TRANSLATIONAL RESEARCH IN WASTING DISEASES: PART 2: Edited by Mariëlle P Engelen and Barbara van der MeijPhysical activity and nutrition in chronic kidney diseaseWang, Angela Yee-Moona; March, Daniel S.b,c; Burton, James O.b,c Author Information aDepartment of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong bDepartment of Cardiovascular Sciences, University of Leicester cJohn Walls’ Renal Unit, University Hospitals of Leicester NHS Trust, Leicester UK Correspondence to Dr Angela Yee-Moon Wang, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong. Tel: +852 22554949; fax: +852 22555411; e-mail: [email protected] Current Opinion in Clinical Nutrition and Metabolic Care 26(4):p 385-392, July 2023. | DOI: 10.1097/MCO.0000000000000947 Buy Metrics Abstract Purpose of review Lifestyle intervention is considered a cornerstone in chronic kidney disease management and has been recommended in different international or regional clinical practice guidelines in chronic kidney disease. However, evidence was largely based on the general population. Here we summarized the latest evidence supporting lifestyle intervention in chronic kidney disease. Recent findings Both observational cohort studies as well as randomized controlled trials have demonstrated health benefits with more physical activity in chronic kidney disease. There are compelling observational data supporting different health and kidney benefits with a healthy dietary pattern rich in fruits and vegetables, whole grains, plant-based foods and low in salt, low in sugar, saturated fat, red meat and ultraprocessed foods, a plant-based diet or Mediterranean diet in chronic kidney disease population. Clinical and epidemiologic studies also showed that higher 24 h urine potassium excretion (as proxy of higher dietary potassium intake) may be associated with lower blood pressure, better kidney outcomes and lower mortality in chronic kidney disease population. Randomized controlled trials also suggested that salt substitutes improved blood pressure control, reduced all-cause death and cardiovascular event risk in the general population compared with regular salt. Summary Accumulating evidence supports the current recommendation of encouraging physical activity and promoting a healthy dietary pattern in chronic kidney disease patients. Whether potassium needs restriction in chronic kidney disease diet requires further review. The safety versus benefits of salt substitutes in patients with moderate and advanced chronic kidney disease warrants further investigation. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.