DASH Diet and CKD

Chronic kidney disease (CKD) affects millions of people worldwide, and its prevalence continues to rise. Managing CKD requires a comprehensive approach for lifestyle, medical and nutrition modifications. You’ve probably read about the benefits of a plant-based diet or Mediterranean diet for CKD. But there is one other diet that has been shown beneficial for delaying progression of CKD. That is the Dietary Approaches to Stop Hypertension (DASH) diet. This diet has gained popularity for its impact in managing hypertension or high blood pressure. But let’s take a look at the benefits of the DASH diet and CKD.

Diet and CKD

Diet plays an important in managing CKD. An appropriate diet can help control blood pressure, reduce proteinuria (excess protein in the urine), maintain electrolyte balance like potassium or phosphorus, and prevent the progression of kidney disease by making the kidneys work better. The DASH diet, initially developed to combat high blood pressure, offers a great way to achieve these goals for delaying the progression of CKD. But as high blood pressure is also a consequence of CKD, this diet can help prevent future complications.

DASH Diet Principles

1. Increased consumption of fruits and vegetables: The DASH diet emphasizes the consumption of fruits and vegetables rich in essential nutrients like magnesium or potassium, antioxidants, and dietary fiber. These components help lower blood pressure and reduce the risk of heart disease.
2. Whole grains as a staple: Whole grains like brown rice, whole wheat bread, and quinoa provide a good source of fiber and essential nutrients while avoiding refined carbohydrates. They additionally contribute to better blood sugar control and reduce the risk of cardiovascular complications.
3. Lean protein sources: The DASH diet recommends lean protein sources such as fish, poultry, legumes, and low-fat dairy products (which provide calcium for blood pressure management). These options provide necessary protein while limiting the intake of saturated fats and cholesterol, which can contribute to heart disease.
4. Reduced sodium intake: Excessive sodium consumption can worsen hypertension and fluid retention in CKD. The DASH diet encourages the reduction of sodium intake by choosing fresh ingredients, using herbs and spices instead of salt, and avoiding processed foods high in sodium.
5. Limited intake of saturated fats and sweets: The DASH diet advises reducing the intake of saturated fats, such as those found in red meat, full-fat dairy products, and tropical oils. And it  promotes the consumption of healthy fats, such as those found in nuts, seeds, avocados, and vegetable oils like olive oil. It suggests limiting saturated fats and avoiding trans fats, which are commonly found in processed and fried foods.
6. Additionally, it suggests limiting the consumption of sweets and sugary beverages to manage weight and blood sugar levels.

DASH Diet Recommendations

The DASH eating plan recommends foods based on serving sizes:

For a 2000 calorie diet an individual would need:

Grains: 6 to 8 servings a day. One serving is one slice whole grain bread, 1 ounce dry cereal like all bran buds, or 1/2 cup cooked cereal, whole grain rice or pasta.

Vegetables: 4 to 5 servings a day. One serving is 1 cup raw leafy green vegetable, 1/2 cup cut-up raw or cooked vegetables, or 1/2 cup vegetable juice. 

Fruits: 4 to 5 servings a day. One serving is one medium fruit, 1/2 cup fresh, frozen or canned fruit.

Fat-free or low-fat dairy products: 2 to 3 servings a day. One serving is 1 cup milk or yogurt, or 1 1/2 ounces cheese.

Lean meats, poultry and fish: six 1-ounce servings or fewer a day. One serving is 1 ounce cooked meat, poultry or fish, or 1 egg.

Nuts, seeds and legumes: 4 to 5 servings a week. One serving is 1/3 cup nuts (almonds =7 g protein), 2 tablespoons peanut butter, 2 tablespoons seeds, or 1/2 cup c 

Fats and oils: 2 to 3 servings a day. One serving is 1 teaspoon soft margarine, 1 teaspoon vegetable oil, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.

Sweets and added sugars: 5 servings or fewer a week. One serving is 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

What To Eat On The DASH Diet and CKD

You may be wondering what can I eat when following a DASH diet? Nutrition can be overwhelming and confusing for those with kidney conditions. Depending on one’s level of function they may have two nutrients of concern (sodium and protein) or four (sodium, protein, potassium and phosphorus). Nutrition is also something that is much more than nutrients and food. It is impacted by socioeconomic status, access to cooking tools/facilities, one’s food skills, as well as their available time to prepare foods. Find foods that patients are already eating and teach them how to make into DASH eating plans is one strategy for success. Following a DASH eating plan does not need to be complicated, here are some examples of what balanced meals can look like.

DASH Diet and CKD Benefits

The DASH diet offers a balanced and effective dietary approach for individuals with CKD. By emphasizing whole foods, limiting sodium intake, and promoting heart-healthy choices, the DASH diet can help manage blood pressure, preserve kidney function, and reduce the risk of cardiovascular complications.

1. Blood pressure management: Hypertension is a common complication of CKD. The DASH diet’s emphasis on fruits, vegetables, whole grains, and lean proteins, along with its low sodium content, helps reduce blood pressure and maintain kidney function.
2. Heart health promotion: Cardiovascular disease is a significant concern for individuals with CKD. The DASH diet’s focus on healthy fats, lean and plant-based proteins, and whole grains supports heart health by reducing the risk of coronary artery disease and stroke.
3. Kidney function preservation: The DASH diet’s emphasis on whole, unprocessed foods promotes overall health and can help preserve kidney function by reducing the workload on the kidneys and minimizing inflammation.
4. Weight management and diabetes control: The DASH diet’s nutrient-rich, low-calorie approach can aid in weight management and blood sugar control, particularly for individuals with CKD and diabetes.

The DASH Diet For Health

A DASH diet can help to reduce blood pressure in just 2 weeks and is one way to help preserve your kidney function. And this diet is reviewed in my group program The Kidney Connection to help you preserve your kidney function. If you’re looking for support with your nutrition and CKD, the doors are open and your spot is saved. 

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This article was written by Rachel Rosenberg, Nutrition Student Volunteer.
This article was reviewed by Emily Campbell, RD CDE MScFN.