From Kon-Tiki to Kidneys: Let the Evidence Speak
I’ve been talking about and studying this paleo nutrition/evolutionary medicine idea since late 1998 when I first ran across the topic. It’s impossible to describe how much the landscape has changed and how much more we know…Holy CATS…13 years later! If you’ve read my book or just caught the right podcast you will recall that I was tinkering with my food in the mid-late 90’s by eating a whole food, vegan diet. I studied at the George Oshawa macrobiotic institute, took classes on Ayurveda and Five Element theory and consulted with several of the luminaries in the vegetarian/vegan scene. The reasons for this tinkering included a sense this way of eating would improve my health, extend my life…and it was a great conversation starter when trolling for unwashed hippy girls, which I have an odd predilection for. Add to that a sense of moral superiority at not eating animals, and a sense that this was an ecologically benign way of eating and it’s easy to understand why I gave it a shot. What’s tough to understand is why I stuck with this way of eating when every parameter of my performance and health tanked. I went from a lean, muscular 180 lbs, squatting over 500lbs and being able to dunk a basket ball from a flat-footed start, to an emaciated 140lbs that could not bench press my body-weight. I had high blood pressure, triglycerides in the 300’s and systemic fatigue that seemed to start in my belly and emanate outwards. I was a mess. I’d sold off my common sense and ability to rationally judge the effects of my eating choices with regards to how I Looked, Felt and Performed. I was wedded to an idea, not to results. Looking back now I understand I was deficient in a host of nutrients due to the severe inflammation in my GI tract. Despite the fact I looked “slender” (substitute gaunt and emaciated if you like) I also had all the signs and symptoms of insulin resistant diabetes brewing. I now understand I was in that purgatory of nearly full systemic melt-down: Autoimmune dysfunction, insulin resistance, nutrient malabsortion…and I lived in a place that has not seen the sun since the pyramids were erected, Seattle, Washington. I changed my eating in a desperate attempt to save myself. I literally had no other options…if this paleo shtick had not worked I’d not be here right now, either by biology’s hand or my own. Things were that bad.
I think this paleo/evolutionary medicine approach to things is pretty close to the bulls-eye with regards how we can optimize our health and wellness…but I insist that we not turn this whole thing into a religion. The transformation that can be wrought with this approach is powerful, anger can be felt at the “powers that be” for recommending what appears to be complete jack-assery…but we can do better than opine on this stuff, we can quantify and tinker and continue to refine what are our collective best practices. Many people have parroted tripe about “open source” with regards to fitness, but it takes something beside paranoia and egotism to change ones position for the better. I credit first and foremost my friend Mat “The Kraken” Lalonde with helping me to update my understanding of these topics and to refine my delivery of the “why’s” behind the recommendations I make. Chris Kresser, John Welbourn and many other folks have also helped but I think I’ve learned the most simply as an outgrowth of the interaction I’ve had with all the readers, podcast listeners and seminar attendees. The why to that is that folks take the basic message that is being broadcast, tinker with it, report outcomes and we move forward. Crowd Sourcing and decentralized markets at their best!
Given the title of the post you may be wondering when the heck I’ll get around to talking about kidneys! I’ll get there, but I have more to say that is decidedly non-kidney related. Last night I started reading the book Kon-Tiki by Thor Hyerdahl. I re-read the introduction by Thor 3 times and am by no means deep into the book but the basic idea is this: Thor posited that the Polynesian islands were settled not in an west–>east expansion as had been previously thought (the book was published in the late 1940’s) but rather that pre-Columbian Incas from the approximate areas of Peru traveled westward on rafts and they and their descendants settled Polynesia and the Pacific islands. What struck me was the recounting on Heyerdahls’ part that once their expedition proved that this trans-Pacific crossing was POSSIBLE, the skeptics who defended an alternate position were little interested in facts, they focused instead on personal attacks and behavior that bordered on slander. In one section Heyerdahl related that most archeologists of the time did not believe the Galapagos Islands had ever had human contact or settlement until after Europeans made landfall in the 1500’s. Based on his success navigating over 43,000 nautical miles Thor felt the paltry distance from Peru to the Galapagos could not have been a barrier to the early Incan seafarers. He also pointed out a hole in the notion that humans had never been to the Galapagos: Not once had there been an expedition of trained archeologists to assess if there was any EVIDENCE of early human habitation. Thor organized such and expedition and in quick order found several camp sites with pottery and artifacts consistent with what one would expect from the early Incan civilizations.
