A practical approach to a low protein diet in Brazil

Abstract

BackgroundChronic kidney disease (CKD) is an emerging health public problem in Brazil. Nutritional counseling with focus on protein restriction is a promising strategy to treatment of nondialysis CKD patients due its effects on slowing renal loss. However, Brazilian people have high protein intake, which is a challenge when low protein diet (LPD) should be prescribed. This review describes a practical approach to the dietetic management of nondialysis CKD patients in Brazil.DiscussionAlthough Brazilian cuisine varies greatly by region, Brazil has current trends of incorporating Western dietary habits, including high intake of red meat. Traditional plant-based foods, such as rice and beans, are also important contributors to the high protein content to the Brazilian diet. Thus, a successful implementation of LPD requires adaptation of these dietary habits, with reduction of portion sizes and adequate food substitution options. Intensive nutritional counseling with specialized renal dietitians is also important to improve compliance to the LPD. Moreover, the precarious health system organization and economic problems are barriers to nutritional care, which could be solved with intensive and specialized perspectives of treatment.SummaryThe adherence to protein restriction is important for better metabolic and clinical control of nondialysis CKD patients. Early dietetic attention, nutrition education strategies and intensive specialized nutritional counseling are essential to achieve diet habits that promote adherence to the LPD without excluding cultural characteristics of the Brazilian diet.

Chronic kidney disease progression: a retrospective analysis of 3-year adherence to a low protein diet

“…During the follow-up time, the dietitian improved the nutritional approach to increase the LPD adherence through some strategies: (a) adaptations in usual diet to incorporate the protein restriction to habitual meals and food habits (e.g., options for nocturnal snacking are provided for patients with prefer do not dining); (b) the use of replacement list of food to avoid diet monotony (e.g., one egg can be substituted by half steak portion); (c) use of portion sizes by measuring tools (with use of replicas of food and kitchen utensils) and photograph albums; (d) Analysis of the label of foods to patients learned where find the data about amount of protein per portion of processed foods; (e) stimulation to improve the meals with specific receipts of low protein content. 23 In fact, to maintain the LPD over time, the diet prescribed has to be pleasant, varied and not too restrictive. 12 Thus, the intensive counseling (up to 3 months apart) by a skilled dietitian, as performed in the present study, is highly recommended.…”

Coronavirus Disease 2019: Quick Diet and Nutrition Guide for Patients With Chronic Kidney Disease

“… 8 A healthy meal plan and lifestyle may help regulate blood pressure and blood glucose levels, as well as improve immunity. 9 , 10 , 11 , 12…”

“…Milk and other dairy products, legumes (e.g., beans), and high-fat meats should be limited in the diet according to the diet prescription. 11 It is also essential to maintain proper hydration (except for those undergoing chronic hemodialysis who follow a more restricted fluid intake).…”

‘Let food be thy medicine…’: lessons from low-protein diets from around the world

“…In countries such as Australia or the US, in which the normal protein intake is well above 1.2 g of protein per kg of body weight per day, a feasible dietary protein reduction would probably be a protein intake of 0.8 g/kg/day. A similar intake may be needed in poorer countries, for balancing malnutrition [16, 32, 33]. …”