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    Rethinking Nutrition in Chronic Kidney Disease: Plant Foods, Bioactive Compounds, and the Shift Beyond Traditional Limitations: A Narrative Review
    (Mdpi, 2025) Nogueira-Rio, Nerea; Mondragon Portocarrero, Alicia del Carmen; Lamas Freire, Alexandre; Franco, Carlos Manuel; Canbolat, Ahmet Alperen; Karav, Sercan; Miranda Lopez, Jose Manuel
    The incidence of chronic kidney disease (CKD) has increased worldwide in recent years. Many factors can contribute to the progression of CKD, some of which are dietary patterns. Adequate control of protein, phosphorus, potassium, and sodium intake can significantly slow the progression of CKD. Most studies and nutritional guidelines addressing the care of people with CKD have focused primarily on dietary recommendations regarding macronutrient intake and the restriction of individual micronutrients. Traditionally, the consumption of fiber-rich fruits and vegetables has been restricted in patients with CKD to combat hyperkalemia. Among the reasons often given for this restriction are concerns about their high potassium and phosphorus contents. Limiting the intake of whole grains in CKD patients has also been recommended. However, findings indicate that phosphorus in plant foods is not fully absorbed in humans. Potassium contribution from vegetables can be reduced by culinary treatments, and when highly insoluble fiber is present in vegetables, it promotes potassium excretion through the intestine, which could help control the risk of hyperkalemia in CKD patients. Other recent findings have shown beneficial effects of vegetable bioactive compounds and resistant starch on CKD patients. The aim of the present review was to compile and discuss traditional recommendations for the use of plant-based foods for patients with CKD, as well as the mechanisms through which such foods may contribute to improving CKD progression.
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    Substitutive Effects of Milk vs. Vegetable Milk on the Human Gut Microbiota and Implications for Human Health
    (Mdpi, 2024) Mondragon Portocarrero, Alicia del Carmen; Lopez-Santamarina, Aroa; Lopez, Patricia Regal; Ortega, Israel Samuel Ibarra; Duman, Hatice; Karav, Sercan; Miranda, Jose Manuel
    Background: In the last two decades, the consumption of plant-based dairy substitutes in place of animal-based milk has increased in different geographic regions of the world. Dairy substitutes of vegetable origin have a quantitative composition of macronutrients such as animal milk, although the composition of carbohydrates, proteins and fats, as well as bioactive components, is completely different from that of animal milk. Many milk components have been shown to have relevant effects on the intestinal microbiota. Methods: Therefore, the aim of this review is to compare the effects obtained by previous works on the composition of the gut microbiota after the ingestion of animal milk and/or vegetable beverages. Results: In general, the results obtained in the included studies were very positive for animal milk intake. Thus, we found an increase in gut microbiota richness and diversity, increase in the production of short-chain fatty acids, and beneficial microbes such as Bifidobacterium, lactobacilli, Akkermansia, Lachnospiraceae or Blautia. In other cases, we found a significant decrease in potential harmful bacteria such as Proteobacteria, Erysipelotrichaceae, Desulfovibrionaceae or Clostridium perfingens after animal-origin milk intake. Vegetable beverages have also generally produced positive results in the gut microbiota such as the increase in the relative presence of lactobacilli, Bifidobacterium or Blautia. However, we also found some potential negative results, such as increases in the presence of potential pathogens such as Enterobacteriaceae, Salmonella and Fusobacterium. Conclusions: From the perspective of their effects on the intestinal microbiota, milks of animal origin appear to be more beneficial for human health than their vegetable substitutes. These different effects on the intestinal microbiota should be considered in those cases where the replacement of animal milks by vegetable substitutes is recommended.