High-Protein Diets Can Hurt Kidneys

[clavicula]

High-Protein Diets Can Hurt Kidneys, Damage Stems From Proteins Found in Meat

By Sid Kirchheimer
WebMD Medical News Archive
Reviewed By Michael Smith, MD
on Monday, March 17, 2003

March 17, 2003 --

http://my.webmd.com/content/article/62/71623.htm?z=2731_00000_0000_ep_04

High-protein diets like that of the popular Atkins diet may accelerate the loss of kidney function in people with early problems. However, these controversial diets do not seem to affect people with normal kidneys, suggests new research.


The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.


"There are no symptoms attributable to this early kidney disease, but it's very prevalent," says Eric Knight, MD, MPH, lead researcher of the study and a doctor at Brigham and Women's Hospital in Boston. Those at highest risk are people with high blood pressure, diabetes, or are older than age 65, he says.


Even in his study, about one in four of the 1,624 women studied had mildly reduced kidney function that produced no obvious symptoms.


Knight's findings on high-protein diets are published in the March 18 edition of Annals of Internal Medicine. It's the latest chapter in the ongoing Nurses Health Study, which has already documented that frequent meat consumption may increase risk of colon cancer.


The women studied were questioned about their consumption of meat and other foods, and other health risks were also evaluated. They were tracked for 11 years, and researchers found that those with mild kidney problems who ate a high-protein diet --- especially protein from meat -- had a faster loss in function. No such association was noted among women with these kidney problems who got most of their protein from dairy foods. However, high meat consumption didn't seem to exacerbate problems in those with healthy kidneys.


"We saw a significantly measurable association in those consuming about 1.3 grams of animal protein for each kilo of body weight," Knight tells WebMD. "That level is not as high as the protein you get from animal sources in the Atkins diet. So clearly a person who is undertaking a high-protein diet such as Atkins should have a kidney function test and carefully be monitored while following this diet."


Are high-protein diets safe for those with normal kidney function?


"If the Atkins diet was the only way of losing weight, perhaps the benefits would outweigh the risks," he says. "Obviously, extreme obesity is a risk factor of kidney disease. But there are other health risks associated with high consumption of meat products, such as too much animal fats and saturated fats that increase the risk of heart disease. I think the message of our study is that people with mild reduced kidney function should be careful to moderate their intake of meat overall and very carefully consider the risk and benefits before starting an Atkins-type diet."


When beginning the Atkins plan, dieters typically eat about 2 grams of animal protein for each gram of body weight, says Colette Heimowitz, director of education and research for Atkins Nutritionals. That means a woman weighing 150 pounds would consume about 135 grams of protein each day -- nearly 40% more than what was typically consumed by those in Knight's study. In later stages of the high-protein diet, the amount of protein is reduced to levels consumed by those in Knight's study.


"We tell people they shouldn't do this program without first getting a physical and be monitored by their doctors, and those with mild renal insufficiency need to be under a doctor's supervision because they can't take in as much protein as the program offers in the induction phase," Heimowitz tells WebMD. "And we already say that in our books and on our web site. They can still follow an Atkins-type weight-loss plan by choosing healthy fats and healthy carbohydrates but will lose weight at a slower pace."


Sorry for posting about kidneys again, but I want to hear some opinions from you guys, what do you think?

[adkpam]

I can't say it better than this fellow:

http://www.theomnivore.com/Kidneys_Aug_2004.html

Recent study showed that upping kidney patients' protein in a specific way improved their condition.

Those protein levels seem over-high to me...I went to town on meat of all kinds, and was getting 80-90 grams a protein. Which did my 150 pound body good.

[Angeline]

I actually posted something interesting regarding this, although no one commented (humph)

http://forum.lowcarber.org/showthread.php?t=203145

So there you have it, an ACTUAL study looking at the effect of low-carb on people with impaired kidneys, as opposed to opinion and conjecture.