This reminds me of the daily refrain from the medical establishment, nutritional science departments and the media who make grand proclamations about what humans did or did not eat in the ancestral life-way, what this might mean for modern human health…and these folks have never bothered to look at or read the literature on the topic. It’s an interesting parallel: In the Galapagos island case the idea was: Europeans were the first to make it there. Even though no one had bothered to actually LOOK, nor use people trained in discovering evidence of early human habitation (archeologists) to validate this claim one way or the other. The refrain from medicine and dietetics is that our heritage as hunter gatherers has no bearing on modern human health, despite the fact that the evolutionary biologists, geneticists and anthropologists beg to differ on the topic. Also interesting to keep in mind is the modern view of the habitation of the Pacific Islands might involve the convoluted story of early seafarers making it west to east across the Pacific, only to subsequently turn around and re-populate those islands. Geneticists are telling us more about this story than pottery shards ever will, but it’s interesting; where once the notion of early seafarers making it across the Pacific AT ALL has now been replaced with perhaps multiple waves of colonization, back and forth across the Pacific. Thor’s original idea may only be partially correct but his early investigations pushed the understanding of this topic forward and we’ve just had to wait for better technology to better understand this topic.
Similar to the migratory waves we now envision as populating the Pacific islands and America’s, so too do we see waves of people entertain this paleo idea of nutrition…with inevitable questions. What about cholesterol? Will paleo help gastrointestinal problems such as Crohn’s and irritable bowel syndrome? Will an ancestral way of eating improve fertility or perhaps halt the progression of various neurodegenerative diseases like Parkinson’s, Alzheimer’s and Huntington’s disease? Won’t a high protein, paleo type diet cause kidney disease? These are great questions and we should have similarly great answers. The kidney issue has received a ton of airplay of late, both in terms of folks asking questions and in new studies showing that a smartly constructed paleo type diet may be the absolute best way one could eat to either reverse existent renal issues, or to avoid these problems in the first place. We should be able to look at the how the kidneys normally function, investigate renal pathophysiology (autoimmunity, advanced glycation end-products, infections and other vectors of disease) then we should be able to retro-engineer the cause of these issues given a solid understanding of these processes and a wee-bit of evolutionary biology. We should then be able to show clinical examples of successful interventions which reverse or ameliorate these diseases. I’d like to call this the “definitive guide to kidney health” but my previous mistake with veganism has made me reticent to call anything definitive. It should however be helpful for folks to understand this topic and feel more comfortable using a paleo approach. So, this will be the (very lengthy) introduction to a multi-part series which will start with how the kidneys work, what things can go wrong with them and how a paleo diet can actually help reverse many of these problems. Unlike my foray into veganism however, we will not believe things because it “seems” right, we will hang our hat’s on positive health outcomes. No matter how much we may “want” a theory to be true, we lose what is best in us when we cease to think and adopt dogma instead of facing the need to change our deeply entrenched positions. Stay tuned for installments in the weeks to come. I’m not sure how many sections it will be, you will know when it’s done ;0)
And for your viewing pleasure, here is the original Thor Heyerdahl film, Kon-Tiki, which won an Oscar for best documentary in 1951.
“I think this paleo/evolutionary medicine approach to things is pretty close to the bulls-eye with regards how we can optimize our health and wellness…but I insist that we not turn this whole thing into a religion.”
Amen brother. I try to think in a holistic way, be open to new ideas and absorb new information. After all
Quality of life is more important than the ratio of macro nutrients you consume.
Health is more important than your personal record in deadlift.
Happiness is more important than your body fat percentage.
I’m really looking forward to this series. I was born with only one fully-formed and functioning kidney. My unformed/malformed/”bad” kidney remained in me until around age five, when it started to become infected and was removed. I’ve always been very concerned about my overall health and cautious about taking any lifestyle change to an extreme because, well, I’m missing one half of a redundant system. I don’t know if relying on one kidney for my whole life makes me any more likely to suffer kidney problems as I age, but I’m not taking chances.
