The research, published in the Canadian Medical Association Journal, provides the “first large-scale prospective evidence” linking the EAT-Lancet Planetary Health diet to a significantly lower risk of chronic kidney disease (CKD), says the study author Fan Fan Hou, MD, a nephrology professor at Nanfang Hospital at Southern Medical University in Guangzhou, China.
The study offers a new tool for chronic kidney disease prevention, with clear guidelines for patients and clinicians — and it “demonstrates that dietary choices good for the planet are also good for the kidneys,” Dr. Hou says.
What Makes This Earth-Friendly Diet Different
The diet is primarily plant-based and emphasizes:
- Vegetables
- Fruits
- Whole grains
- Legumes (aka beans)
- Nuts
The diet permits moderate amounts of fish, poultry, eggs, and dairy while calling for dramatic reductions in red meat, added sugars, refined grains, and saturated fats.
But a key difference is that the EAT-Lancet diet is “built for health and also the planet,” says Anjay Rastogi, MD, PhD, a professor and the clinical chief of nephrology at the University of California in Los Angeles, who was not involved with the latest research.
Meat production in particular has a serious impact on the planet. Livestock farms account for nearly 20 percent of greenhouse gas emissions, and they contribute to water depletion, pollution, and other negative environmental effects.
Study Finds an Intersection Between Diet, Genetics, and Environment
The new study was based on data from the UK Biobank and included nearly 180,000 adults. Participants filled out questionnaires about their diet, and received a score based on how closely they hewed to the EAT-Lancet diet.
During an average follow-up of 12 years, about 5,000 (2.7 percent) developed kidney disease.
Based on diet scores, researchers divided the participants into four groups called quartiles. People in the top quartile had the highest scores, meaning they closely followed the EAT-Lancet diet, while people in the bottom quartile had the lowest diet scores. The analysis showed that people in the top quartile had a 10 to 24 percent lower relative risk of developing chronic kidney disease than the low-score bottom quartile.
There was a stronger link between the plant-forward diet and lower kidney disease risk among participants who lived in areas with less green space — which suggests people living in cities may benefit more from the diet, Hou says.
“This adds a crucial layer of nuance, suggesting that dietary recommendations for chronic kidney disease prevention could be personalized based on genetic and environmental context,” she adds.
Why Would This Diet Be Good for the Kidneys?
Researchers identified specific molecular patterns in the body, known as metabolomic and proteomic signatures, that could explain the diet’s protective effect, Hou says. “This provides a plausible biological explanation, involving pathways like inflammation reduction and lipid [fat] metabolism, for how this dietary pattern may lower CKD risk.”
These diets are also heart-healthy, and Dr. Rastogi says, “What’s good for the heart is good for the kidneys.”
About a quarter of the blood pumped from the heart goes directly to the kidneys, which purify the blood, eliminate waste, and regulate fluid balance, he adds.
Study Supports Other Research
The new research has some limitations. Study participants were mostly middle-aged to older white adults in the UK: “Further research is needed in more diverse ethnic, age, and geographic populations,” Hou says.
Researchers relied on questionnaires, which may not fully capture long-term patterns, she adds. It’s also possible some diagnoses of chronic kidney disease may have been missed in the analysis.
The research is also observational, Hou notes. “While we controlled for many factors, we cannot prove direct causation, only association.”
Still, the study offers support for the role diet plays in chronic kidney disease, says Joshi.
“Eating more fruits and vegetables and eating less red meat has been consistently associated with a lower risk of chronic kidney disease,” he says.
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