The key points were to have a diet low in carb and iron and to replace iron rich meat such as red meat meat by white meat. Also key was taking CoQ10 supplements

[clavicula]

Hey, Adkpam & Angeline,

Thanks, I've read the article (okay, they were the same, what a coincidence), I have to admit that my kidney functions are regularly monitored because I have a lot of cysts in both of them (not polycystic kidney disease just so called multicystic which is a benign syndrome).
I have had no problem with my kidneys so far, npo symptoms, CN, creatinine levels are normal, etc. I'm not worried just curious, and want to know your opinion about it.
I was in a hurry, I hope I didn't make too big mistakes in my post... :agree:

[adkpam]

To me, the fuss over Atkins type diets and kidney problems are THE most overblown and ridiculous part of the low carb diet bashing around.

NO studies, NO proof, only the conjecture that because overworked kidneys need restrictions on protein, ALL kidneys need it.

Makes as much sense as the sodium restrictions. SOME people are salt sensitive, so everyone has to limit salt? It turned out that is a fallacy.

[iojanam]

Are kidney infections considered a kidney "problem"? I have had two kidney infections before.
Thanks

[Dodger]

Are kidney infections considered a kidney "problem"? I have had two kidney infections before.
Thanks
In the context of the article, no an infection is not a kidney problem. They are talking about degradation/failure of the kidneys.

[mcsblues]

"We saw a significantly measurable association in those consuming about 1.3 grams of animal protein for each kilo of body weight," Knight tells WebMD. "That level is not as high as the protein you get from animal sources in the Atkins diet. So clearly a person who is undertaking a high-protein diet such as Atkins should have a kidney function test and carefully be monitored while following this diet."


Lets do some numbers here;

Protein from meat averages about 25% so what they are saying is that problems may arise if a 100kg person (220 pounds) eats 1.3 x 4 x 100 = 520 grams of meat per day (1 pound 2 ounces) over and above dairy protein (which apparently isn't a problem - although they offer no explanation as to why, and fish, eggs and nuts are not mentioned at all so presumably you can add as much protein as you like from those sources).

They then say that people on Atkins eat MORE meat than this!

Hands up who does.:lol:

Cheers,

Malcolm

[Angeline]

That level is not as high as the protein you get from animal sources in the Atkins diet

According to them, people on Atkins actually eat more than this. So who eats 2 lbs of meat a day ??? If you are doing that, you aren't following the guidelines of eating till your satisfied not till your inside are ready to burst out. EVen if you spread it out over the course of 3 meals, you still are eating an awful lot of meat.

[gotbeer]

You can get a 50-oz (3 1/8 lbs) Porterhouse steak here:
http://www.trailduststeakhouse.com/menu1.htm
for a mere $34.99.

I've never seen anyone order it, though.

http://www.executiveseafoodgifts.com/Qstore/custom/porter_350.jpg

[kyrie]

Before you start Atkins, you're supposed to get your bloodwork done, which includes looking at your creatinine levels-- can't be over 2.4.

So my question, to those more knowledgeable-- is it possible for a person to have mildly reduced kidney function that would NOT be detected by this test?

[wcollier]

When beginning the Atkins plan, dieters typically eat about 2 grams of animal protein for each gram of body weight, says Colette Heimowitz, director of education and research for Atkins Nutritionals. That means a woman weighing 150 pounds would consume about 135 grams of protein each day -- nearly 40% more than what was typically consumed by those in Knight's study. In later stages of the high-protein diet, the amount of protein is reduced to levels consumed by those in Knight's study. This comes from the horse's mouth. :confused: It seems a little high to me.

The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.
I'm being the devil's advocate, I realize, b/c I like to keep an open mind and not fall into the defensive trap, closing my mind to new research. So this is what jumps out at me. Atkins doesn't dispute that someone with impaired kidney function shouldn't eat high protein. The question is how do you know?