I could only be happier if you were also working on a deep-dive look into Paleo during and after pregnancy, which is another “medical condition” I am currently afflicted with. Maybe?
The pregnancy thing has been covered! Look through the archives, check out http://www.everdaypaleo.com and http://www.growinguppaleo.com
http://healthybabycode.com/signup chris kresser
Whol eee smokes. Epic post.
It’s been a while since I posted here. First note, I like the book and all the new stuff going on. I first checked your stuff at your blog before the green topped one. Don’t remember what it looked like. I do have to admit though, I have a fondness for the green blog. I guess just nostalgia.
I love the evolving thought going on as of late. Kurt Harris, Stephan, Robb Wolf, all seeing new evidence and not being afraid to shift course to what y’all believe to be a better path to health.
I have had a couple Aha moments during the hundreds or more hours I have spent reading nutrition blogs and listening to Podcasts. The first was when you got shit canned from crossfit and in the ensuing 600+ comments I saw a link to the Kurt Harris blog. He had a post about your dismissal and in that post he had a profound statement. One that is now so obvious, in fact it was glaringly obvious the moment I read it. But until I read it the thought had never crossed my mind. He said (I might be paraphrasing here) “Crossfit is in the business of selling certifications” YES they are! Interesting note: Notice how I spelled CrossFit, three different ways. The first one got squiglied because I didn’t take the time to caps the letters. The second one too. When spelled with a capital C/F no red line. They have made their way into Apple spell check on my mac. WOW!
My other Aha moment was when I read this post. Maybe these moments occurred because I had a personal interest in both. I really like this post. And I really like how you take a stance on not turning nutrition into a religion. Very important.
Well I should say my personal take on this post and the follow up posts are that my dad and grandmother are type 2’s. I have banged the drum trying to tell them they need to look beyond meds to fix their disease. It always falls on a deaf ear. My grandma is in a nursing home with failing kidneys. I guarantee she wishes she was dead. Has some Dementia too. I am going to let my dad listen to your podcast about kidney problems and diabetes. Then I will point him to this post. After I tell him about how I don’t want to have to deal with all the problems he is dealing with caring for his mom right now, and he sees this stuff from someone other than his own know it all son, i HOPE a light bulb goes on. If not my toes are still tapping.
By the way. I was listening off your main page and distracted. Could not rewind. I think I heard right though and it may be one of the sweetest phrases ever. I would in fact wear a shirt( it would have to be beefy t type not an affliction type) in black with maybe metal lord or some other basic white font that had this phrase across the chest “Macronutrient Agnostic” For me it would be right up there with the “Listen To Black Sabbath” shirt that came out in the mid 90’s when I was into skate culture. ( still love Sabbath)
Anyhow, take care. It has been awhile since I shot you a compliment for giving me free advice. Really looking forward to the coming posts.
Clay
It’s my belief that an understanding of the scientific method and logical reasoning are essential prerequisites for the future well being of our species. Otherwise we will be led astray by false feelings (at best) or by self-interested groups or corporations who will manipulate us (at worst).
The paleo lifestyle fascinates me. Not only from the wonderful changes I’ve seen in myself but also on an intellectual level as I can see the cognitive dissonance being played out in the public.
Another area that fascinates me is group differences as it pertains to health,nutrition,intelligence,behaviour, etc. Whatever your position on this topic, you have to agree w me that right now in the cultural climate we are in, it is extremely difficult to have an open honest debate w only the facts argued and w/out resorting to ad hominem attacks.
I am looking forward to reading this series. My husband has a kidney transplant. While we would never do anything to jeopardize that without approval, it will be interesting to see the theory and whether any of that can be translated over safely for him. I have one kidney also (hubby has the other one) and the paleo diet has suited me just fine with no problems or issues with blood work or renal function numbers.
Thanks for sharing this! I recently donated a kidney to my mom and docs stress keeping protein to a minimum. For me they said no more than 45 grams/day max which is quite a transition for me because I was a fitness enthusiast and clean eater. (They also said no herbs either).
Great post Rob — we are always “spiraling in on the truth.” I LOVE seeing posts like this that emphasize investigation and discovery over dogmatism and personal attacks.
