Plant-Powered GI and Kidney Systems
I am lumping gut and kidney health together because pee and poop just seem like a natural fit. More studies on disease reversal akin to those done on heart diseases and cancer are needed. Nonetheless, whenever you choose a WFPB meal for your heart, prostate, and brain, you will also be treating your kidneys and GI system to a healthy experience.
I discussed the microbiome in prior chapters and how the Plant-Based Solution favors bacterial colonies that promote insulin sensitivity. I also explained the causation between processed red meat and colorectal cancer. The production of TMAO by gut bacteria and the impact on cardiac and kidney health is familiar to you now. The champion status of vegans and bowel movement frequency was reviewed with the discussion on Parkinson’s disease. This chapter will emphasize other important GI- and kidney-related topics.
CASE STUDY
Curing Ulcerative Colitis with the Plant-Based Solution
Like many college athletes, Kenny was focused on packing in foods rich in animal proteins—spicy buffalo wings, curly fries, raw eggs, and chocolate milk—to fill out and compete in football. Junk food was fine with him. It all fell apart a few years ago when he was rushed to the hospital with rectal bleeding and abdominal pain during his freshman college year. He required blood transfusions and was diagnosed with ulcerative colitis. He was treated with steroids. He experienced major weight loss from the inflammation in his colon. His dreams of a football career seemed crashed.
Kenny received little nutrition advice from his medical team, but other patients mentioned a WFPB diet as an option. Kenny would not give up on his dreams so he read everything he could on diet and GI health. He decided to adopt a vegan diet that was rich in fruit. Some days he would eat eighteen bananas a day. Other food staples were mangoes, dates, papayas, potatoes, and rice. Within a month he had gained ten pounds, felt fit, and was back on the team. Within a year, all lab tests and symptoms had normalized, and his doctors could not find any traces left of colitis. Furthermore, his weight returned to normal while he worked out, and he bulked up with plant-based muscle.
Now Kenny is ripped and feels great. He is often seen eating a plateful of baked potatoes with guacamole and steamed broccoli. Other days some beans and rice, vegetable bowls, and even Pad Thai without egg will fill him up. When we talked, he said, “I thought I would never be able to give up meat or dairy and that it would be a constant battle to not be tempted to eat a steak here and there, but in reality I don’t miss it. I am more than happy with the food I am eating and have no intentions of going back. A vegan lifestyle has saved my life and healed all traces of the disease ulcerative colitis.” 
Study In-Depth: Animal-Based Foods and Gut Health
Inflammatory bowel disease (IBD), like the ulcerative colitis that Kenny suffered from, afflicts many people. Diet is rarely mentioned as either a potential cause or a potential treatment pathway. A large study in France sought to investigate if there might be a connection between meat-based diets and IBD.1
Among 67,581 participants followed for many years, seventy-seven developed new cases of IBD. High total protein intake, specifically animal protein, was associated with a significantly increased risk of IBD. In fact, there was three times higher risk for those who ate the most total protein and specifically animal protein. Among sources of animal protein, high consumption of meat or fish was associated with IBD risk. High protein intake is also associated with an increased risk of incident IBD in French middle-aged women.
Science Corner: The Plant-Based Solution and Colon Health
The dramatic case of Kenny and his IBD is powerful but not unique. A thirty-six-year-old man who adopted a low-carb diet patterned after the Atkins diet began to lose weight but noticed bloody stools. A colonoscopy revealed diffuse inflammation limited to the rectum, and the man was diagnosed with ulcerative colitis. He was aware of data on plant-based diets and IBD and was provided a diet free of meat during his hospitalization. His bloody stools disappeared, and he achieved remission without medication for inflammatory bowel disease. This case indicates that an onset of ulcerative colitis can be an adverse event with a low-carbohydrate weight-loss diet.
