The New Nordic Diet: phosphorus content and absorption

Salomo, Louise; Poulsen, Sanne Kellebjerg; Rix, Marianne; Kamper, Anne-Lise; Larsen, Thomas Meinert; Astrup, Arne

doi:10.1007/s00394-015-0913-2

Cited by 11 publications

(4 citation statements)

References 26 publications

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“…The NND [24] has been tested in different populations, with promising results regarding the cardiovascular risk profile, and the Nordic diet has been recognized by World Health Organization to represent a healthy alternative to the Mediterranean diet [25]. We investigated whether the NND could serve as a recommended diet in CKD patients by estimating the phosphorus content and absorption of the NND; however, this was not the case in its present form [23]. We modified the NND into the NNRD by removing the most phosphorusrich food items, such as rye bread, dairy products, nuts and fish but still keeping in mind a nutritiously well-balanced diet with a phosphorus content of $850 mg/day (Tables 1 and 2).…”

Section: Development Of the Nnrdmentioning

confidence: 99%

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Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

Salomo

Rix

Kamper

et al. 2018

Nephrology Dialysis Transplantation

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Abstract Background The New Nordic Diet is a food concept favouring organically produced food items, fruits, vegetables, whole grains and fish. We investigated the short-term effects of a modified phosphorus-reduced New Nordic Renal Diet (NNRD) in chronic kidney disease (CKD) patients on important parameters of phosphorus homoeostasis. Methods The NNRD contained a total of 850 mg phosphorus/day. A total of 18 patients, CKD Stages 3 and 4 were studied in a randomized crossover trial comparing a 1-week control period of the habitual diet with a 1-week period of the NNRD. Data were obtained at baseline and during 1 week of dietary intervention (habitual diet versus NNRD) by collecting fasting blood samples and 24-h urine collections. The primary outcome was the difference in the change in 24-h urine phosphorus excretion from baseline to Day 7 between the NNRD and habitual diet periods. Secondary outcomes were changes in the fractional excretion of phosphorus, fibroblast growth factor 23 (FGF23) and plasma phosphate. Results As compared with the habitual diet, 24-h urine phosphorus excretion was reduced in the NNRD by 313 mg/day (P < 0.001). The mean baseline phosphorus was 875 ± 346 mg/day and was decreased by 400 ± 256 mg/day in the NNRD and 87 ± 266 mg/day in the habitual diet. The 24-h urine fractional excretion of phosphorus decreased by 11% (P < 0.001) and FGF23 decreased by 30 pg/mL (P = 0.03) with the NNRD compared with the habitual diet. Plasma phosphate did not change. Conclusion This study demonstrates that dietary phosphorus restriction in the context of the NNRD is feasible and has positive effects on phosphorus homeostasis in CKD patients.

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Section: Development Of the Nnrdmentioning

confidence: 99%

“…The diet is very similar to the Mediterranean diet, but with replacement of, for example, olive oil with rapeseed oil, garlic with rams, etc. We have previously tested the phosphorus content of the NND and did not find it suitable for the CKD population in its present form [23].…”

Section: Introductionmentioning

confidence: 99%

Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

Salomo

Rix

Kamper

et al. 2018

Nephrology Dialysis Transplantation

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“…Our group has previously developed the New Nordic Renal Diet (NNRD) with a reduced phosphorus content and tested the short-term effect on phosphorus homeostasis in moderate CKD. 8 9 NNRD is a modification of the New Nordic Diet (NND), which was developed in 2004 in Copenhagen, Denmark. 10 NND was designed as a Scandinavian counterpart to the Mediterranean diet and has been investigated in large studies regarding parameters on weight loss among obese individuals, blood pressure, lipid metabolism and blood sugar.…”

Section: Introductionmentioning

confidence: 99%

“…The main source of phosphorus is protein-rich food; and in a typical western diet, more than half of the protein load originates from animal protein where the bioavailability is high compared with vegetable sources. Our group has previously developed the New Nordic Renal Diet (NNRD) with a reduced phosphorus content and tested the short-term effect on phosphorus homeostasis in moderate CKD 8 9. NNRD is a modification of the New Nordic Diet (NND), which was developed in 2004 in Copenhagen, Denmark 10.…”

Section: Introductionmentioning

confidence: 99%

Study protocol: long-term effect of the New Nordic Renal Diet on phosphorus and lipid homeostasis in patients with chronic kidney disease, stages 3 and 4: a randomised controlled trial

et al. 2021

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IntroductionChronic kidney disease (CKD) causes severe disturbances in phosphate metabolism. New Nordic Renal Diet (NNRD) is a new dietary concept designed by the present research group that aims to offer patients with moderate CKD a whole food approach with a markedly reduction in dietary phosphorus intake, corresponding to 850 mg/day. The present protocol describes a randomised controlled trial aiming to test the long-term effects of dietary intervention with NNRD versus a non-restricted habitual diet on important parameters of phosphorus and lipid homeostasis.Methods and analysisThis trial will be executed at the Department of Nephrology, Rigshospitalet, University of Copenhagen, Denmark. Sixty patients aged >18 years with CKD stages 3 and 4 (estimated glomerular filtration rate between 15 and 45 mL/min) will be recruited and randomly assigned to the intervention or control group. The other inclusion criterion includes a medically stable condition for at least 2 months prior to the start of the study. Exclusion criteria are treatment with phosphate binders, metabolic disorders that require specific dietary regulation, pregnancy and breast feeding, any types of food allergies or those who are vegans. The observation period is 26 weeks including seven study visits at the outpatient clinic combined with a weekly telephone consultation in both groups. A follow-up visit 3 months after study completion finalises the intervention. The primary outcome is the difference in the change in 24-hour urine phosphorus excretion from baseline to week 26 between the two study groups. Secondary outcomes include changes in phosphate-related and lipid metabolism-related blood and urine biochemistry, blood pressure and body composition. Moreover, we wish to explore adherence to the diet as well as quality of life.Ethics and disseminationThe study has been approved by the Scientific Ethical Committee of the Capital Region of Denmark and the Danish Data Protection Agency. The results of the studies will be presented at national and international scientific meetings, and publications will be submitted to peer-reviewed journals.Trial registration numberClinicalTrials.gov (wwwclinicaltrialsgov) Registry (NCT04579315).Protocol versionThe protocol, version 2, has been approved by the Ethical Committee Denmark on 18 September 2020. The protocol has also been approved by Data Protection Regulation and Data Protection Law on 15 September 2020. This study protocol is in accordance with the Standard Protocol Items: Recommendations for International Trials.

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The effect of healthy Nordic diet on cardio-metabolic markers: a systematic review and meta-analysis of randomized controlled clinical trials

2018

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The New Nordic Diet: phosphorus content and absorption

Abstract: Contrary to expectations, the NND had a high phosphorus intake and did not decrease the fractional phosphorus excretion compared with ADD. Further modifications of the diet are needed in order to make this food concept beneficial regarding phosphorus absorption.

Cited by 11 publications

References 26 publications

Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

Study protocol: long-term effect of the New Nordic Renal Diet on phosphorus and lipid homeostasis in patients with chronic kidney disease, stages 3 and 4: a randomised controlled trial

The effect of healthy Nordic diet on cardio-metabolic markers: a systematic review and meta-analysis of randomized controlled clinical trials

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