Wanda

[ladyj816]

I went into kidney failure among other things during labor with my second child in 2002 due to a rapid and severe toxemia, so they are guessing. I had no symptoms prior to labor. I was suffering from gestaional diabetes and required insulin shots. My platlet level crashed. Since having my c-section I was kept in the hospital for a week and underwent many tests, they figured nothing out and came to that conclusion. This is now 2004 and I have had many blood work done prior to April this year, and my sugar levels made me borderline diabetic(as it has always been, for the past 10 years)I had a scan of both my gallbladder and kidneys revealing stones in each, and my gallbladder was so damaged,I had it taken out one year ago.Since April of this year since I started to slowly cut back the carbs, my sugar level is now normal!!!! and so is my cholesterol!!! Also, I have had no other problems with my platlet level and creatinine levels ect...... :)

[clavicula]

I would never be able to eat as much protein as the article says (2 lbs of meat a day?!). I eat meat 2 times a day usually, but just till I'm satisfied, no more. With my cream and cheese and eggs...still below that amount I think.
My kidney functions are regularly tested because of these cysts, but no problem yet.
I think I eat just a little bit more protein on Atkins than before. :agree:
:wave:

[wcollier]

How do we know who funded the research for this study? I'm very curious.

Wanda

[eepobee]

i never considered atkins a "high-protein diet". of course these terms are relative, but i would describe atkins as a high-fat, normal-protein, and low-carb diet when compared to typical "expert" recommendations.

[kyrie]

When beginning the Atkins plan, dieters typically eat about 2 grams of animal protein for each gram of body weight, says Colette Heimowitz, director of education and research for Atkins Nutritionals.

Oops... that would have me eating twice my body weight in protein!

[Dodger]

The women studied were questioned about their consumption of meat and other foods, and other health risks were also evaluated. They were tracked for 11 years, and researchers found that those with mild kidney problems who ate a high-protein diet --- especially protein from meat -- had a faster loss in function. No such association was noted among women with these kidney problems who got most of their protein from dairy foods. However, high meat consumption didn't seem to exacerbate problems in those with healthy kidneys.
The problem with over-analyzing data is that it is easy to get false correlations. The more you subdivide the data, the less meaningful the results get. I have worked as a quality/reliability engineer for years and know that I can find all sorts of correlations as long as I subdivide the data enough. Of course these correlations are invalid and are just statistical flukes.

For the correlations to be significant (other that statistically), they must be explainable. In the case of the kidney degradation case, no explanation was offered as to why meat proteins caused a problem and milk proteins did not. I and not aware that meat proteins break down into any amino acids that milk proteins do not have. Once inside the body, their is no difference between a given amino acid from meat proteins or from milk proteins.

[SkinnySoon]

If you ask me, this occurs only a few different situations.

#1. You have a predisposition to kidney problems.

#2. You already have kidney problems and don't know it.

#3. You do not drink enough water to flush that waste out of your kidneys.


Most of us do not fall into #1 or #2.... but I'm sure ther are alot of people who fall into #3, so DRINK YOUR WATER, and stop making excuses!!

[HoserLC]

Unless you are trying to eat the 96-ouncer like John Candy from The Great Outdoors, you are probably safe. :lol: What they don't tell you is the #1 kidney killer is diabetes, from excessive glycation, and that generally isn't a problem on Atkins.

[TwilightZ]

This is a typical non-study. No mention is made as to what amounts and types of carbs and fat were eaten, consequently there are too many variables to conclude anything. They then take this piece of nothing and conclude that since people on Atkins eat even more protein, that they are at higher risk. Nice propaganda, but factually empty.

I wonder why these studies are not performed on people who started Atkins in the 70's and continued to eat that way to the present time.

[Quinadal]

After 2 years of eating at least 130g protein a day, my BUN and creatinine levels are perfect! BUN is 18 creat is 0.5

[Judynyc]

#3. You do not drink enough water to flush that waste out of your kidneys.

Yup!! This was me!! I have never had a UTI in my life until this past July. I got very ill with a fever of over 103 for a couple of days. Saw blood in my urine and ran for tests.

Urinalysis showed an infection and calcium oxylate crystals( from protein) in my urine. My kidney's overall function was fine through this.