I’ll have to watch that Kon-Tiki doc when I have more time, pretty interesting stuff. It’s amazing the things we find out as time goes by. I can’t imagine the things we’ll discover in another few hundred years.
I’m looking forward to this series too. My brother had kidney cancer a few years ago and had one of his kidneys removed. His other kidney has a small cyst in it, but the doctor said it was fine. Not too long ago I actually got him to start eating paleo most of the time.
In the last podcast you were talking about high protein diets and diabetics. Here’s a study that looked at a high protein diet and resistance training in type 2 diabetics. They also measured creatinine clearance and urinary albumin.
http://care.diabetesjournals.org/content/33/5/969.long
Robb, this is terrific. You have been getting some great information out. I have been following for a while. Thank!!
John
I like this very literary direction you’re taking. The quality of the writing is excellent here, which is like mental crack for the bibliphilic graphophiles among us.
The kidney issue itself is fascinating. I know you have some background info rolling around in your dome regarding the Chinese medicine perspective on the kidneys and their function. It’s very interesting that the TCM view of diabetes (called Xiao Ke or Wasting and Thirsting Disease) is one of profound kidney dysfunction, among others.
Thanks Luke, I’ll probably not include any TCM perspectives on this, but thanks for the kind words.
Nevermind the paleo; I can’t believe that little man can dunk. That’s very impressive!
I have never found anybody else that has even heard of this book. I found a copy at an open air market in Spain years ago and loved reading it.
I also agree with the point about not turning nutrition into a religion. It’s when we decide that we know what is right and close ourselves off to differing opinions that we start to alienate people and they tend to write off what we say, even if it is valid.
hi Rob,i have been on the Paleo diet for 3 weeks thanks to Adam at Hoover Family Acupuncture & Oriental Medicine.Thanks to the very powerful and inthusesastic talk he gave me and the ill health taht i was in ,i went head force into it. i have lost 15 pounds but most of all feel very good ,i have a long way to go and so appriciate your knowledge and guidance .cheri
AWESOME! cheri, please keep us updated on your fantastic progress.
My sister, who introduced me to your work, believes I must live a charmed life based on your posting this article on Kidney Disease. I’ve been semi-paleo for a year or so (low carb, very limited grains & sugar)–I’m in excellent health and extremely fit for a 74-yr old woman (5’7″, 127 lbs, Pilates Instructor, walk 5 mi a day,work out 5xwk, take no meds, etc.) Feel fabulous. That said, I was shocked at my physical a couple of years ago to find I have Level 3 Chronic Kidney Disease. Even more surprising, my GFR went from 55 in ’09 to 65 in ’10 then boom, down to 54 in 2011! Not a good trend! I am not diabetic (glucose 98) and have great blood pressure (120/65) pretty good cholesterol (HDL 99, Tri-56 and LDL 141) and was concerned that my paleo protein was a problem–I’ve become more aware of how much protein I eat. I am looking forward to the rest of your series to help me figure out how to stay healthy! Thanks! This is great information and much appreciated! Judy
I’ll give you a preview: protein does NOT damage kidneys. Damaged kidneys do not process protein by products effectively. Two very different scenarios.
Thanks – looking forward to learning more – this stuff is SO interesting.
The medical field is finally understanding this as well. We only promote low protein diets in the presence of pre-existing chronic kidney disease. Looking forward to this series.
I have borderline high creatinine, BUN; just being “watched” for “elevated creatinine”. I was advised to limit my protein to 2 servings per day. >>So I am wondering if I can do the Paleo diet safely – I started a week ago after reading the book. I had been doing the vegan/grains/soy for the past 10 years with bad sugar cravings. My cholesterol, LDL, HDL okay, but the triglygerides tend to be higher than normal. Could that have caused small blood vessel damage & thus kidney issue? No diabetes, yet. …>>I also have history of an autoimmune blood dyscrasia ITP which occurred x4 in 27 years; prednisone rx. A bone marrow biopsy revealed high mast cells which I was told may indicate allergy. A basic allergen test (trees, pets, etc.) revealed no allergies. So I wonder if I should be tested for gluten/food allergies, got IBS too. I am anxious to see if this Paleo diet will help both issues, creatinine & dyscrasia. I’m doing the 30 days.
