By Akhila Gullapuram, MS, RD
A popular vegetarian belief in hindi is: “Jaisa Ann, Waisa Mann, Aur Jaisa Mann, Vaisa hi Tann”. In short, this means “You are what you eat”. Due to the cultural and religious beliefs, India has one of the largest vegetarian populations on the Earth. Food Agriculture Organization estimates 20-42% Indians being vegetarian. Many people eating animal based foods also abstain from it on some days due to the cultural beliefs. Restaurants in India exclusively cater pure vegetarian choices in their menu and even accommodate exclusions of foods like onion and garlic if required. With this scenario, suggesting people on dialysis to eat animal based foods such as fish, poultry, eggs, for providing more protein may not be a good idea. There is a lot of confusion among some patients when some professionals suggest eating animal based foods to vegetarians on dialysis.
Plant based foods are more beneficial than animal based foods in curtailing the progression of kidney disease. Research has revealed that protein loss in urine and cyst growth is decreased with plant protein. Eating animal based food means eating more protein. Eating more protein in early stages of chronic kidney disease can worsen existing kidney function. Dialysis is done at the end stage of kidney disease and body needs more protein then, to compensate the loss of protein during dialysis and to meet needs due to stress and inflammation in the body.
India has mainly two kinds of vegetarians:
Lacto vegetarians- they eat all plant based foods, milk and milk products as part of their diet.
- Lacto-ovo-vegetarians- they eat all plant based foods, milk, milk products and also eggs as part of their diet.
If more protein is required on dialysis then why eat plant protein?
Because you want to remain vegetarian and not start eating animal based foods because of dialysis.
Plant protein can provide enough protein for dialysis.
Vegetarian diet can lower cholesterol level, risk of heart disease, and overall cancer rates.
- Eating vegetarian food may help decrease prescriptions and economic burden on the patients as phosphorus from the plant based foods is less absorbed than animal based food.
Vegetarian sources of protein
Staple diet in India is mainly comprised of protein rich grains and vegetables. Various grains, dals, peas, paneer, cheese, milk, curd, tofu, soy, nuts and nut butters can provide high quality protein. However, what may work for one, may not work for another due to the varied health conditions.
Vegetarian meals can work for dialysis patients
- Eating various grains, dals, vegetables and other sources of protein over the day can provide all the essential proteins required by the body.
- Eating foods which are in sync with mind and beliefs can be synchronous to our bodies as well. It can avoid food aversions, loss of appetite, nausea or vomiting.
- Research has indicated that discarding water after soaking and boiling foods can help decrease phosphorus levels and potassium in some foods.
- Nutrition supplements can be added to the meal plan to meet the additional requirements.
- Proper meal planning can eliminate the concerns of vegetarianism.
Be in sync with what is so close to us naturally
In my observation, many people in India who eat animal based foods eat only twice or thrice a week mostly. Plant based foods have several health and economic benefits. It requires little patience and follow- up with your dietitian to arrive to a good nutritional plan which will work for you on dialysis. If you are a vegetarian, you certainly do not have to follow an eating method which is alien to you. Finding ways to provide enough nutrition in eating methods which are close to us may reap more benefits and create edge for better care on dialysis. After all eating food is not only about its nutrients, it is also about finding meaning and joy in life!