Crews Deidra C
Clin Nephrol. 2020 Supplement-Jan;93(1):36-41. doi: 10.5414/CNP92S106.
Persons with or at risk for chronic kidney disease (CKD) and their healthcare clinicians seek ways to prevent adverse kidney outcomes. Recent studies highlight that specific healthful dietary patterns may lead to favorable kidney outcomes; these include dietary patterns rich in fruits and vegetables such as the Mediterranean diet, the Dietary Approaches to Stop Hypertension diet, and dietary patterns low in dietary acid load. However, for many socioeconomically disadvantaged individuals, healthful dietary patterns are inaccessible due to inability to afford or access healthful foods. Barriers may exist at multiple levels, including the individual level (e.g., knowledge and beliefs about healthful eating habits) and the institutional level (e.g., rules and regulations about healthy food availability and cost). In this review, recent studies are described that document dietary patterns that may promote kidney health. A framework for considering barriers and facilitators of healthful eating among disadvantaged individuals modified from the social ecological model is offered, and their potential impact on kidney diseases is discussed. Recent epidemiologic and intervention studies addressing dietary factors in the setting of chronic kidney disease and other conditions are detailed. Finally, knowledge gaps in intervention studies, evaluation of public programs, and advocacy efforts are discussed towards promoting "food as medicine" to support kidney health for all. .
患有慢性肾脏病（CKD）或有患CKD风险的人群及其医疗保健临床医生在寻求预防不良肾脏结局的方法。最近的研究强调，特定的健康饮食模式可能会带来良好的肾脏结局；这些模式包括富含水果和蔬菜的饮食模式，如地中海饮食、终止高血压饮食疗法饮食模式，以及饮食酸负荷低的饮食模式。然而，对于许多社会经济地位不利的个体而言，由于无力购买或获取健康食品，健康的饮食模式难以实现。障碍可能存在于多个层面，包括个体层面（例如，对健康饮食习惯的知识和信念）和机构层面（例如，关于健康食品供应和成本的规则与规定）。在本综述中，描述了记录可能促进肾脏健康的饮食模式的近期研究。提供了一个从社会生态模型修改而来的、用于考虑弱势群体健康饮食的障碍和促进因素的框架，并讨论了它们对肾脏疾病的潜在影响。详细介绍了针对慢性肾脏病及其他病症背景下饮食因素的近期流行病学和干预研究。最后，讨论了干预研究、公共项目评估和倡导工作中的知识空白，以推动“食物即药物”理念，支持所有人的肾脏健康。
