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low protein diet side effects
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What is a low-protein diet?
A low-protein diet is a diet that limits the amount of available protein. Generally used for acute nephritis, uremia, and patients with liver failure.
The daily protein supply is about 0.5 grams per kilogram of body weight, and the total amount is generally limited to 20-40 grams (including animal and vegetable protein). depending on the situation. Within the limited range. an appropriate selection of high-quality protein, such as milk, eggs, lean meat, fish, shrimp, etc., is required.
For a long time:
the low-protein diet has been widely used in the clinic as an important measure to delay. the progression of chronic kidney disease.
The basic principle is based on. the long-term control of protein intake in the diet. which can significantly reduce the state of glomerular hyperfiltration and hyper metabolism. thereby reducing. the high pressure of residual nephrons and delaying. the rapid deterioration of renal function. In addition.
a low-protein diet can reduce proteinuria and improve metabolic acidosis in patients with renal insufficiency. Studies have shown that controlling.
a high-protein diet can prevent or improve endocrine disorders such as secondary hyperparathyroidism. directly or indirectly regulating some production.
Of the cell growth factors. and some vasoactive substances have a good effect on reducing. the inflammatory response of renal tissue. all of which are also beneficial for CKD patients to reduce. the workload of the residual nephron.
Sensitive indicators of dietary protein:
consumption and protein metabolic status of patients. and the degree of proteinuria is the most important indicator for assessing the prognosis of CKD. When the kidney function is normal.
the protein in food is digested and absorbed. and degraded. and some proteins and amino acids are absorbed and used. the body to maintain the normal physiological function of the human body.
and some are degraded. To produce nitrogen-containing wastes such as urea nitrogen, etc. which are excreted by the kidneys.
In renal insufficiency:
the ability of the kidneys to excrete these metabolic wastes is greatly reduced. and protein catabolic wastes. such as urea, creatinine, and guanidine, accumulate in the blood.
If you eat a lot of protein at this time, it will increase the glomerular filtration load. and the metabolites of these proteins will accumulate in the body. which will worsen the patient's condition.
A low-protein diet can reduce. the generation and accumulation of protein catabolism, and protect kidney function by reducing glomerular hyperperfusion and high filtration. thus reducing the high-load working state of residual nephrons. delaying glomerular sclerosis and renal function. Incomplete progression.
the main modality:
Therefore. low-protein nutritional therapy.is the main modality of treatment without dialysis for patients with chronic renal insufficiency.
With the introduction of the glomerular ultrafiltration theory in. the 1980s, the application of low-protein diets in chronic kidney disease has received more attention.
Studies by Cianciaruso et al confirmed that reducing dietary protein intake can improve the acid-base. and phosphorous disturbances, relieve clinical symptoms. and patients with chronic kidney disease will not be at risk of malnutrition.
Theoretically, optimal protein intake should satisfy three requirements. as far as possible. namely delaying renal failure and reducing hematuria symptoms. avoiding malnutrition as much as possible. and ensuring patient compliance.
However, patients who follow a long-term low-protein diet. will suffer from malnutrition and calcium metabolism disorders.
Nutritional therapy is one of them. the important methods of treating polyuria. and it is especially important to enhance the nutritional care of patients in clinical practice.
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nutritional principles:
A low-protein diet is dominated by animal protein for the following reasons:
More essential amino acids can be obtained, which is useful in correcting the deficiency of amino acids in the body.
Maintain patient nutrition, enhance body resistance and reduce infection.
If protein intake is reduced and tissue protein breakdown is reduced, it will cause negative nitrogen balance and cause malnutrition.
Studies have shown that a low-protein diet improves appetite and inhibits albumin metabolism in uremic patients by reducing or even correcting acidosis;
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In the past:
patients mistakenly believed that a low-protein diet ate only a few vegetables. and it was strictly forbidden to eat chicken, duck, eggs, milk, lean meat, fish, and other high-protein foods, for fear of exacerbating the condition.
Vegetables are rich in vitamins and cellulose, and the protein content is very little, 1% to 3%, which does not meet the needs of the body.
A low-protein diet requires a daily supply of 20 grams of high bioequivalent protein to maintain the nitrogen balance in the body. and a reduction in protein intake will lead to malnutrition. which will lead to a negative nitrogen balance in patients, leading to hypoproteinemia and exacerbation of the disease.
Therefore, low-protein diets should choose high-quality animal proteins with essential amino acids, such as eggs, milk, lean meat, fish, etc. to promote urea reuse, reduce blood urea nitrogen and increase plasma protein.