Oops, forgot to say I am 62 years old & otherwise in fairly good health. BP normal to low. Pulse 60 or so. Sometimes it is in 50’s & they ask if I exercise, which I do – only it is water: aerobics, foam weights, zumba. Can’t do land due to osteoarthritis knees, one partial knee replacement in ’09. Hypothyroid too, so trying to get 40 pounds off after that dreaded prednisone x4 in 27 years, does get dyscrasia into remission. Oh & thanks for your great work!
I strongly object to your pejorative use of the word tripe. Tripe is lovely.
Ok, got me there.
Rob, I am so excited about your upcoming posts regarding paleo and kidney functions. Great fan of the podcast and your book. I started low carb 3 years ago with pretty good results as long as I kept the carbs down. Ironically thanks to Jimmy Moore’s websites/podcasts I was introduced to Cordain’s and your work and have transitioned to a paleo lifestyle. Unfortunately, maybe tragically ironic, over the course of the last 3 years, averaging 1 a year, I have developed calcium oxalate kidney stones, unbelievably painful. All the conventional medical advice from my cardiologist and urologist goes against a low carb/paleo diet. After my most recent bout several months ago, I did 2 24 hour urine collection tests that showed that I had high uric acid levels and high oxalates. The advice from my doctor, dramatically cut down on anything with a skin – fish, poultry, meat, cut down on oxalate foods, no nuts, spinach, leafy greens. ??? All mainstays of my paleo diet. So I’m in a bind. What the hell am I supposed to eat? Been trying to drink much more water with lemon juice (hopefulling improving my acid/alkaline balance), more salads, etc. Please, please in your upcoming posts, address the issue of the causes/solutions to kidney stones. Thanks again for your great work.
You mentioned in episode 80 about that guy you helped who had only 10% renal function. Care to share specifics regarding the diet you put him on that restored him to normal kidney function?
so excited for this – among my husband wide host of inexplainable medical issues is kidney stones… (needless to say the list is extensive from blood, heart, kidneys, guy, etc)… I’m slowly coxing him to the paleo lifestlye!
I can’t wait for this series so he can’t get on board even further!
Robb I have been a crossfitter for almost a year in a half now and have eat the paleo diet pretty strict for that year in a half. I am 22 6’1,183,9.70 bf. My only problem right now is im having trouble eating the paleo since well I am deployed for 13months so we are limited to what we eat. I am going on my R&R leave next month for 2weeks and my parents dont exactly believe in my kind of eating so I know there will be lots of pizza and bagels I do not really find joy in eating those things anymore but I mean its all that will be around me and I need to eat. My question is will all this really hurt my status where I was before in health was and everything or is a couple weeks totally off not going to kill me. I do order alot of paleo stuff to where im at in afghanistan but I mean obvisoulsy im not eating grass fed beef and stuff like that. Please any information is great I am trying to get my nutritional science degree also I love the paleo diet and I plan on opening my own box when im out and helping with nutrition but still I would really like your knowledge on how far back this might set me even though Im still really young and in good shape and healthy but will this 2weeks kill me? Thank you and hope to get your nutrition cert once im back.Hopefully your going to NJ sometime soon.Take Care
You’ll be fine. Make the best decisions you can, but It’ll be fine.
Hi Robb. I am really excited by your post on this topic. I was diagnosed with a kidney disorder last year around this time (Focal Segmental Glomerulosclerosis, FSGS for short) in addition to Crohn’s Disease which I have had for 17 years. For the past month or so I have been experimenting with the paleo way of life and I have to say it has really made a noticeable difference in my GI symptoms. My family is on board with the grain free part of the diet but highly concerned what the increase in protein will do to my kidneys. I am told by my nephrologist that my kidneys are currently at about 50% functioning. I am interested in your opinion as I am learning that the conventional medical opinion (and did I mention I am a nurse) is not always spot on and needs further analysis. Looking forward to the rest of these posts. Thanks so much.
Thanks for the interest. Use a ketogenic type Paleo approach. Lowish protein, mod-high fat lowish carb.
Robb , is there anywhere to find more ideas on a lowish protein, mod high fat , lowish carb diet idea for a person who has mild ckd and pre diabetes ?
Hmmmm….I honestly don’t know. Dr. phil BLair in florida does this work but not sure how much he has written.
