Nuts and seeds have been part of the human diet for about 25 million years now. They are convenient snack and cooking ingredients. Nuts and seeds have vitamins and minerals beneficial for the body but a diet consisting of these foods may not be ideal for people with Chronic Kidney Disease. Several nuts and seeds have high potassium and phosphorus content which may worsen kidney health.
In this article, we will help you in choosing kidney-friendly nuts that you can include in your diet:
Nuts: How can it benefit the body?
A nut is a dry fruit enclosed in a hard shell and contains an edible kernel of one or two pieces. Nuts do not open naturally and need to be opened by a nutcracker or by hand. On the other hand, seeds typically open themselves naturally when planted.
Here are a few examples of Nuts and Seeds:
Nuts and seeds may be small, but they give a handful of benefits. Below are their most highlighted benefits:
1) Promotes good heart health.
Eating nuts has been associated with lowered heart problems because they are rich sources of good fats or Omega-3 and Omega-6 fatty acids. Omega-3 and Omega-6 fatty acids can help lower LDL (low-density lipoprotein) cholesterol in the body. LDL cholesterol is more popularly known as "bad cholesterol."
It contributes to a process called "atherosclerosis," wherein the bad cholesterol causes plaque (blockage) to build up - making it hard for blood to pass through the arteries, leading to heart diseases.
2) It has arginine.
One good source of dietary protein is nuts and seeds. They are a good substitute for animal protein because some nuts, like walnuts, pine nuts, and almonds, are high in amino acid arginine. Arginine is also beneficial to heart health as it helps maintain healthy blood vessels and blood pressure by making the wall of your arteries flexible and less prone to clots that can disrupt normal blood flow.
3) Nuts are high in antioxidants, vitamins & minerals.
Nuts are rich in vitamins such as B6 (pyridoxine), B3 (niacin), and minerals such as calcium, plant iron, selenium, phosphorus, copper, and potassium. They also contain Vitamin E and antioxidants. Due to nuts' rich nutrient content, they can help combat inflammation by inactivating unstable molecules and protecting the cell from harmful bodies that may cause potential damage.
Incorporating Nuts & Seeds into the CKD diet
It is a well-known fact that there is no generic or "one-size- fits- all" type of diet because people have different needs and requirements.
The real challenge here is to control its portion size and how often it is used. Here are a few tips that you can try so that you can enjoy its health benefits while supporting your kidney health:
1) Using nuts as an ingredient.
A CKD diet can get bland at times, so we need to be creative in adding flavor to our food without increasing sodium in the diet. Try crushing some nuts, add a bit of oil, vinegar, or lemon, and season it with herbs and spices. Then pair this with your roast chicken, or better yet, use it to season your chicken before roasting!
2) Nuts as coating or breading.
Crushed nuts are a perfect way to add texture-- and flavor-- to food naturally. Upgrade any baked meat by simply coating it with crushed nuts before cooking. By doing this, you add an element of crunch and creamier taste to your meat without using a commercially packaged coat mix.
3) Sprinkle it on top of your soup.
Together with croutons, a bit of nut could also add flavor and texture to any plain soup. Be it a carrot soup or zucchini soup, nuts could add flavor and excitement to it! Just keep tabs on your fluid intake, though; not all CKD patients can freely eat a whole bowl of soup.
4) The right balance of food choices.
Partnering nuts with other low potassium and phosphorus-containing foods is also an excellent way to balance your meals. Here is an example of a CKD-friendly Lunch meal you can do at home:
- Walnut-Crusted Salmon
- ½ cup portion of Aglio olio spaghetti
- One medium-sized (4 oz.) apple
Good Nuts & Seeds for CKD
Potassium and Phosphorus are two nutrients that are restricted in a CKD diet. They are limited because increased levels of potassium and phosphorus can complicate kidney health. After all, the kidney can no longer filter the blood normally.
Nuts and seeds may have potassium and phosphorus, but at the same time, they have numerous vitamins and minerals that are beneficial to the body. Research suggests that CKD patients should watch out for the inorganic phosphorus or phosphates being used as a preservative and additives in boxed meals. These additives include:
- Dicalcium phosphate.
- Disodium phosphate.
- Monosodium phosphate.
- Phosphoric acid.
- Sodium hexameta-phosphate.
- Trisodium phosphate.
- Sodium tripolyphosphate.
- Tetrasodium pyrophosphate.
Researchers are looking into the possibility of including a few servings of nuts and seeds, which may help the overall health of a CKD patient and even dialysis patient to prevent nutrient deficiencies and risk decrease of lowered immunity. Here are examples of nuts and seeds that we can consider in a kidney-friendly diet:
1. Macadamia Nuts
Macadamia Nuts are lower in phosphorus than other nuts and contain a good source of healthy fat and selenium. Selenium is a mineral that works with Vitamin E to combat harmful bacteria and intruders in the body. The normal body requirement for selenium is 0.05 mg - 0.07 mg.