The staple food is starch:
to ensure adequate calories, and reduce vegetable protein intake.
High-quality proteins such as eggs, and milk. and lean meats are the main sources. and foods with. as low protein content as possible are used as the main source of calories.
Uremic substances that cause urination in the blood are protein metabolites. so protein intake should be limited.
But you cannot completely avoid protein, because protein is a nutrient. If you don't eat protein. your body will break down muscle and cause urine, so you need to adjust your diet appropriately.
1/2 to 2/3 of high-quality protein should be included in the protein, such as eggs, milk, meat, etc. The use of vegetable protein in. the body is low, and uremia is easy to worsen after metabolism. so it should not be eaten casually, and please use it according to the instructions of the nutritionist.
Examples of these foods are:
1. Beans and soy products: soybeans, tofu, dried tofu, soy milk, red beans, red kidney beans, kidney beans, kidney beans, peas, and other beans.
2. Gluten products: gluten, sausages, baked pasta, etc.
3. Fruit with a core: melon seeds, walnuts, cashews, peanuts, chestnuts, almonds, etc.
4. Rice noodles and cereals: rice, noodles, bread, noodles, corn, sweet potatoes, taro, potatoes, etc.
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Calories:
For people with renal insufficiency, sufficient calories are needed to promote effective protein utilization. Eat more foods that are high in calories and very low in protein.1. Oils:
salad oil, peanut oil, corn oil, sunflower oil, sesame oil, etc. When cooking, use more oil for frying, or use cooking methods such as frying and frying. When cooking, use more oil for frying, or use cooking methods such as frying and frying.2. Low protein starch:
pure flour, corn starch, lotus root flour, winter flour, noodles, sago, flour balls, low protein rice flour, etc., to make all kinds of delicious snacks.
3. People with normal blood sugar can add sugar (white sugar, rock sugar, honey, ginger candy, fruit candy, etc.) to foods, drinks,
or snacks to increase calories.
4. Low-protein rice:
Low-protein rice with almost zero protein content can be chosen as the usual staple food, which not only ensures calorie intake but also ensures the absorption of high-quality protein.diet:
High-Quality Low Protein Foods for Chronic Kidney Disease
Eat two eggs a day, or two eggs from lean pork, or one or two crucian carp, do not eat too much, as t will increase the burden on the kidneys.
Eat two balanced meals. The most important thing is to be in a good mood, do not get tired, not get angry, not catch a cold, and just want to get better. Happiness is more important than medicine.
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Long-term problems with low-protein diets:
From the actual clinical application, the problems caused by a long-term low-protein diet are also more prominent, mainly reflected in the following aspects:(1) Clinical implementation:
is difficult. According to the recommendation of the current Dietary Guidelines for Kidney Diseases in China. patients with CKD stage 3 and above should control. the intake of high-quality protein to 0.3-0. 6 g/(kg/day), and the daily protein intake for patients weighing 70 kg is only 40 g / day approx. According to this criterion. there are too few optional ingredients. the range of recipes is too narrow to meet. the daily needs of patients with kidney disease. and many patients suffer from malnutrition due to a lack of protein and calories.(2) It is difficult to convert low-protein:
ingredients into traditional food. To ensure that the protein does not exceed the standard.in addition to supplementing animal protein with high essential amino acids.
basic rice can be limited to about 2 taels (100 grams) per day. and other ingredients should be replaced with starch-rich ingredients.
Generally difficult for the Chinese to Adapt to it. especially since the food made of wheat starch after protein extraction is difficult to form and tastes very bad. so it can not be eaten as a staple food by the majority of CKD patients for a long time.
The same is true of clinical facts, as quite a few chronic kidney patients cannot tolerate it. the extreme hunger caused by a low-protein diet. and some abandon adherence to diet therapy. the difficulty of adapting to the taste of wheat starch components.
A large number of clinical studies :
have also found that patients. who stick to a low-protein diet for a long time have a higher incidence of malnutrition.
According to literature reports. the incidence of abnormal protein and energy metabolism in CKD patients can be as high as 56%-87%. and the incidence of malnutrition in CKD patients who enter dialysis treatment is high.
It is clear that this high rate of malnutrition. is closely related to the long-term dietary control of CKD patients and inadequate calories. and other nutrients.
Therefore, from a clinical point of view. a low-protein diet is a double-edged sword. and it is easy to become a limitation if not properly assimilated. restricting the natural supplementation of essential nutrients and calories in CKD patients. directly affecting the quality of life of kidney patients. chronic.
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