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Kidney Diet Tips

February 5, 2015

Kidney Diet Tip: Choosing the best milk substitute

MilkSubs-273Cow’s milk is naturally high in protein and minerals. An 8-ounce cup of 1% low fat milk contains 8 grams protein, 366 mg potassium, 232 mg phosphorus, 305 mg calcium, 107 mg sodium and 27 mg magnesium.

Because of the high levels of potassium and phosphorus in milk, people with severe or total loss of kidney function (stages 4 and 5 chronic kidney disease) are generally advised to limit milk to 4 to 8 ounces a day. Non-dairy milk substitutes such as almond, rice or soy milk are recommended instead. Read more…

April 10, 2014

DaVita Diet Helper “How to” Part 2: Meal Planner Pre-planned Meals

The Meal Planner feature in DaVita Diet Helper provides pre-planned meals, or allows you to create your own meals. The pre-planned meals, or DaVita suggested meals, provide kidney-friendly menus and recipes for 3 meals and 2 snacks each day. These meals are designed to meet daily nutrition targets for protein, sodium, potassium and phosphorus selected in the meal plan settings.  The meals are on a 2 week rotation, plus additional meals are available in the “Substitute” list. Read more…

November 19, 2013

Why are phosphorus binders important?

iStock_000011386435XSmall-pillsPhosphorus is a mineral necessary to maintain good health; however, people with chronic kidney disease who are on dialysis are not able to eliminate excess phosphorus efficiently. High phosphorus levels can lead to heart disease, brittle bones, itchy skin and other complications so a low phosphorus diet as well as phosphorus binders are prescribed to help block some of the phosphorus consumed in foods. Read more…

July 2, 2013

Favorite 4th of July Kidney-friendly Picnic Recipes

Fireworks, outdoor games and friendly gatherings are a great way to kick off the first holiday of the summer. Naturally, when people get together there’s bound to be food. It can be a challenge to stick to a kidney-friendly eating plan when attending 4th of July picnics and cookouts. To help with planning, here are a few picnic-favorite recipes—including muffins, salads, chicken and cookies—to bring along so you can enjoy the festivities and not pay for it by feeling bad later. Read more…

May 16, 2013

Kidney Diet Tips: Our Ever-Changing Food Supply

Have you noticed the changes occurring in our foods? I am amazed every time I walk through the grocery store. A few examples are:

Cool Whip® is no longer non-dairy; it now includes skim milk and light cream.

Cottage cheese, half and half and milk with expiration dates 1-2 months ahead.

Sugar and low calorie sweeteners are blended together.

Packaged gelatin and pudding mix and some canned or bottled sodas, lemonade and teas now contain phosphate additives.

Fresh pork and chicken may be injected with sodium-phosphate solution to maintain the fresh appearance while waiting for purchase.

Heat and eat foods extend beyond the grocery store deli section, and unfortunately, often provide half or more of the daily sodium target .

Can you think of other examples?  Read more…

February 27, 2013

Kidney Diet Tips on Phosphate Additives – Your Great Phosphorus Saver (G.P.S.) Guide

DaVita Dietitian Julia from Ohio is today’s guest blogger with some great kidney diet tips about phosphorus.

Phosphorus by the Numbers

  • 250 mg to 1,000 mg of phosphorus is the amount removed in a dialysis treatment
  • 800 mg to 1000 mg of phosphorus per day is the typical daily target for a low phosphorus kidneydiet
  • 85% of fast food entrees and side dishes contain phosphate additives
  • 28% to 100% – a recent review of frozen chicken products revealed that the frozen chicken contained 28% to 100% more phosphorus than unenhanced fresh or frozen chicken.
  • 40% to 60% of the phosphorus that NATURALLY occurs in foods is absorbed into the bloodstream.
  • 90% to 100% of the phosphorus that is ADDED to foods, as a food additive, is absorbed into the bloodstream.
  • 100% of dialysis patients will benefit from avoiding foods with phosphate additives!

Just knowing that because your kidneys cannot remove phosphorus you need to avoid phosphate additives is the first step.  Knowing where these additives are found and how to avoid them is the all important next step.  Think of this article as your G.P.S. for phosphorus additives (G.P.S. – “great phosphorus saver”). Read more…

January 3, 2013

A Fresh Food Start for Your Kidney Diet

Happy New Year!

