WHAT WE EXPECTED
by G. Curran
Being from a family of doctors, a family
that also includes a kidney patient, a specialist in
diabetes, and a professor at Harvard Medical School, I
have been exposed to more than the layman's usual
allotment of medical news. And over the last few years our
entire extended family has become intrigued by medical
literature on using diet in the control of kidney disease
(as well as in the prevention of other illnesses,
including cancer and heart disease).
At a meeting of the American Diabetes
Association, Dr.G. C. Viberti of Guys Hospital, London,
reported that his East Indian patients with renal
impairment had a far slower progression of disease and
renal failure than did his other patients. Hypothesizing
that the Indian vegetarian diet might account for this,
Viberti did experiments which, as anticipated, showed that
unlike animal protein, vegetable protein did not cause
unacceptably high increases in glomerular pressure, and
thus tended to preserve kidney function.
Similarly, the work of Dr. Mackenzie
Walser at Johns Hopkins has left little doubt that a
low-protein diet, with adequate supplementation, is highly
effective in preserving renal function, even in patients
with advanced kidney disease. The question has been raised
by others, however, as to whether patients can be expected
to comply with such "severe" and, by
implication, unpalatable restrictions.
It was to explore this question that our
family decided to experiment with a vegetarian diet.
What we found surprised us. One female
member needed iron supplements to prevent anemia, and it
was necessary for me, as family cook, to learn basic
substitutions. Instead of dairy cheese, for example, I
learned to use tofu* cheese, and for sour cream, we used
soft, silken tofu with lemon juice and sweetener. But the
biggest surprise was that our new diet was anything but
"severe." Critics of treating kidney disease
with low-protein diet had led us to expect that the
sacrifice of meat and dairy produces would be like giving
up the luxury of a mansion for a one-room poverty of
vegetables. To our amazement and delight, however, quite
the opposite proved true.
Unthinking reliance on "meat and
potatoes" had led to what, in retrospect, appears as
itself a restricted diet, relatively unvaried,
comparatively uninteresting. After closing the door to
meat, we found that an entire new visit had opened to us.
One could imagine a procession of joyous Neapolitan
peasant girls displaying their baskets of fresh glistening
grapes, olives, fresh green vegetables, fruits, and
grains, the rich harvest of the earth that previously we
had all but ignored. Italian spices and seasonings soon
became favorites, and other ethnic cuisines, with
appropriate substitutions where needed, soon filled out a
rich variety of fare, more exciting, more delicious, and
easier to prepare than the meals we had known before we
accepted these vegetarian "restrictions."
A pressure cooker proved to be an
amazingly fast (three-minute) means to healthy stews and
soups of all kinds--Indian lentil soups and curries, Greek
rice and lemon soup, Italian minestrone with any
combination of legumes, other vegetables, and pasta,
topped with grated tofu cheese, French "cream"
(tofu) of broccoli or cauliflower soup, Russian borscht
with beets or red cabbage topped with tofu sour cream,
Chinese and Japanese soups--the possibilities are endless.
Traditional Buddhist dishes, unusually delicious, have for
centuries been totally vegetarian, and there are many
Middle Eastern dishes, such as falafel and sesami tahini,
that are not only entirely vegetarian but robustly
flavored. In addition, some vegetarian cookbooks offer a
tantalizing variety of recipes for nutmeats to be prepared
as roasts, patties, meatloafs, casseroles,
stuffing--almost anything imaginable. And for dessert, the
wide range of fruits, tofu ice creams, cakes, and
vegetable-based pastries make possible hundreds of
Certainly we do not miss "meat and
gravy." It would be inconceivable to us now to give
up this splendid new variety. We continue to follow with
much interest medical reports on diet in managing renal
disease. As new studies are done on specific amino acids
and their effects on renal function, it is possible that
certain foods, egg whites, for example, as well as certain
dairy cheeses, may be reintroduced to the
"kidney-friendly" diet, at least in certain
stages of renal disease.
Meanwhile, in addition to the health
benefits, we continue to enjoy our international culinary
G. Curran is married to an IgAN patient.
* Tofu, made from fermented soybeans, is
widely used in Japanese and Chinese cooking. It has become
popular in vegetarian cooking as a source of protein and
calcium and as a versatile food that can
change shape and absorb flavorings well.
[Reprinted from Network News, No.
4 (November 1994)]