Unfortunately, CKD patients on dialysis risk getting hyposelenemia or nutrient deficiency of selenium because Selenium is one of the nutrients excreted by the body during dialysis. Adding serving macadamia nuts to the diet could help prevent the deficiency in the long run.
A serving (28 g or 1 ounce) of Macadamia Nuts contain:
- Selenium: 3.3 mg
- Potassium: 103 mg
- Phosphorus: 56 mg
Walnuts are a good source of folate. Folate helps the body make new DNAs and works hand-in-hand with Vitamin B12 to make new blood cells. The body needs at least 1 mg a day, both for dialysis and non-dialysis patients.
Folate is one of the vitamins being studied to help improve kidney health and reduce the risk of heart diseases in CKD patients. In research conducted on CKD patients in 2011, folic acid (a synthetic version of folate) supplementation has reduced the risks of heart problems. While on a study conducted in 2016, folic acid was found to significantly delay the progression of chronic kidney disease of those who are mild to moderately kidney impaired.
One serving (28 g or 1 ounce) of Walnuts contain:
- Folate: 28 mg
- Potassium: 125 mg
- Phosphorus: 98 mg
3. Brazil Nuts
Brazil Nuts are highly recommended to be included in a CKD diet by health professionals due to their significant amount of selenium. Dialysis patients can benefit from the high selenium content as it can help prevent hyposelenemia or nutrient deficiency of selenium for hemodialysis patients. Hyposelenemia may develop in hemodialysis patients as it is one of the minerals being excreted during dialysis.
It could be included in a CKD patient's renal vitamin with just a piece of a brazil nut. Interestingly, a follow-up study was done in Chronic Kidney Disease patients where they were given one brazil nut a day for three months. Results showed that it was effective in reducing inflammation and tissue damage in hemodialysis patients.
A serving (28 g or 1 ounce) of Brazil Nut contains:
- Selenium: 543.5 mg
- Potassium: 206 mg
- Phosphorus: 187 mg
4. Flax Seeds
Flax Seeds are a rich source of omega-3 fatty acids and fiber. It contains anti-inflammatory properties and has been studied to reduce the risks of heart problems.
In a study conducted in rats, it was seen that including flax seeds in the diet can reduce proteinuria or excessive urination of protein and preserve the renal function of those with mild CKD.
- A serving (28 g or 1 ounce) of Flax Seeds contain:
- Potassium: 230.90 mg
- Phosphorus: 182.30 mg
"Can I eat nuts and seeds?" this question may pop into your head right now as we end our article. The answer is simply a matter of knowing your priorities in the diet. Nuts and seeds can be a good source of natural supplementation of the nutrients you need in a CKD diet and can help reduce the risk of heart problems. But you need to know first if you need more selenium and folate in your body and how much potassium and phosphorus are allowed in your diet.
If this has been answered, you can ask your healthcare professionals to identify which nut can help improve your condition. Nuts and seeds can be part of your kidney-friendly diet with proper guidance by your healthcare professionals and appropriate portion sizes.
Crunch on This…A Fresh Look at Nuts for Renal Nutrition; J. White, RDN-
Go Nuts (But just a little!); Americal Heart Association - https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/go-nuts-but-just-a-little
Eat a handful of nuts, get a bucketful of benefits; Harvard Medical School -
13 Essential Vitamins that are good for People with Chronic Kidney Disease (CKD); DaVita Kidney Care -
CRN Special Article: Nutrition Myth-Busting; T. Fuhrman, RDN-
Selenium and Kidney Disease; P. Iglesias, R. Selgas, S. Romero, & J. Diez-
Efficacy of Folic Acid Therapy on the Progression of Chronic Kidney DiseaseThe Renal Substudy of the China Stroke Primary Prevention Trial; Xin Xu, MD, PhD; Xianhui Qin, MD, PhD; Youbao Li, MD; et al. - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2544880
A follow-up study of the chronic kidney disease patients treated with Brazil nut: focus on inflammation and oxidative stress; M B Stockler-Pinto, O Malm, C Moraes, N E Farage, W S Silva, S M F Cozzolino, D Mafra - https://pubmed.ncbi.nlm.nih.gov/25395121/
Folic Acid Therapy and Cardiovascular Disease in ESRD or Advanced Chronic Kidney Disease: A Meta-Analysis; Xianhui Qin, Yong Huo, Craig B. Langman, Fanfan Hou, Yundai Chen, Debora Matossian, Xiping Xu and Xiaobin Wang - https://cjasn.asnjournals.org/content/6/3/482.short
Dietary Flaxseed as a Strategy for Improving Human Health; Mihir Parikh, Thane G. Maddaford, J. Alejandro Austria, Michel Aliani, Thomas Netticadan,& Grant N. Pierce - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567199/
Dietary flaxseed meal reduces proteinuria and ameliorates nephropathy in an animal model of type II diabetes mellitus; Manuel T.Velasquez, J.Bhathena, TedineRanich, et al. - https://www.sciencedirect.com/science/article/pii/S008525381549578X