Rx Nutrition Resource Center

Rx Nutrition Resource Center

Disclosures: Borin reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
May 26, 2021
2 min read

Plant-based milks acceptable for patients with CKD, may help mitigate climate change

Disclosures: Borin reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Investigators from New York University have identified the plant-based milks that compare most favorably to dairy milk for patients with chronic kidney disease, as well as those prone to kidney stones.

According to James F. Borin, MD, and colleagues, plant-based milks could not only serve as viable alternatives to dairy in terms of nutritional content for these patients but could also aid in environmental protection efforts.

Dairy alternatives
Infographic content was derived from Borin JF, et al. J Ren Nutrit. 2021;doi:10.1053/j.jrn.2021.03.011.

“Patients with kidney stones are counseled to eat a diet low in animal protein, sodium and oxalate and rich in fruits and vegetables, with a modest amount of calcium, usually from dairy products,” Borin and colleagues wrote. “Restriction of sodium, potassium and oxalate may also be recommended in patients with chronic kidney disease. Recently, plant-based diets have gained popularity owing to health, environmental and animal welfare considerations. Our objective was to compare concentrations of ingredients important for kidney stones and chronic kidney disease in popular brands of milk alternatives.”

Comparing nutrition labels of popular plant-based milks (including almond, cashew, soy, hazelnut, hemp, oat, macadamia, rice, flax and coconut) with each other and with dairy milk (whole and fat free), the researchers focused on sodium, calcium and potassium content. Oxalate content was determined through ion chromatography and mass spectrometry.

Researchers determined oat, rice, macadamia and soy milk were most similar to dairy milk in terms of fewer kidney stone risk factors (containing moderate calcium and potassium, modest sodium and low oxalate, according to the researchers), thereby serving as the better options for patients prone to stone formation. On the other hand, almond and cashew milk had more potential stone risk factors.

For patients with CKD, researchers recommend coconut milk as the first choice (due to its low potassium, sodium and oxalate content), but noted that macadamia milk may provide another option (though it contains a higher sodium content than coconut milk).

“There are many reasons why plant-based milk alternatives are attractive to consumers, making their effect on kidney stone risk and CKD an important clinical question,” Borin and colleagues wrote, highlighting challenges that many people have with digesting lactose, as well as the potential risk for breast and prostate cancer with the consumption of dairy milk.

“Others avoid dairy owing to concern for animal rights or environmental impact, including carbon emissions, land and water use, and reduced biodiversity,” the researchers wrote. “A recent study found that replacing half of all animal-based foods (eg, dairy, meat, and fish) with plant-based foods would save 224 million metric tons of carbon per year, equivalent to 47.5 million passenger vehicles. Modeling studies have projected substantial increases in kidney stones due to climate change; therefore, substitution of dairy by plant-based milks with favorable stone risk profiles is an attractive solution to reduce future stone risk at the individual and societal level.”