Good Fat, Bad Fat: Being Kidney Smart About Your Diet
Fats are an essential part of the diet. They aid the absorption of certain vitamins, help maintain the integrity and function of cell membranes, and support the immune system. Too much dietary fat can contribute to heart disease, diabetes, obesity and certain cancers. Recent research on animal models of PKD reveal a correlation between both quantity and quality of fat in the diet on disease progression, including kidney size, amount of scar tissue and rate of decline in kidney function. Let's take a look at several types of fats and how they can affect your health and the health of your kidneys:
POLYUNSATURATED FATS/ ESSENTIAL FATTY ACIDS
These fats are important because we cannot make them in our bodies and, therefore, must eat them in the diet. They are by nature very fragile and are often destroyed in most processed foods. Many Americans are deficient because they do not eat enough foods that contain these important fats such as fish, nuts, whole grains, seeds and leafy greens. There are two essential fats, Omega 3 fatty acids and Omega 6 fatty acids. Both are important for general health and the health of the kidneys. Omega 6 fatty acids are much more prevalent in the diet than Omega 3; therefore, much research on essential fats and PKD focuses on Omega 3 fatty acids.
OMEGA 3 FATTY ACIDS
This is one of the most important essential fatty acids. Sources include fish, flax seeds, walnuts, soybeans and leafy greens. These fats are important because they have the effect of cooling down inflammation, which is a primary goal in the treatment of PKD. Animal studies using fish oil, flax oil and flax seeds show an overall slowing of disease progression, reduced kidney size, reduced fluid infiltration in the cysts and reduced scar tissue in the kidneys. This effect was found to be stronger in animals eating a lower-protein diet. Although the exact beneficial dose in humans has not been established, taking 2-3 grams fish oil, 1 tablespoon flax oil or 1-2 tablespoons flax meal per day is safe even for people taking blood-thinning medications such as coumadin. You can also increase your intake of Omega 3fatty acids by eating fatty fish such as wild salmon, halibut and cod 1-2 times per week and eating leafy greens, walnuts and soy beans. ** Store fish oil and flax oil in the refrigerator to protect them from going rancid.Cooking with Omega 3 oils or exposing them to high heat will destroy them.
Monounsaturated fat is found in olive oil, avocado, canola oil, peanut oil, and in most nuts and nut butters. This type of fat does not cause cholesterol to increase in the same way that saturated and trans fat does. If you substitute monounsaturated fat for saturated fat, it helps to lower bad cholesterol (LDL) and maintains healthy levels of the good cholesterol (HDL). It is likely that monounsaturated fats may not have the same cyst-promoting properties that saturated fats do; however, this has not been studied in humans with PKD. Monounsaturated oils such as olive oil are healthy fats that should be the main source of fat used in cooking. Add a little chopped garlic and balsamic vinegar to your olive oil and use as a dip for whole grain bread. Yum!
Trans fatty acids (trans fat) are found in foods such as vegetable shortening, some margarines, crackers, candies, baked goods, cookies, snack foods, fried foods, salad dressings, and many processed foods. Trans fats start out as liquid vegetable oils and are artificially saturated in order to make them more shelf stable in food processing. There is a direct, proven relationship between diets high in trans fat and increased risk of heart disease. It is unknown if trans fats increase the progression of PKD; however, there is enough evidence that they are bad for health, so they should be avoided. Trans fats are listed in the ingredients as "hydrogenated" or "partially hydrogenated" oils. It is mandatory for food manufacturers to list trans fats on the nutrition facts label. Look for foods that say "trans fat free" to keep trans fatty acids out of your diet!
Saturated fats are mostly found in animals. Meat, seafood, whole-milk dairy products (cheese, milk, and ice cream), poultry skin, and egg yolks are the main sources of saturated fat in the diet. Some plant foods are also high in saturated fats, including coconut and coconut oil, palm oil, and palm kernel oil. Saturated fats raise total blood cholesterol levels more than dietary cholesterol because they tend to boost both good (HDL) and bad (LDL) cholesterol. Excessive saturated fats increase the risk for heart disease, diabetes and some cancers, but their effect on PKD is not clearly known. The recommendation from the National Academies of Science is to consume no more than 10 percent of daily caloric intake as saturated fat. Until more is known about the relationship between saturated fat and PKD, it would be wise to eat within the established guidelines.
THE BOTTOM LINE
Research on animal models of PKD show clear benefits from eating a lower-fat diet that includes a regular source of Omega-3 fatty acids. Although specific recommendations have not been made for humans, eating roughly a 20 percent fat diet may be a good target. (See the chart below to gauge how many grams of fat you should aim for if following a 20 percent fat diet.)
When reading food labels, make sure to pay attention to both the quantity and quality of fats and oils you consume. Choose olive oil as your main cooking fat, and try to avoid hydrogenated (trans) fats. Eat food high in Omega 3 fatty acids such as fish, walnuts, and leafy greens. Consider taking 1 tablespoon flax meal every day along with 2-3 grams fish oil. Look for a brand that is "molecularly distilled" to ensure quality. If you are vegetarian, consider taking 1 tablespoon flax oil in place of the fish oil. These oils can be purchased at a health
food store or the health food section of most grocery stores.
There is still much that needs to be learned about how different fats impact the progression of PKD in humans. Until we know more, there is no harm in improving the quality of fat in the diet. We know that eating healthy fats helps prevent heart disease and certain cancers as well as reduces inflammation and supporting mental health. We hope it will help improve health for those with PKD!
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