This is my favorite time of the year to not only reflect on the past year, but to start changes that will make 2013 even better. Today, my focus is on fresh foods in the kidney diet as a healthy change. The whole nation is experiencing a transformation in how we think about our food, with a renewed focus on

  • where and how food is grown
  • how it goes from the farm to food distributors, then to our tables
  • the amount of food processing and impact it has on personal health and the health of our country

This food transformation has an impact on kidney diet and food recommendations. New research on the best foods for kidney diets and health outcomes will further influence recommendations made by kidney health professionals in the future. Gaining control over how and what we eat means choosing fresh foods and preparing food at home instead of relying on takeout, fast foods, convenience foods and restaurants. Dietary Guidelines for Americans 2010, used in policy making, education materials and nutrition programs, is a valuable resource with guidance for building healthy eating patterns and making healthy choices.

For kidney patients, a fresh food start means lower sodium, phosphorus and potassium intake from processed foods, and more control over what goes in or stays out of the foods consumed. Think about ways you can make a fresh start with your foods in 2013. Here are some of my suggestions. Read more…

November 20, 2012

Positively Thanksgiving: Kidney Diet Tips to Keep You on Track

It’s almost here—my favorite fall holiday! Maybe it’s the cooking or the fact there are no presents to buy, or maybe it’s the memories of Thanksgivings past and the leftovers on Friday.  As you plan for this year’s holiday, think about the good times past and what you can do this week to feel good and stay healthy.  A positive approach can make the difference in how you handle your food choices on Thanksgiving and throughout the holiday season. Many dishes are high in sodium, potassium and phosphorus. You have several options though.  Think ahead and plan your Thanksgiving plate with the goal of feeling good afterwards.

Here are our favorite Thanksgiving kidney diet tips:

  • Look at the table and select 2-3 of your favorites but focus on the dishes that are closest to your diet.
  • Apply the 25% rule. Serve yourself a 25% portion of the item in question. For example, instead of one piece of pumpkin pie, have 1/4th piece. Fill in the gap with another dessert that’s more kidney-friendly.
  •  If the potatoes are not reduced-potassium, decide on either the mashed white potatoes or the sweet potatoes or yams, then limit to a small portion.
  • Salted gravy on the table? Take only 1-2 tablespoons and see if it satisfies. You can always add more if needed.
  • Count the number of items served that fit into your kidney diet plan. Fill your plate with these items first then fill the gap with smaller amounts of the foods that are not on your plan.
  • Remember your phosphate binders and make adjustments if recommended by your doctor or dietitian.
  • Remove the cheese or nut topping—no need to eat extra phosphorus when what’s underneath is so good.
  • Identify the foods high in sodium and leave these off your plate. Do you really need the bread or rolls that have hidden sodium? Can you go gravy-free? What about the soup—are you happy with a salad with vinegar and oil or low-sodium dressing instead?
  •  When limiting fluids focus on the glass that is half full; sip slowly and savor your favorite holiday beverage. Hot or very cold drinks require you to slow down and sip so your liquid is not gone before you know it.
  • The first and last sips are the best. Enjoy every drop but focus on these two the most.
  • Ice, gelatin, gravy and anything that pours at room temperature are foods that count as fluid. Pick the ones you like the most and leave off or limit the others.
  • Take a break. In-between the main meal and dessert is a great time to take a walk or play a game for extra exercise.
  • Prepare some of your favorite holiday recipes from DaVita.com to serve with the holiday feast.
  • Do a recipe makeover with family favorites to reduce ingredients high in sodium, potassium or phosphorus.
  • Be prepared to choose from the best choices first—turkey, roast beef or fresh pork with cranberry sauce instead of salted gravy.
  • Rice or pasta dishes are lower in potassium than potato dishes.
  • Choose low potassium vegetables without sauces— broccoli, turnips, carrots cauliflower, peppers, cabbage, green beans, green peas, zucchini  squash, lettuce salad with cucumbers, celery, peppers onions and radish.
  • Best desserts include fruit pies such as apple, berries or lemon meringue; a dollop of whipped topping is fine.

