How Not to Die from Kidney Disease

Kidney failure may be both prevented and treated with a plant-based diet, and it’s no wonder: Kidneys are highly vascular organs, packed with blood vessels. Harvard researchers found three significant dietary risk factors for declining kidney function: “animal protein, animal fat, and cholesterol.” Animal fat can alter the actual structure of our kidneys. In my video How Not to Die from Kidney Disease, you can see plugs of fat literally clogging up the works in autopsied human kidneys from a study published in The American Journal of Pathology.

Animal protein can have a “profound effect” on normal kidney function, inducing “hyperfiltration,” increasing the workload of the kidney. Not plant protein, though. After eating a meal of tuna fish, the increased pressure on the kidneys goes up within only a few hours. We aren’t talking about adverse effects decades down the road, but literally within hours of it going into our mouths. What happens if, instead of having a tuna salad sandwich, you had a tofu salad sandwich with the exact same amount of protein? No effect on your kidneys. Our kidneys have no problem dealing with plant protein is no problem.

Why does animal protein cause the overload reaction, but plant protein doesn’t? It appears to be due to the inflammation triggered by the consumption of animal products. Indeed, taking a powerful, anti-inflammatory drug along with that tuna fish sandwich can abolish the hyperfiltration, protein-leakage response to meat ingestion.

There’s also the acid load. Animal foods, such as meat, eggs, and dairy, induce the formation of acid within the kidneys, which may lead to “tubular toxicity,” damage to the tiny, delicate, urine-making tubes in the kidney. Animal foods tend to be acid-forming—especially fish, which is the worst, followed by pork and poultry—whereas plant foods tend to be relatively neutral, or actually alkaline or base-forming to counteract the acid, especialy green leafy vegetables. So, “[t]he key to halting progression of CKD [chronic kidney disease] might be in the produce market, not in the pharmacy.”

It’s no wonder plant-based diets have been used to treat kidney disease for decades. In my video, you can see a remarkable graph that follows the protein leakage of subjects first on a conventional, low-sodium diet, which is what physicians would typically put someone with declining kidney function on, then switched to a supplemented vegan diet, back to the conventional diet, once more on the plant-based diet, and back and forth again. The chart is filled with zig-zags, showing kidney dysfunction was effectively turned on and off like a light switch, based on what was going into their mouths.


The first time someone visits NutritionFacts.org can be overwhelming. With videos on more than 2,000 health topics, where do you even begin? Imagine stumbling onto the site not knowing what to expect and the new video-of-the-day is about how a particular spice can be effective in treating a particular form of arthritis. It would be easy to miss the forest for the trees, which is precisely why I created a series of overview videos that are essentially taken straight from my live, hour-long 2016 presentation How Not to Die: Preventing, Arresting, and Reversing Our Top 15 Killers.

For the other videos in this overview series, see:

Inspired to learn more about the role diet may play in preventing and treating kidney disease? Check out these other popular videos on the topic:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Why is Extra Salt Injected into Meat?

Why is the salt industry so powerful? It has its own PR and lobbying firms to play tobacco industry-style tactics to downplay the dangers of high salt intake, but salt is so cheap. How much money is the industry really making? As I discuss in my video Big Salt: Getting to the Meat of the Matter, it’s not the salt mine barons who’re raking it in—it’s the processed food industry. Indeed, the trillion-dollar processed food industry uses dirt-cheap added salt and sugar to sell us their junk, and, by hooking us on hypersweet and hypersalty foods, our taste buds get so dampened down that natural foods may taste like cardboard. The ripest fruit may not be as sweet as Froot Loops, so we just continue to buy more and more of the processed junk.

There are two other major reasons the food industry adds salt to food. “The other 2 reasons, however, are entirely commercial and for most foods are the real reason the food industry wants the intake of salt to remain high.” If salt is added to meat, it draws in water, so the weight can be increased by about 20 percent. Since meat is often sold by the pound, that’s 20 percent more profit for very little cost.

