Have you ever counseled a patient who frequently seems to be in an “off” mood?  What does that look like? Merriam-Webster Dictionary defines mood as the following: “predominant emotion” or “a prevailing attitude.”  When someone is “moody” they may display one or more of these emotions:

  • Anger
  • Sadness
  • Tension
  • Gloominess
  • Fearfulness

Perhaps the patient’s seemingly negative mood is related to poor gut health.  A growing amount of evidence shows a connection between gut health and mood, though the mechanism is not fully clear.

A healthy gut is defined by high diversity and balance of healthy bacteria throughout the gut microbiome and a diet can significantly influence this balance. Diets low in vegetables, fruits and legumes result in decreased production of short-chain fatty acids (SCFAs) which help maintain intestinal barrier integrity and protect against inflammation. Diets higher in pro-inflammatory foods such as processed meat, fried foods and refined carbohydrates have been linked to mood disorders such as depression and anxiety by negatively impacting gut microbiome diversity.

Scientifically supported ways such as regular exercise, reducing stress, getting enough sleep, and eating less sugar contribute to improving the health of human gut microbiome, which in turn improves mood. Another factor to develop and sustain a healthy gut is by eating an adequate amount of fiber. Diets rich in fiber have been implicated in supporting and improving gut health, however, most Americans do not consume enough of it.


Benefits of fiber include:

  • Helps decrease intestinal transit time
  • Increase stool bulk/output
  • Promotes growth of beneficial bacteria in the gut
  • Supports production of SCFAs
  • Improves/strengthens the gut barrier
  • Assists with blood sugar control

Patients with CKD should gradually aim for 25-35g of fiber per day by incorporating more whole foods like fruits, vegetables, beans, and whole grains. They may also look for products that claim to be “high fiber,” to make this claim on a food label the product must contain five grams of fiber or more per serving.

Reaping the mood boosting benefits of high fiber foods can also be tasty, check out the following high fiber, renal-friendly recipe your patients may enjoy:

Shitake, Soba Noodle and Miso Bowl

Yield: two servings



3 cups water
½ cup shiitake mushrooms, dried
4 ounces soba noodles
1 tablespoon white miso
2 tablespoon chopped green onion



  1. Boil the water in a medium saucepan over high heat.
  2. Add the mushrooms and cook until softened and swollen, about 6 minutes.
  3. Add the noodles and cook until al dente.
  4. Ladle about ¼ cup of noodle broth into a liquid measuring cup.
  5. Add the miso into the cup and mix thoroughly with a whisk or fork.
  6. Pour the miso mixture back into the saucepan. Serve in bowls, top with green onion, and enjoy!

(Source: American Kidney Fund’s American Kidney Kitchen, contributed by FamilyCook Productions)


Nutrients Per Serving (1/2 recipe):

Calories:                               156
Fat:                                         1 g
Saturated Fat:                   <1 g
Cholesterol:                         0 g
Carbohydrates:                 33 g
Sugar:                                    1 g
Fiber:                                    6 g
Protein:                                8 g
Sodium:                            390 mg
Calcium:                              10 mg
Phosphorus:                     68 mg
Potassium:                        196 mg


Learn more on Gut Dysbiosis by downloading our webinar handout: Improving Gut Dysbiosis in Patients with CKD and ESRD AB Handout

Thank you to our guest blogger, Kathleen Meyer, for her contributions and valuable insight.