Growing Healthy Guts with Plants
The Japanese medical community has adopted plant-based diets for IBD with more consistency than other health communities. A large study was performed using a semi-vegetarian diet for the prevention of Crohn’s disease relapse.2 In a single medical center over two years, sixteen adult patients with Crohn’s in clinical remission consumed a semi-vegetarian diet after hospitalization. Remission was maintained in fifteen of the sixteen patients (94 percent) in the diet group versus two of six patients (33 percent) in the omnivorous group. Remission rate in the diet-compliant group was 100 percent after one year and 92 percent after two years. A blood test for inflammation was normal at the final visit in more than half of the patients in remission who were compliant with the diet. Overall, it appeared that the diet was highly effective in preventing relapse of IBD.
As discussed earlier, the World Health Organization announced in October 2015 that processed red meats can cause cancer. An additional few words on the topic are in order in view of a large analysis of diets and cancer.3 The Adventist Health Study assessed the association between dietary patterns (non-vegetarian, lacto-, pesco-, vegan-, and semi-vegetarian) and the overall cancer incidence among 69,120 participants; 2,939 incident cancer cases were identified. A statistically significant association was found between a vegetarian diet and cancers of the gastrointestinal tract, with nearly a 25 percent reduction in the rates of these cancers in the vegetarians. Vegan diets showed statistically significant protection for overall cancer incidence of over 15 percent in men and women and by over 30 percent for female-specific cancers. On the whole, a vegan diet seems to confer lower risk for overall and female-specific cancer than other dietary patterns.
Diverticular disease, particularly diverticulitis, results in abdominal pain, fever, bowel dysfunction, and many emergency room visits requiring labs, CT scans, antibiotics, and occasionally surgery. While the medical community may be excellent at addressing the problem, what about the root cause? Fiber, which is present only in plant-based foods and not in any animal-based foods, is the key to great gut health and prevention of this problem. It is timely to mention the important contributions of Dennis Burkitt, MD, an English physician who spent many years practicing medicine in Africa. His experience in Uganda led him to make observations that were decades ahead of his time. There, he hardly ever saw anyone with the most common diseases in the United States and England, including coronary heart disease, adult-onset diabetes, varicose veins, obesity, diverticulitis, appendicitis, gallstones, dental cavities, hemorrhoids, hiatus hernias, and constipation. The Ugandan diet was simple and plant-based. He recalled removing only one gallbladder in twenty years in Africa.
In addition to discovering that one of the most common cancers in African children was due to an Epstein-Barr viral infection (known as Burkitt lymphoma), Dr. Burkitt’s other major contribution was focusing on the role of dietary fiber to promote health. He wrote a bestselling book, Don’t Forget Fibre in Your Diet to Help Avoid Many of Our Commonest Diseases, in 1979 that influenced the thinking of many health authorities and the food industry. He gets credit for placing plant-based fiber as a central pillar of disease prevention.
The EPIC-Oxford study in the United Kingdom examined over 47,000 men and women for dietary patterns and the development of diverticular disease.4 Dietary fiber was estimated by food diaries. With a follow-up time of twelve years, there were 812 cases of diverticular disease including six deaths. Vegetarians had a 31 percent lower risk of diverticular disease compared with meat eaters. The probability of admission to a hospital or death from diverticular disease between the ages of fifty and seventy for meat eaters was 4.4 percent compared with 3 percent for vegetarians. Study participants with the highest intake of fiber (>25 grams daily) had a 41 percent lower risk compared with those in the lowest group (<14 grams daily). Overall, consuming a vegetarian diet and a high intake of dietary fiber were both associated with a lower risk of admission to a hospital or death from diverticular disease. Looks like Dr. Burkitt was right, whether in Uganda, the United Kingdom, or the United States.
Kidney Disease
It is time to turn to kidney disease and your health. As the kidneys go, so goes overall health. Kidney health is crucial for overall health, and when they weaken, all systems suffer. The spilling of protein in the urine is a sensitive early test for generalized kidney failure and specifically renal endothelial dysfunction. The simple MACR (microalbumin-to-creatinine ratio) test is what improved dramatically in Adam in just thirty days on a WFPB diet (see chapter 6).