Salt also makes us thirsty. There’s a reason bars offer free salted peanuts and soda companies own snack food companies. It is not coincidence that Pepsi and Frito-Lay are the same company. Would we shell out nine dollars for a drink at the movies after eating a bucket of unsalted popcorn? Would we supersize our soda if they didn’t salt our fries and Big Mac?

Salt is also added to meat because it solubilizes the muscle proteins into a gel for “optimum” meat texture, which is one of the reasons the meat and fish industries like transglutaminase, the “meat glue” enzyme. Meat glue can help gel the muscle protein without adding salt.

Some of these salt alternatives leave a bitter aftertaste in the meat, but this problem can be managed by adding chemical “bitter blockers…which work by blocking the activation  of [our] taste receptor cells and thereby preventing taste nerve simulation”—that is, the information is stopped from ever reaching our brain.

The meat industry acknowledges that its products contribute a significant amount of dietary sodium, “maligning their own image,” but salt is just so cheap that using anything else would cost the industry money. However, if the meat industry is able to resolve this cost issue—if it can make it cost-effective—then, one day, perhaps it could end up (as the meat industry itself said) “saving millions of lives as well as dollars.”


You can rejuvenate your taste buds if you cut down on foods with added salt, sugar, and fat. Check out Changing Our Taste Buds.

Did I say meat glue? If you have never heard of it, see my video Is Meat Glue Safe?.

The meat industry’s reaction to salt reminds me of its response to the classification of processed meat as a known human carcinogen. See Meat Industry Reaction to New Cancer Guidelines and The Palatability of Cancer Prevention.

Isn’t there controversy as to how bad salt really is for you? Decide for yourself with the science:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Make Sure Iodine is in Your Prenatal

Although severe iodine deficiency was eliminated in the United States nearly a century ago after the introduction of iodized salt, iodine intake has declined in recent decades. “Public health efforts to limit salt intake to decrease cardiovascular risk, in conjunction with increasing use of kosher salt and sea salt (neither of which contain iodine),” may in part be to blame. Not adding salt to foods is a good thing, as sodium is considered the second leading dietary killer in the world (second only to not eating enough fruit), but if you do add table salt, make sure it’s iodized. “It is a myth (often also false advertising) that ‘natural’ sea salt contains significant amounts of iodine.”

Fruits and vegetables provide iodine, but the amounts can vary depending on where it’s grown and how much iodine is in the soil. Because iodine is particularly important for fetal brain development, there’s a recommendation that “all US women who are pregnant, lactating, or even planning a pregnancy should ingest dietary supplements containing 150 mcg of potassium iodide per day,” which I discuss in my video Iodine Supplements Before, During, and After Pregnancy.

Is there evidence they’re not getting enough? We’d like to see urine levels over 150 mcg/L in pregnant women, but in the United States, pregnant women only average about 125 mcg/L. For example, a recent survey in New York City showed only about half of pregnant women were making the cut.

Don’t most pregnant women take prenatal vitamins, though? Only about half of prenatal multivitamins contain any iodine at all, and so only about one in five pregnant women in the United States are following the recommendations of the American Thyroid Association to take a daily iodine supplement, specifically in the form of potassium iodide rather than seaweed, as the levels in seaweed are subject to natural variability. Though the iodine content was as much as 90 percent off in some of the potassium iodide prenatal supplements, the kelp supplements varied even wider, off by as much as 170 percent.

Now, the American Thyroid Association admits it doesn’t have evidence that the current borderline insufficiency levels are leading to undesirable outcomes and so its rationale that all pregnant women take iodine supplements is a bit tenuous. Until such data are available, though, it figures better safe than sorry.

A randomized, placebo-controlled, interventional trial would answer the question once and for all, but the existing evidence for iodine supplementation during pregnancy is so convincing that it would be considered unethical to randomize pregnant women to a placebo.

When it comes to sufficient iodine intake during pregnancy, I’d recommend: Just do it.


Women eating plant-based diets may find this video of special importance: Pregnant Vegans at Risk for Iodine Deficiency.

This isn’t to say sea vegetables aren’t good for you in their own right. See Which Seaweed Is Most Protective Against Breast Cancer?.

For more videos on having a healthy pregnancy, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: