อาหารมังสวิรัติกับโรคไตเรื้อรัง
คำสำคัญ:
อาหารมังสวิรัติ อาหารเน้นพืชผัก โภชนาการ โรคไตเรื้อรังบทคัดย่อ
อาหารมังสวิรัติ (Vegetarian diet) หรืออาหารเน้นพืชผัก (Plant-based diet) เป็นที่รู้จักกันทั่วไปและได้รับความนิยมอย่างแพร่หลายในกลุ่มคนที่ห่วงใยสุขภาพ มีรายงานวิจัยจำนวนมากที่เกี่ยวกับผลดีต่อสุขภาพของอาหารมังสวิรัติ ด้านการป้องกัน และชะลอการเกิดโรคไต และโรคเรื้อรังต่างๆ ทั้งในสัตว์ทดลองและระบาดวิทยาในประชากรกลุ่มต่างๆ อย่างไรก็ตาม มีนักวิจัยบางส่วนเสนอว่าอาหารมังสวิรัติอาจไม่เหมาะสมกับผู้ป่วยโรคไตเรื้อรัง เพราะผัก ผลไม้และธัญพืชอาจทำให้ผู้ป่วยไม่ได้รับพลังงานและโปรตีนเพียงพอ และทำให้ระดับโพแทสเซียมและฟอสฟอรัสในเลือดสูงกว่าปกติ ซึ่งจะนำไปสู่การทำงานหนักมากขึ้นของไต1 ยังไม่มีความชัดเจนระหว่างความคิดเห็นแตกต่างกันดังกล่าว บทความเรื่องนี้จึงมีวัตถุประสงค์เพื่อทบทวนผลการศึกษาวิจัยที่เกี่ยวข้อง เพื่อหาคำตอบว่า อาหารมังสวิรัติมีผลต่อภาวะโภชนาการของผู้ป่วยโรคไตเรื้อรังอย่างไร? สารอาหารในอาหารจากพืชผักมีมากน้อยเพียงพอหรือมากเกินไปต่อผู้ป่วย การบริโภคอาหารควรจะมีการจัดการและควบคุม เพื่อรักษาสมดุลแร่ธาตุในเลือด และส่งเสริมภาวะโภชนาการที่ดีได้แท้จริงหรือไม่?
References
1. Gluba-Brzózka A, Franczyk B, Rysz J. Vegetarian Diet in Chronic Kidney Disease—A Friend or Foe. Nutrients. 2017;9(4):374.
2. Chittinandana A, Chailimpamontree W, Chaloeiphap P. Prevalence of chronic kidney disease in Thai adult population. J Med Assoc Thai. 2006;89(Suppl 2):S112-20.
3. Ministry of Public Health Department for development of Thai traditional and alternative Medicine. Academic textbook. Food for health. Bangkok.: The War Veterans Organization of Thailand Publishing Office; 2008 (in Thai).
4. Moe SM, Zidehsarai MP, Chambers MA, Jackman LA, Radcliffe JS, Trevino LL, et al. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clinical Journal of the American Society of Nephrology. 2010:CJN. 05040610.
5. Fishbein L. Natural non-nutrient substances in the food chain. Science of The Total Environment. 1972;1(3):211-44.
6. Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional Update for Physicians: Plant-Based Diets. The Permanente Journal. 2013;17(2):61-6.
7. Suttajit M, Khanaree C, Tantipaiboonwong P, Pintha K. Omega-3, omega-6 fatty acids and nutrients of Nga-mon seeds in Northern Thailand. Naresuan Phayao J. 2015;8(2):82-6.
8. Asif M. Health effects of omega-3,6,9 fatty acids: Perilla frutescens is a good example of plant oils. Oriental Pharmacy and Experimental Medicine. 2011;11(1):51-9.
9. Craig WJ. Health effects of vegan diets. The American Journal of Clinical Nutrition. 2009;89(5):1627S-33S.
10. Chauveau P, Combe C, Fouque D, Aparicio M. Vegetarianism: Advantages and Drawbacks in Patients With Chronic Kidney Diseases. Journal of Renal Nutrition. 2013;23(6):399-405.
11. Piccoli GB, Attini R, Vasario E, Gaglioti P, Piccoli E, Consiglio V, et al. Vegetarian supplemented low-protein diets. A safe option for pregnant CKD patients: report of 12 pregnancies in 11 patients. Nephrology Dialysis Transplantation. 2010;26(1):196-205.
