A recent study found that replacing half of all animal-based foods (e.g., 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. Others avoid dairy due to concern for animal rights or environmental impact, including carbon emissions, land and water use, and reduced biodiversity. 8 In addition, many studies have linked dairy with common malignancies including breast and prostate cancer, 9– 12 possibly mediated by IGF1. Approximately 2/3 of the world population has a reduced ability to digest lactose after infancy. 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. Macadamia milk is another option for patients who are restricting potassium and oxalate, but has a higher sodium content than coconut milk. For patients with CKD, coconut milk compares favorably with dairy milk based on the lowest sodium, potassium, and oxalate levels. Our results suggest that oat, rice, macadamia and soy milk may be appropriate substitutes for stone-formers. In addition, we compared the concentration of ingredients that should be monitored in CKD (sodium, potassium, oxalate). Our objective was to evaluate the concentrations of ingredients which promote (sodium, oxalate) or inhibit (calcium, potassium) stones in milk alternatives. Additionally, urinary oxalate excretion declines with waning kidney function, which can raise plasma oxalate levels and may lead to further decline in kidney function. For example, in this patient population, sodium and potassium restriction is often recommended, although our understanding of the effect of dietary potassium in CKD is currently evolving. 5 This could have implications for patients with kidney stones.īesides kidney stones, the micronutrient distribution of the various milk alternatives may affect those with chronic kidney disease (CKD). 4 However, there is concern that some nut-based milks may have high oxalate content. Prospective data from the Health Professionals Follow-up Study and Nurses’ Health Studies showed that increased calcium intake from dairy or non-dairy dietary sources is associated with a lower risk of incident symptomatic kidney stones. 3 Unfortified nondairy milks have less calcium than dairy, although many commercially-available non-dairy milks are calcium-fortified. 1, 2 Recently, plant-based diets have gained popularity the US nondairy milk market grew by 50% in 2018. Patients with kidney stones are counseled to eat a diet low in animal protein, sodium and oxalate and rich in fruits and vegetables, as well as a modest amount of calcium, usually from dairy.
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