I had not been drinking my water. I had been having maybe 20 ounces per day. I was very stupid and suffered for it!! The water isn't just about losing weight, its about helping your body to flush out the protein and toxins.

I am not coming off my food plan because of what happened to me BUT, I AM now drinking my water everyday!! :agree:

[goldberri]

This comes from the horse's mouth. :confused: It seems a little high to me.

I'm being the devil's advocate, I realize, b/c I like to keep an open mind and not fall into the defensive trap, closing my mind to new research. So this is what jumps out at me. Atkins doesn't dispute that someone with impaired kidney function shouldn't eat high protein. The question is how do you know?

Wanda
Hi, it is true that Atkins does not dispute that people with kidney disease or impaired kidneys should not use the diet...

However, if you read the book -which really is the individual responsibility of anyone who chooses to follow this or any diet- you'll see that before you begin to diet you are instructed to get a full medical workup including bloodwork. This is how you determine if your kidneys (or other parts of you) are healthy enough to follow the diet.

Most people think that they can successfully follow the diet without actually knowing ALL the rules. For example, I'm willing to bet that many people on the diet DO NOT supplement with all of the necessary vitamins and minerals (again which are discussed in the book). This can cause serious complications -for example if you do not supplement what you eat with enough potassium you can get heart palpitations when you get too low. And, should someone become ill or even die from those complications the blame is always placed (by the media at any rate) on the diet. When in actuality, by not following the very specific rules, you are technically not following the diet.

This really is a case of knowledge being power. There is a formula to it and if you don't follow the formula then ultimately you are responsible for any bad things that happen.

Would you blame the recipe if you didn't follow all of the directions and the meal came out tasting awful?

Just some thoughts.
Btw: my father-in-law has been a type 1 diabetic since age 11. Especially since he is in his 50's he has to watch his kidneys, among many other things. For the last 5 years he has been on the diet and has amazed his doctors by 1) being able to perfectly control his blood sugar, 2) has reversed numerous diabetic complications that he had previously developed, and 3) is in perfect health (monthly bloodwork). And boy does he ever take his vitamins.

Of course different things do work for different people; but the impetus is on you to know what's going on in your own body -it is one of the few true freedoms man can have in this world. :)

[wcollier]

Hi Goldberri:

However, if you read the book -which really is the individual responsibility of anyone who chooses to follow this or any diet- you'll see that before you begin to diet you are instructed to get a full medical workup including bloodwork. This is how you determine if your kidneys (or other parts of you) are healthy enough to follow the diet.If you look at my profile, you'll notice that I've read the book and then some.... ;)

I'm not denying the fact that people should have tests done. I'm responding to the following quote:

The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.
How do you know you're at risk to damage your kidneys before the damage is done? Do the authors assume that no one has kidney function tests done or is there truly no way to determine if you're at risk until later on in the game? Maybe this is my misinterpretation of the information, but it seems to suggest to me that you don't know ahead of time. Please, someone set me straight, but don't accuse me of not reading the book. :)

Wanda

[Lisa N]

The problem is, as many as 20 million Americans are at risk for reduced kidney function but don't know it. Therefore, people on high-protein diets may be unknowingly damaging their kidneys.

What I'd like to know is where they are getting this figure from? On what is it based? Are they assuming that everyone with diabetes, hypertension or other risk factors is "at risk" and therefore should consume a low protein diet? Is it the disease process that puts them at risk or the higher protein intake (and how did they control for either so they could clearly differentiate)? What if their diabetes or hypertension is controlled? Are they still "at risk"? How do they account for studies of those with already existing kidney problems that showed less deterioration of their kidneys on a higher protein level than those on a lower protein level?
There is also a difference between "may cause" and "has been conclusively shown to cause".
Frankly, this sounds suspiciously like another scare tactic to me. Throw around some large numbers regarding who is "at risk" for kidney disease and people assume without question you must have some hard data to back it up; another version of the "high protein diets will cause kidney failure" argument despite the fact that they have yet to link a high protein diet to an actual case of kidney failure. I'd like to see the data that this figure is based on.