An advantage of vegan diets on renal function has been formally studied, and the MACR measurement has been confirmed to be lower with a plant-based diet.5 In fact, increased spilling of protein in the urine as an early sign of kidney damage has been directly associated with dietary animal fat and the consumption of meat.6 In a sub-study of the Nurses’ Health Study, 3,348 women had data at baseline and follow-up for MACR along with dietary histories. In women eating the highest amount of animal fat, the risk of developing urinary protein (called proteinuria) was almost twice as high as those eating lower amounts of animal fat.7 In addition, in the nurses eating two or more servings of red meat per week, there was a 150 percent increase in developing proteinuria. To be kind to your kidneys, you may want to be kind to the animals too and choose plants.
In addition to the above factors for kidney disease, diabetes mellitus and hypertension are two potent forces that damage kidney health. The role of WFPB diets in those conditions has been discussed previously. By preventing diabetes and hypertension, the burden of advanced kidney disease would dramatically shrink.
Dietary recommendations to prevent and manage advanced kidney diseases are complex and require considerations of protein sources, phosphorus accumulation, calcium, and other factors. There is at least some basis to recommend a WFPB diet to patients already suffering from chronic kidney disease (CKD). In a small trial of such patients, a meat-based diet was compared to a grain- and soy- and plant-based diet in terms of phosphorus levels and hormone production affecting calcium metabolism.8 Over a seven-day diet period, the plant-based patients had lower serum phosphorus levels. Their hormone levels also decreased in a favorable direction. Overall, the choice of plant-based protein had a significant effect on phosphorus homeostasis in patients with CKD. The better tolerance of the grain and soy diet suggested that dietary protein restrictions that are imposed in patients with CKD might be able to be revised, focusing on plant-based protein sources.
Ever have a kidney stone? Kidney stones cause the worst pain of a lifetime, in most people’s opinion. Rather than treat them, why not prevent them with a WFPB diet? The EPIC-Oxford study examined the frequency of new kidney stones requiring hospital admission in over 51,000 participants.9 Compared to those with a high intake of meat (>100 grams per day), the risk for vegetarians was nearly 40 percent lower. High intakes of fresh fruit and fiber from whole grains were also associated with a lower risk of kidney stone formation. That vegetarians may have a lower risk of developing kidney stones compared with those who eat a high-meat diet should motivate many who have felt the pain of a kidney stone to follow the Plant-Based Solution.
There is nothing sexy or macho about picturing a caveman on dialysis. Kidney disease has weakened some of my patients, aged their arteries and body, and often shortens their lifespan and healthspan. The ideas that meat and animal fats are needed for muscle development and brain health, that we need more and more animal protein particularly from grilled chicken, and that plant-based proteins are somehow inadequate are all doing great harm to many. An elephant eats plants. A gorilla eats predominantly plants. A horse pulls six people and eats hay and oats. Muscle develops just fine with the amino acids that make up the proteins in plant-based foods because they are the same amino acids as in animal muscle. Lysine is lysine no matter where it comes from. Just check out a vegan body builder website if you have any doubt about the potential to feed a rough and tough muscular man or woman on fruits, vegetables, legumes, nuts, and seeds alone.
THE PLANT-BASED PLAN Try a Probiotic Food to Support Your Microbiome
The availability of probiotic foods has exploded in recent years. Natural food stores offer a variety of options, and some are easy to make at home too. See if you can find one or more that you like to include in your daily diet:
• Fermented vegetables, like sauerkraut and kimchi
• Sour pickles (check the label to confirm they contain probiotics)
• Kombucha, a fermented tea beverage
• Kvass, a fermented vegetable and/or fruit beverage
• Nondairy yogurts (made from soy, coconut, or almond milk)
• Water kefir, a fermented beverage made from flavored water, juice, or coconut water
• Miso (use as an ingredient in recipes for dressings, sauces, soups, and more)