Can’t wait for the rest of the blog posts in this series. I am a 30 year old track sprinter, regular crossfit/oly lifter, and paleo eater. I have low kidney functioneGFR of 66-72 which concerned me, but I am told that low kidney function is ‘normal’ for a high intensity athlete? I’d love to hear your thoughts on this. Clearly flushing out higher than average levels of CK (muscle breakdown) (level 470) has an effect on your eGFR result. Keen to find out if that low eGFR result really means much – given that the high quality of the food (including lots of protein) is still keeping the body in a generally higher state of function, regardless of the eGFR…
Will keep my eyes/ears out for the next post!
Scott
Scott- the higher creatinine is just a symptom of training and muscle mass, not remotely an issue.
Thanks Rob. So I guess the Low eGFR is just a side effect of processing that excess creatinine? All other tests said kidneys are fine. But the low eGFR still bothered me.
It’s a relative test…like body mass index. Is a BMI of 30 bad? Not if you are a 10% body fat power athlete!
Wonderful information. I just began doing crossfit a week ago and am newly introduced to the paleo lifestyle. I had Wilms Tumor at 2, had my left kidney removed and am now 24 in perfect health. should I be weary of crossfit? Anything is appreciated, thank you!
I believe that the Paleo diet has helped reverse a kidney condition I once had. A couple of years ago I was diagnosed with bilateral hydronephrosis (enlargement of both kidneys). I had blood tests, an ultrasound and a renal scan (basically an MRI for kidneys, ureters and bladder) that showed enlarged kidneys. The plan was to keep an eye on my kidneys and to put stents in my ureters to increase the flow if necessary. Coincidentally, the week of my diagnosis was the week that I finished reading the Paleo Solution and did a 180 on my diet. I went from eating about 3/4 of a bag of pasta every day, to zero planned grains in my diet, lots of lean meat, vegetables and fish oil supplementation. At the first six-month check up, my urologist was shocked that I showed no signs of enlarged kidneys. She asked me if I had made any lifestyle changes during that time and I told her about my switch to Paleo. She didn’t seem convinced that it could just have been that, but in my mind, the results speak for themselves.
This is just one random anecdote, but I hope it adds to everything that Robb and the whole Paleo crew do!
Thanks!
Alexander,
I am a 23 year old male who developed right flank pain in the past 6 months which led to a series of exams that found I have Hydronephrosis caused by a kidney deformity that apparently is a birth defect I had no idea about. My kidney has never given me problems until this year and I’m otherwise a healthy person. Before seeking medical treatment options, I decided to look for holistic/nutrition based remedies and treatments when I came across your post. I’m going to give Paleo a try and I pray it has the same impact on me as it did on you.
I have a kidney transplant and i’m considering going paleo, even though it’s about 80%. my only problem is that my transplant nurse has advised me not to have a high protein diet-i don’t know how high is high.
i would appreciate your opinion.
It’s going to depend on your size for sure. It’s really hard to give an amount without knowing more about your situation, but a paleo diet doesn’t necessarily insinuate a high protein diet. You can eat a moderate to low protein diet and still be paleo, so don’t give the idea up just because of the protein stipulation. And Good Luck!
Thank you for this post. I have been working with a personal trainer and she put together a nutrition plan that is mostly Paleo. She does allow some dairy, but not much. I was concerned about the plan she gave me because of Class 5 Lupus Nephritis. I will definitely do more research and run it by my nephrologist, but I think I might give the Paleo diet a try.
Robb, my girlfriend is becoming paleo, and I am reading your work. She has growing cysts in her kidneys, do you have any suggestions? Thank you!
Track things and see what the dietary changes bring about.
Opensource is a nice way of describing the wellness community that has grown up around ancestral health. I agree that the interchange is what is refining the knowledge levels, and it is awesome.
I see the major defining factor as being occam’s razor or simple logic. Joining the dots. No religion – no superficial or blindly accepted notions. No taboos.
“First they ignore you, then they laugh at you, then they fight you, then you win.”
