet can help slow down the advancement of the disease. This means it may take much longer for patients to get to the stage where they will need dialysis.
“There is actually a long gap between the onset of the disease to the time they may actually need dialysis, so intervention can take place during this stage, “ says Chan.
EATING HEALTHY
When kidneys can no longer do their job, patients have to control the type and amount of food that they consume.
The National Kidney Foundation Malaysia recommends that patients work with a dietitian to come up with a daily eating plan which meets their nutritional needs, cut down the workload of the kidneys and control the build-up of food waste.
The diet should also reduce symptoms patients may face such as fatigue, nausea, itching and a bad taste in the mouth. It should also control the effects of high blood sugar if the patient is diabetic.
However, each person has different needs, depending on their age, medical history and kidney function. A dietitian will work with the patient to design an individual daily eating plan that’s right for him.
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