Survey reveals why nephrology professionals might not recommend plant-based diets
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Nephrology professionals may not routinely recommend plant-based diets to patients with kidney disease due to concerns over patient acceptance and their ability to follow the diet plan, according to survey results.
The results, presented virtually at the National Kidney Foundation Spring Clinical Meetings, also highlighted a lack of patient knowledge regarding the benefits of such diets.
Melanie Betz, MS, RD, CSR, CSG, LDN, chronic kidney disease nutrition and education specialist with University of Chicago Medicine, told Healio Nephrology that she designed the survey to gain a better understanding of how frequently plant-based diets are adopted by this patient population, as well as to explore potential barriers that may limit recommendations.
“I found that [plant-based diets] were being discussed quite a bit in the literature, and in professional communities, but patients seemed to be unaware of them — and even afraid of them — in online CKD groups I help with,” she said.
For the study, Betz and colleagues administered questionnaires to 657 health care professionals, 58% of whom were registered dieticians and 53% of whom worked in dialysis, and 844 patients, 35% of whom had non-dialysis-dependent CKD and 35% of whom had a kidney transplant.
Despite 79% of health care professionals indicating plant-based diets can be an effective lifestyle modification for treating CKD, only 56% reported that they recommend the diets to their patients.
“My research showed that the most common reason [plant-based diets] are not recommended is low perceived patient acceptance and that they are not realistic for patients,” Betz said. “I found this surprising because I had guessed that concerns over electrolyte abnormalities would be a much bigger barrier to recommendation.”
Among patients, most reported that the eating preferences of their families, their personal preference for meat and meal planning were the primary challenges to following a plant-based diet.
Betz contended it is critical not to view incorporating plant-based diets as an “all-or-nothing” approach.
“We need to meet patients where they are and encourage plant-based diets to the extent patients can or are willing to follow them,” she said.
According to Betz, it is not necessary for patients to completely stop eating meat; just one to two “meatless meals” per week could help reduce protein and dietary acid load, thereby slowing CKD progression, she said.
Regarding specific methods to increase adherence to plant-based diets, both professionals and patients ranked counseling sessions with a registered dietician as most beneficial.
“Recommending early dietitian intervention can help patients make these dietary changes,” Betz said. “Dietitians have the time and expertise to help patients learn how to implement plant-based diets.
“I also think it may help to frame nutrition interventions as a way to slow CKD progression, rather than just, ‘this is good for your kidneys.’ Patients are usually very interested in what they can do to prevent dialysis, and plant-based diets can do this.”
More information on nutrition in kidney disease can be found at: www.thekidneydietitian.org/.
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Betz M, et al. Abstract #336. Presented at: National Kidney Foundation Spring Clinical Meetings (virtual meting); April 6-10, 2021.
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