Predominantly Vegetarian Diet in Patients with Incipient and Early Clinical Diabetic Nephropathy: Effects on Albumin Excretion Rate and Nutritional Status

Abstract

Several studies have suggested that dietary protein quality may be an important determinant in the natural history of renal disease. We have therefore studied the effects of a predominantly vegetarian diet in eight patients with Type 1 diabetes mellitus and an albumin excretion rate (AER) in excess of 30 micrograms min-1. The AER was measured after an 8-week run-in period on the patient's usual diet, and again after 8 weeks of a predominantly vegetarian diet in which the proportion of vegetable protein was supplemented in order to minimize the reduction in total dietary protein intake. The median fractional albumin clearance fell during the study from an initial value of 188 x 10(-+) (range 58-810 x 10(-4)) at the end of the run-in period to 87 x 10(-4) (23-829 x 10(-4)) at the end of the period on low animal protein diet (difference 79 x 10(-4) (95% Cl 9-149 x 10(-4)), p less than 0.05). The AER then returned to values similar to those obtained at the beginning of the study after a further 8 weeks in those patients returning to their usual diet. No significant changes in blood glucose control or in arterial pressure were observed. A predominantly vegetarian diet may therefore have important beneficial effects on diabetic nephropathy without the need for a heavily restricted total protein intake.

Protein intake and urinary albumin excretion rates in the EURODIAB IDDM Complications Study

“…The statistically significant relationship between intakes of total protein and AER was observed for animal protein, but not for vegetable protein, a finding which supports other evidence of the specially deleterious effect on renal function of animal protein [21,24,27,56]. Since long-term compliance to low-protein diets is often poor [21,22] a modification of protein intake [22,25,27,28,56,57], substituting vegetable protein for protein from animal sources, should be more fully explored as a feasible therapeutic approach which would also reduce total fat and saturated fatty acid consumption.…”

“…Since long-term compliance to low-protein diets is often poor [21,22] a modification of protein intake [22,25,27,28,56,57], substituting vegetable protein for protein from animal sources, should be more fully explored as a feasible therapeutic approach which would also reduce total fat and saturated fatty acid consumption. While high protein intakes were a unanimous finding in all EU-RODIAB centres [32] the pattern of food groups providing protein/animal protein may vary considerably across European countries.…”

Beneficiary effect of dietary soy protein on lowering plasma levels of lipid and improving kidney function in type II diabetes with nephropathy

“…In this crossover randomized clinical trial, the patients were asked to follow a diet containing 0.8 g/kg protein (70% animal and 30% vegetable protein) for 7 weeks (Jibani et al, 1991). After a washout period of 4 weeks consuming the prestudy diet, subjects were readmitted to repeat the same cycle while consuming a similar diet with 0.8 g/kg protein containing 35% soy protein, 30% vegetable protein and 35% animal protein.…”

Dietary soya protein during pregnancy and lactation in rats with hereditary kidney disease attenuates disease progression in offspring

“…Dietary manipulation with a vegetarian soya diet for as little as 8 or 16 weeks in nephrotic patients decreases proteinuria and vegetarians exhibit lower glomerular filtration rates than omnivores (Bosch et al 1983;Kontessis et al 1990;Barsotti et al 1991;D'Amico et al 1991;Gentile et al 1993). In diabetic patients, soya protein interventions have been shown to reduce glomerular hyperfiltration, proteinuria or albuminuria (Jibani et al 1991;Azadbakht et al 2003;Teixeira et al 2004;Stephenson et al 2005). Due to practical limitations, however, human studies to date have been of short duration and have not examined the effects of soya protein on renal histological damage.…”