12. Wu TT, Chang CY, Hsu WM, Wang IK, Hsu CH, Cheng SH, et al. Nutritional status of vegetarians on maintenance haemodialysis. Nephrology. 2011;16(6):582-7.
13. Rizzo NS, Sabaté J, Jaceldo-Siegl K, Fraser GE. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes care. 2011;34(5):1225-7.
14. Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Jaster B, et al. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes. Diabetes Care. 2006;29:1777-83.
15. Chen J, Muntner P, Hamm LL, Fonseca V, Batuman V, Whelton PK, et al. Insulin resistance and risk of chronic kidney disease in nondiabetic US adults. Journal of the American Society of Nephrology. 2003;14(2):469-77.
16. Satirapoj B. Prevalence of insulin resistance in patient with non-diabetic chronic kidney disease. Royal Thai Army Medical Journal 2009;62(1):3-10. (in Thai).
17. DeFronzo RA, Ferrannini E. Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease. Diabetes Care. 1991;14(3):173.
18. Lovejoy JC, Windhauser MM, Rood JC, Jacques A. Effect of a controlled high-fat versus low-fat diet on insulin sensitivity and leptin levels in African-American and Caucasian women. Metabolism. 1998;47(12):1520-4.
19. Lebovitz H. Insulin resistance: definition and consequences. Experimental and clinical endocrinology & diabetes. 2001;109(Suppl 2):S135-S48.
20. Hung C-J, Huang P-C, Li Y-H, Lu S-C, Ho L-T, Chou H-F. Taiwanese vegetarians have higher insulin sensitivity than omnivores. British journal of nutrition. 2006;95(1):129-35.
21. Rigalleau V, Combe C, Blanchetier V, Aubertin J, Aparicio M, Gin H. Low protein diet in uremia: effects on glucose metabolism and energy production rate. Kidney international. 1997;51(4):1222-7.
22. Levey AS, Rocco MV, Anderson S, Andreoli SP, Bailie GR, Bakris GL, et al. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. American Journal of Kidney Diseases. 2004;43(5 SUPPL. 1).
23. Bergesio F, Monzani G, Guasparini A, Ciuti R, Gallucci M, Cristofano C, et al. Cardiovascular risk factors in severe chronic renal failure: the role of dietary treatment. Clinical nephrology. 2005;64(2):103-12.
24. Teixeira SR, Tappenden KA, Carson L, Jones R, Prabhudesai M, Marshall WP, et al. Isolated soy protein consumption reduces urinary albumin excretion and improves the serum lipid profile in men with type 2 diabetes mellitus and nephropathy. The Journal of nutrition. 2004;134(8):1874-80.
25. Liakopoulos V, Roumeliotis S, Gorny X, Dounousi E, Mertens PR. Oxidative Stress in Hemodialysis Patients: A Review of the Literature. Oxidative Medicine and Cellular Longevity. 2017;2017:3081856.
26. Goraya N, Simoni J, Jo C, Wesson DE. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney international. 2012;81(1):86-93.
27. Chanwikrai Y. Nutrition therapy for predialysis chronic kidney disease. Royal Thai Army Medical Journal. 2012;65(1):49-56 (in Thai).
28. Saunders W. KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. 2007.
29. Beto JA, Bansal VK. Medical nutrition therapy in chronic kidney failure: integrating clinical practice guidelines. Journal of the American Dietetic Association. 2004;104(3):404-9.
30. Burrowes JD, Ramer NJ. Removal of potassium from tuberous root vegetables by leaching. Journal of renal nutrition. 2006;16(4):304-11.
31. National Nutrient Database for Standard Reference Release [Internet]. 2016 [cited June 28, 2018]. Available from: https://ndb.nal.usda.gov/ndb/.
32. Jongjaitad N, Pengpan W, Aungsongtam P, Boonchu W. Content of fiber, sugar and mineral in fruits. Department of Health, Ministry of Public Health; 2009 (in Thai).
33. Sparks B. Nutritional Considerations for Dialysis Vegetarian Patients, Part Two. Journal of Renal Nutrition. 2018;28(3):e19-e23.
34. Chanwikrai Y, Singhan C, Dansukda S, Thatsanasuwan N, Sinchaiyakit P, Suttajit M, et al. Nutritional value of indigenous foods and food consumption behavior among end stage renal disease Proceedings in Phayao research conference 6th, January 26-27, 2017: University of Phayao; 2017 (in Thai).
35. Chanwikrai Y, Suttajit M. Umami substances: Research history, mechanisms of delicious food taste and natural sources. Naresuan Phayao J. 2017;10(2):54-6 (in Thai).
