Low Protein Animal and Plant Diet for CKD patients And their Nutritional inadequacy

A recent study in Journal of Renal Nutrition reports that omnivorous low protein diet (LPDs), both vegan and lacto-ovo LPD are more likely to be deficient in several EAAs and other essential nutrients when compared.

A low-protein diet is often recommended to help treat certain health conditions. Impaired liver function, kidney disease or disorders that often interfere with protein metabolism are some of the most common conditions that may require a low-protein diet. In recent years, some research has also found that low-protein diets may extend longevity and offer protection from chronic disease.

The nutritional adequacy of both animal-based and plant-based low protein diets (LPDs) and moderate protein diets (MPDs) that are recommended for patients with chronic kidney disease (CKD)however not been well examined.

Dr Dina A. Tallman, PhD, RD and team therefore aimed to analyze the nutrient content of three representative LPDs and MPDs (lacto-ovo vegetarian, omnivorous, and vegan) containing foods that are likely to be prescribed for non-dialyzed CKD or chronic dialysis patients in the United States to determine the nutritional adequacy at different levels of protein intake.

A Theoretical three-day menus was developed according to current renal dietary guidelines to model each diet at seven different levels of protein intake (0.5–1.2 grams/kilograms body weight/day [g/kg/d]). The diets were analyzed for their content of essential amino acids (EAAs) and other essential nutrients.

The key findings of the study are

•At an a priori recognized inadequate dietary protein level of 0.5 g/kg/d, all three diets failed to meet the Recommended Dietary Allowances (RDAs) for the following EAAs: histidine, leucine, lysine, and threonine.

•The omnivorous LPD met both the RDA and Estimated Average Requirement (EAR) at levels of 0.6 g protein/kg/d or greater.

•The lacto-ovo and vegan diets at 0.6 and 0.8 g protein/kg/d, respectively, were below the RDA for lysine.

•The amounts of several other vitamins and minerals were not uncommonly reduced below the RDA or Adequate Intake (AI) with all three LPDs.

Researchers ended that, "In comparison to omnivorous LPDs, both vegan and lacto-ovo LPDs are more likely to be deficient in several EAAs and other essential nutrients. In order of provide sufficient amounts of all EAA, vegan and lacto-ovo LPDs must be carefully planned to include adequate amounts of appropriate dietary sources. Supplements of some other essential nutrients may be necessary with all three LPDs."

Reference: Dina A. Tallman, PhD, RD, Ban-Hock Khor, PhD, Tilakavati Karupaiah, PhD, RnD, Pramod Khosla, PhD, Maria Chan, PhD, RD, Joel D. Kopple, MD Nutritional Adequacy Of Essential Nutrients In Low Protien Animal- And Plant-Based Diets In The United States For Chornic Kidney Disease Patients; DOI:https://doi.org/10.1053/j.jrn.2022.10.007