— Mahatma Gandhi
I look forward to your kidney series. Because I specialize in reversing diabetes (prediabetes and Type 2), I talk often about the medical complications of untreated diabetes, including kidney failure. Normally, our kidneys do a great job of filtering our blood and protein and sending waste particles to urine. But, high levels of blood sugar make the kidneys filter too much blood. All this extra work is hard on the filters. After many years, they start to leak and useful protein is lost in the urine. Having small amounts of protein in the urine is called microalbuminuria. Catching at this stage can help prevent kidney failure before it becomes macroalbuminuria. But, the best scenario is early diagnosis and treatment. I recommend getting your A1c tested annually so you have a better chance of preventing type 2 diabetes in the first place.
Thank you for this introduction and for Part Deux; hugely informative. But, 5 years later I’m still waiting (and hoping) for the continuation of articles on this subject that you said you’d do.
https://robbwolf.com/contact/robb/ does not work !
Dear Robb URGENT
I read about Pete “Proteinuria” Paducka in my online search and am writing with some urgency on behalf of a forum friend whom I will call “CharlieT” who has been hospitalised twice so far. We are from Singapore.
I suspect CharlieT had Refeeding Syndrome complications leading to his 2nd Admission to SGH (Singapore General Hospital) in May 2017. His CKD3 in March is now End-Stage CKD5 and he is slated for dialysis in August when he is expected to be back on solid food. He really wants to avoid dialysis and further possible refeeding or other complications once he starts eating.
“The course of action involved a low protein (10-15% protein) low carb ( less than 10%) high fat (mainly from coconut products), ketogenic diet.”
It would really help if there is a CLEAR Simple Eating Plan that CharlieT could easily follow with the precise food items and daily amounts to take out the guesswork regarding electrolytes nutrients etc for laymen eg which vegetable is SAFE for him [the amount etc] & which to AVOID completely. Must he avoid even avocado or spinach or the healthy fats such as olive oil (other than coconut oil – how much allowed etc) etc which are supposedly ‘healing’ foods ?
Looking forward to your reply on an urgent basis & thanking you in advance for your time & kindness.
You can reply to this email [email protected]
Btw CharlieT is a crowdfunding recipient as he is unable to work.
Read/Hear from CharlieT on his medical history below :
“Anyway my whole case
• Warded SGH ICU 9 Oct 2016 ‘cos sudden severe stomach pain/breathing problem
• weight 98kg @168cm
• Severe inflammation of pancreas – severe acute pancreatitis (high hereditary TG)
• Removed part of pancreas (*** multiple CPR done during operation)
• Complication led to diabetes
• Complication led to kidney function impairment – was CKD3
• Was on tube feeding for 4 months [till Feb 2017]
• Allowed to eat during the last month [Feb-Mar 2017]
• Off dialysis before 1st discharge in mid-March 2017
• Off insulin injection before 1st discharge
• Lost 56kg, discharged at 42kg
• Discharged in mid-March 2017 & had to learn to walk after 5 months’ of bed stay
• Tried & went off vegan diet (to avoid adding load to kidney) – had poor appetite with constant vomiting
• Hospitalised AGAIN before mid-May 2017 after found severely disoriented with uremic encephalopathy leading to memory loss + some stomach infection
• Stomach got hole and from CKD3 to now end-stage CKD5, can only drink
Nepro-LP milk (5 packs per day)
• 42kg dropped to 37.1kg after 2nd discharge on 16 June 2017 – unable to walk again & to ingest solid food until hole in stomach heals in August or so
Medical Diagnosis :
1. CBD Stones – CBD stricture with cholangitis – stented
2. Pancreatitis with retroperitoneal collection via cystgastrostomy
3. Ascites, transudative, likely 2′ to hypoalb & CKD
4. CKD
5. Severe malnutrition 2′ poor intake hypercal state
6. L incomplete PV thrombosis (16/2)
• Dietitian advise me that when I can eat solid food again, make sure I take some animal protein (7x matchbox-sized protein servings per day), even though it might increase the load on my kidney but without all the animal protein, my body will not gain weight and instead of healing my kidney, my body will fall apart first.
* My latest blood report shows everything under control, but only my blood pressure always on the high side
• in two months time in early August 2017, doc plans to do a ERCP to replace the bile duct “stent” and will have to stay few days in hospital again
& also to operate on my vein in preparation for dialysis.”
Thanks & Best Regards
Joanna & CharlieT