36. Jiwakanon S. Nutrition support in chronic kidney disease In: Tejavanija S, Pisprasert V, Keawtanom S, Supasyndh O, editors. Nutrition review. Bangkok Wetchasan Printing House: Society of Parenteral and Enteral Nutrition of Thailand; 2017. p. 66-74 (in Thai).
37. Supasyndh O. Nutrition in predialysis chronic kidney disease. In: Satirapoj B, Ruangkanchanasetr P, Kanjanakul I, Chaiprasert A, Supasyndh O, Choovichian P, editors. Essential nephrology. Nam Akson Printing House: Phramongkutklao College of Medicine Book Project; 2013. p. 426-37 (in Thai).
2. Chittinandana A, Chailimpamontree W, Chaloeiphap P. Prevalence of chronic kidney disease in Thai adult population. J Med Assoc Thai. 2006;89(Suppl 2):S112-20.
3. Ministry of Public Health Department for development of Thai traditional and alternative Medicine. Academic textbook. Food for health. Bangkok.: The War Veterans Organization of Thailand Publishing Office; 2008 (in Thai).
4. Moe SM, Zidehsarai MP, Chambers MA, Jackman LA, Radcliffe JS, Trevino LL, et al. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clinical Journal of the American Society of Nephrology. 2010:CJN. 05040610.
5. Fishbein L. Natural non-nutrient substances in the food chain. Science of The Total Environment. 1972;1(3):211-44.
6. Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional Update for Physicians: Plant-Based Diets. The Permanente Journal. 2013;17(2):61-6.
7. Suttajit M, Khanaree C, Tantipaiboonwong P, Pintha K. Omega-3, omega-6 fatty acids and nutrients of Nga-mon seeds in Northern Thailand. Naresuan Phayao J. 2015;8(2):82-6.
8. Asif M. Health effects of omega-3,6,9 fatty acids: Perilla frutescens is a good example of plant oils. Oriental Pharmacy and Experimental Medicine. 2011;11(1):51-9.
9. Craig WJ. Health effects of vegan diets. The American Journal of Clinical Nutrition. 2009;89(5):1627S-33S.
10. Chauveau P, Combe C, Fouque D, Aparicio M. Vegetarianism: Advantages and Drawbacks in Patients With Chronic Kidney Diseases. Journal of Renal Nutrition. 2013;23(6):399-405.
11. Piccoli GB, Attini R, Vasario E, Gaglioti P, Piccoli E, Consiglio V, et al. Vegetarian supplemented low-protein diets. A safe option for pregnant CKD patients: report of 12 pregnancies in 11 patients. Nephrology Dialysis Transplantation. 2010;26(1):196-205.
12. Wu TT, Chang CY, Hsu WM, Wang IK, Hsu CH, Cheng SH, et al. Nutritional status of vegetarians on maintenance haemodialysis. Nephrology. 2011;16(6):582-7.
13. Rizzo NS, Sabaté J, Jaceldo-Siegl K, Fraser GE. Vegetarian dietary patterns are associated with a lower risk of metabolic syndrome: the adventist health study 2. Diabetes care. 2011;34(5):1225-7.
14. Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Jaster B, et al. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes. Diabetes Care. 2006;29:1777-83.
15. Chen J, Muntner P, Hamm LL, Fonseca V, Batuman V, Whelton PK, et al. Insulin resistance and risk of chronic kidney disease in nondiabetic US adults. Journal of the American Society of Nephrology. 2003;14(2):469-77.
16. Satirapoj B. Prevalence of insulin resistance in patient with non-diabetic chronic kidney disease. Royal Thai Army Medical Journal 2009;62(1):3-10. (in Thai).
17. DeFronzo RA, Ferrannini E. Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease. Diabetes Care. 1991;14(3):173.
18. Lovejoy JC, Windhauser MM, Rood JC, Jacques A. Effect of a controlled high-fat versus low-fat diet on insulin sensitivity and leptin levels in African-American and Caucasian women. Metabolism. 1998;47(12):1520-4.
19. Lebovitz H. Insulin resistance: definition and consequences. Experimental and clinical endocrinology & diabetes. 2001;109(Suppl 2):S135-S48.
20. Hung C-J, Huang P-C, Li Y-H, Lu S-C, Ho L-T, Chou H-F. Taiwanese vegetarians have higher insulin sensitivity than omnivores. British journal of nutrition. 2006;95(1):129-35.
