Phosphorus Content of Several Plant-Based Yogurts.

OBJECTIVE: In people with chronic kidney disease (CKD), hyperphosphatemia is an independent risk factor for mortality in observational studies. Despite not having proven benefit, dietary control of phosphorus is thought to be essential in CKD. Though dietary and serum phosphorus are correlated, ingested phosphate is less bioavailable from plant-foods rich in phytate than from animal and processed foods. Yogurt is considered a useful food due to its relatively low phosphorus and high protein content but may be detrimental since the protein content is from animal sources. Instead, plant-based yogurts (PBYs) may offer similar benefits without the associated downsides of animal protein in kidney disease, but little is known about the phosphorus contents of PBYs. DESIGN AND METHODS: Protein contents and phosphorus additives were obtained from nutrition labels of several, widely available PBYs of almond, cashew, oat, coconut, and soy substrates. Phosphorus content was measured via emission spectrometry by Eurofins (Madison, WI). Based on these data, phosphorus-to-protein ratio (PPR) for each PBY was calculated. RESULTS: Phosphorus was highest in Silk Soy Strawberry, then Silk Almond Strawberry and Siggi's Coconut Mixed Berries. Phosphorus was lowest in So Delicious Coconut Strawberry, then Oatly Oat Strawberry, Forager Cashew Strawberry, and Kite Hill Almond Strawberry. According to the ingredient labels, Silk Soy Strawberry, Silk Almond Strawberry, and Oatly Oat Strawberry contained phosphorus additives while Siggi's Coconut Mixed Berries contained pea protein additives. Of PBYs from the same substrate class, So Delicious Coconut Strawberry and Siggi's Coconut Mixed Berries had the largest differences in their phosphorus and protein contents. These seven samples' PPR ratios were higher than that of dairy yogurt values reported from the literature, including Stonyfield Organic Oikos Strawberry, Chobani Nonfat Strawberry, and Yoplait Greek Strawberry. CONCLUSION: Low phosphorus-to-protein ratio (PPR) foods are emphasized for people with CKD. Siggi's Coconut Mixed Berries had the lowest PPR. However, So Delicious Coconut Strawberry had the highest ratio which underscores product variability despite both using the same PBY substrate. Of the samples analyzed, Siggi's Coconut Mixed Berries may be the most desirable for patients with CKD because its PPR was the lowest.

Taking the Kale out of Hyperkalemia: Plant Foods and Serum Potassium in Patients With Kidney Disease.

Traditionally, diets for kidney disease were low in potassium. This recommendation was based on outdated research and often wrong assumptions that do not reflect current evidence. In fact, studies conducted over the past decades show patients with CKD, including kidney failure, do not benefit from the restriction of plant foods relative to control. Generally, dietary potassium does not correlate with serum potassium, and we posit that this is due to the effects of fiber on colonic potassium absorption, the alkalinizing effect of fruits and vegetables on metabolic acidosis, and the bioavailability of dietary potassium in plant foods. Also, consumption of plant foods may provide pleiotropic benefits to patients with CKD. Emerging dietary recommendations for kidney health should be devoid of dietary potassium restrictions from plant foods so that patient-centered kidney recipes can be encouraged and promoted.

Advancing Lifestyle Medicine in New York City's Public Health Care System.

Chronic diseases are the leading cause of death and disability in the United States, and much of this burden can be attributed to lifestyle and behavioral risk factors. Lifestyle medicine is an approach to preventing and treating lifestyle-related chronic disease using evidence-based lifestyle modification as a primary modality. NYC Health + Hospitals, the largest municipal public health care system in the United States, is a national pioneer in incorporating lifestyle medicine systemwide. In 2019, a pilot lifestyle medicine program was launched at NYC Health + Hospitals/Bellevue to improve cardiometabolic health in high-risk patients through intensive support for evidence-based lifestyle changes. Analyses of program data collected from January 29, 2019 to February 26, 2020 demonstrated feasibility, high demand for services, high patient satisfaction, and clinically and statistically significant improvements in cardiometabolic risk factors. This pilot is being expanded to 6 new NYC Health + Hospitals sites spanning all 5 NYC boroughs. As part of the expansion, many changes have been implemented to enhance the original pilot model, scale services effectively, and generate more interest and incentives in lifestyle medicine for staff and patients across the health care system, including a plant-based default meal program for inpatients. This narrative review describes the pilot model and outcomes, the expansion process, and lessons learned to serve as a guide for other health systems.