Chronic kidney disease (CKD) patients who consume a diet high in vegetables rather than meat may prevent the accumulation of toxic phosphorus levels, according to a study published online Dec. 23 in the Clinical Journal of the American Society of Nephrology.Sharon M. Moe, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues conducted a crossover trial in nine patients with a mean estimated glomerular filtration rate of 32 ml/min to compare vegetarian and meat diets containing equivalent nutrients prepared by clinical research staff.
The investigators found that one week of a vegetarian diet led to lower serum phosphorus levels, decreased phosphorus excretion in the urine, and reduced fibroblast growth factor-23 levels compared with a meat diet, despite equivalent protein and phosphorus concentrations in the two diets.
“In summary, this study demonstrates that the source of protein has a significant effect on phosphorus homeostasis in patients with CKD. Therefore, dietary counseling of patients with CKD must include information on not only the amount of phosphate but also the source of protein from which the phosphate derives,” the authors write.
Tips for Managing Food Allergy
Get a professional diagnosis. Don't try to diagnose a food allergy yourself. If you suspect that your child has a food allergy, discuss this with your doctor. He or she can advise you accordingly and may refer you to an allergist for additional testing and treatment if needed. You should work with your doctor and/or allergist to develop an action plan for managing the allergy through indicating which foods your child should avoid, and possibly prescribing medication, such as an antihistamine or, for severe reactions, self-injectable epinephrine (EpiPen® or Twinject®).
Pass around the plan. Give your child's food allergy action plan to people who regularly see your child, including relatives, caregivers and their friends' parents.
See an Accredited Practicing Dietitian. An APD like Nastaran can help you and your child identify foods and ingredients to avoid, and develop an eating plan to ensure your child gets all the nutrients needed to grow and develop properly. For example, if your child is allergic to milk, the dietitian will recommend other calcium-containing foods and beverages.
Always read food labels. Always read food labels to see if the product contains any of the eight major allergens, or other ingredients your child is allergic to. Since food and beverage companies continually make improvements, read the label every time you purchase a product. Teach your child how to read labels, too.
Get support at school. Meet with staff at your child's school to review and distribute your child's food allergy action plan. At minimum, involve your child's primary teacher, the school nurse (if there is one), and key food service staff. Make sure all supervisory staff your child sees during the school day and during after-school activities have a copy of the plan. It is highly recommended that school administrators, teachers, and even food service staff are aware of the food allergy action plan in the absence of a school nurse.
Be cafeteria cautious. Go over the school lunch menu with your child to identify foods to avoid. Work with food service staff to plan substitutions or pack a lunch for your child to take to school. Remind your child not to share or trade food with others and make sure they know which staff can help if they have questions about a food, or if they have a reaction to a food. Be sure your school food service staff has copies of the School Foodservice and Food Allergies information sheet and review it with them when you talk to them about your child's food allergies.
Ask questions when eating out. Most life-threatening allergic reactions to foods occur when eating away from the home. Explain your child's situation and needs clearly to your host or food server—and teach your child to do the same when you're not with them. If necessary, ask to speak with the chef or manager. Some fast food restaurants provide a list of the ingredients in their menu items, as well as information on whether any of the eight major allergens are present.
Keep an allergy-safe kitchen. Rather than singling out your food-allergic child, prepare allergy-free recipes the whole family will enjoy.
Make peers “allergy allies.” Encourage your child to talk openly with friends and classmates about their allergy, what foods they must avoid, and what could happen to them if they don't. Suggest that your child enlist their friends in helping them “stay on the alert” for foods in question so they won't get sick.
Most importantly, be ready for emergencies. Teach your child the possible symptoms of a serious allergic reaction (anaphylaxis), such as difficulty breathing or swallowing, or tingling in the hands, feet, lips or scalp. If they experience symptoms after eating a food, make sure they know to immediately call 0-0-0 and, if prescribed by your allergist, use their medication to treat the reaction. If possible, have your child wear a medical alert bracelet or necklace that identifies the specific allergy. Every few months, “role play” an allergic reaction to make sure your child knows what to do.
For more information and resources on managing food allergies see Nastaran or your doctor.
Source: International Food Information Council