21. Rigalleau V, Combe C, Blanchetier V, Aubertin J, Aparicio M, Gin H. Low protein diet in uremia: effects on glucose metabolism and energy production rate. Kidney international. 1997;51(4):1222-7.
22. Levey AS, Rocco MV, Anderson S, Andreoli SP, Bailie GR, Bakris GL, et al. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. American Journal of Kidney Diseases. 2004;43(5 SUPPL. 1).
23. Bergesio F, Monzani G, Guasparini A, Ciuti R, Gallucci M, Cristofano C, et al. Cardiovascular risk factors in severe chronic renal failure: the role of dietary treatment. Clinical nephrology. 2005;64(2):103-12.
24. Teixeira SR, Tappenden KA, Carson L, Jones R, Prabhudesai M, Marshall WP, et al. Isolated soy protein consumption reduces urinary albumin excretion and improves the serum lipid profile in men with type 2 diabetes mellitus and nephropathy. The Journal of nutrition. 2004;134(8):1874-80.
25. Liakopoulos V, Roumeliotis S, Gorny X, Dounousi E, Mertens PR. Oxidative Stress in Hemodialysis Patients: A Review of the Literature. Oxidative Medicine and Cellular Longevity. 2017;2017:3081856.
26. Goraya N, Simoni J, Jo C, Wesson DE. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy. Kidney international. 2012;81(1):86-93.
27. Chanwikrai Y. Nutrition therapy for predialysis chronic kidney disease. Royal Thai Army Medical Journal. 2012;65(1):49-56 (in Thai).
28. Saunders W. KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. 2007.
29. Beto JA, Bansal VK. Medical nutrition therapy in chronic kidney failure: integrating clinical practice guidelines. Journal of the American Dietetic Association. 2004;104(3):404-9.
30. Burrowes JD, Ramer NJ. Removal of potassium from tuberous root vegetables by leaching. Journal of renal nutrition. 2006;16(4):304-11.
31. National Nutrient Database for Standard Reference Release [Internet]. 2016 [cited June 28, 2018]. Available from: https://ndb.nal.usda.gov/ndb/.
32. Jongjaitad N, Pengpan W, Aungsongtam P, Boonchu W. Content of fiber, sugar and mineral in fruits. Department of Health, Ministry of Public Health; 2009 (in Thai).
33. Sparks B. Nutritional Considerations for Dialysis Vegetarian Patients, Part Two. Journal of Renal Nutrition. 2018;28(3):e19-e23.
34. Chanwikrai Y, Singhan C, Dansukda S, Thatsanasuwan N, Sinchaiyakit P, Suttajit M, et al. Nutritional value of indigenous foods and food consumption behavior among end stage renal disease Proceedings in Phayao research conference 6th, January 26-27, 2017: University of Phayao; 2017 (in Thai).
35. Chanwikrai Y, Suttajit M. Umami substances: Research history, mechanisms of delicious food taste and natural sources. Naresuan Phayao J. 2017;10(2):54-6 (in Thai).
36. Jiwakanon S. Nutrition support in chronic kidney disease In: Tejavanija S, Pisprasert V, Keawtanom S, Supasyndh O, editors. Nutrition review. Bangkok Wetchasan Printing House: Society of Parenteral and Enteral Nutrition of Thailand; 2017. p. 66-74 (in Thai).
37. Supasyndh O. Nutrition in predialysis chronic kidney disease. In: Satirapoj B, Ruangkanchanasetr P, Kanjanakul I, Chaiprasert A, Supasyndh O, Choovichian P, editors. Essential nephrology. Nam Akson Printing House: Phramongkutklao College of Medicine Book Project; 2013. p. 426-37 (in Thai).
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2019-03-07
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วารสารพยาบาลศาสตร์และสุขภาพเป็นเจ้าของลิขสิทธิ์ในการเผยแพร่ผลงานที่ตีพิมพ์ห้ามผู้ใดนำบทความที่ได้รับการตีพิมพ์ในวารสารพยาบาลศาสตร์และสุขภาพไปเผยแพร่ในลักษณะต่าง ๆ ดังนี้ การนำบทความไปเผยแพร่ออนไลน์ การถ่ายเอกสารบทความเพื่อกิจกรรมที่ไม่ใช่การเรียนการสอน การส่งบทความไปตีพิมพ์เผยแพร่ที่อื่น ยกเว้นเสียแต่ได้รับอนุญาตจากวารสารพยาบาลศาสตร์และสุขภาพ