Ask your dietitian and other patients about their best tips for staying healthy during Thanksgiving and the holidays. Check out past Thanksgiving tips for the kidney diet:

Thanksgiving Tips for the Kidney Diet

 More Kidney Diet Tips for Thanksgiving

 Make Kidney-friendly Changes to Your Thanksgiving Meal

Kidney diet resources from DaVita.com


August 31, 2012

Labor Day Weekend: Tips for Kidney Patients to Stay on Track

Happy Labor Day!

Who doesn’t look forward to a 3-day weekend? (Perhaps that’s why we officially celebrate most of our holidays on Mondays.) For some people, however, a holiday weekend can be a challenge. Following your health plan is easier when you are on the regular, weekly routine. Getting out of the usual schedule can be stressful and derail your best intentions, especially with your kidney diet or diabetes diet.

Cookouts, picnics, travel and social activities are fun, but also add the challenge of sticking with your diet, exercise and medication routines.

Before you kick off the holiday weekend, read these 7 tips to help you stay on track with your kidney diet and health plan.

Use your planner  In business, successful people rely on their day planners and ‘To Do’ lists to stay on track. You can use the same tools and plan for diet success over the holiday weekend. Start by mapping out your activities, meals and medications. Knowing when and what you will be doing helps you focus on ways to stay on track with your diet.  Make a ‘To Do’ list and check it off as you do things like refill your pill holder, take a morning walk, make a grocery list and prep for a recipe or meal.

Create a menu With so many kidney-friendly recipes on DaVita.com, you have lots of great food choices for breakfast, brunch, picnics or backyard cookouts. Start planning your 3 day menu or select from a menu already created in Diet Helper. After you have a menu, a shopping list and trip to the grocery store is sure to motivate you to start preparing for your weekend meals. To get started, check out 5 ingredients or less recipes, Grill recipes, No Cook recipes, Picnic recipes or Potluck recipes from the DaVita kidney diet recipe collection.

Utilize leftovers Part of your holiday plan is to minimize time spent in the kitchen, so as you create your menu, add extra entree and vegetable portions to save as leftovers for a quick meal the next day. Turn leftover grilled chicken or fish into an entrée salad. Create a breakfast smoothie with leftover fruit salad. Top those leftover beef or turkey burgers with grilled veggies on a bun or as an open-face sandwich. Recreating a new meal with leftovers can inspire you and cut down on cooking time.

Write it down People who write down what they eat are more aware of the cumulative effect of food, and they are more likely to stick to an eating plan. Use a pad and pen or download one of the many apps for tracking your intake as you go.

Out of sight, out of mind Whether it’s taking your medications on time, remembering the best foods to choose at a social event, or tracking how much liquid you are consuming, you are more likely to remember if you have triggers like sticky notes, handouts posted on your refrigerator, alarms, or visual reminders.

Tune in Our bodies give us cues before problems get out of hand. Tune in by taking your blood pressure, monitoring your blood glucose or weighing yourself each day. Do an assessment on yourself . Are you short of breath or have swelling? Are you experiencing familiar or unfamiliar symptoms? Is your appetite good or do you feel stuffed from eating too much? Once you tune in and identify things that might be happening to your body, you can focus on a plan to get back on track.

Over/under Even the best made plans do not always go according to your intentions. Make adjustments to correct for overeating by having less the next day. If you veer from your plan by eating foods higher in sodium, potassium or phosphorus, or drinking too much fluid, decrease your intake the next day.

Remember to ‘begin with the end in mind’ as you plan for a fun 3-day holiday weekend, and stay on track with your diet and health plan. I hope you feel great when the short week starts Tuesday morning.

Kidney diet resources from DaVita.com


August 1, 2012

Normal Phosphorus in Early Kidney Disease: The FGF-23 Link

Phosphorus is a big deal for chronic kidney disease (CKD) patients, but often isn’t addressed until dialysis is needed. Thanks to a very efficient regulating hormone called fibroblastic growth factor-23 (FGF-23), blood phosphorus levels stay normal, usually until stages 4 & 5 CKD. What’s not obvious is that phosphorus can cause damage despite normal lab values, even in early kidney disease.

It’s well documented that excess phosphorus intake is bad, and we’re consuming more now than ever before. Here’s what we know:

  • In the general population, risk for developing cardiovascular disease increases as phosphorus levels increase—even within the normal range.
  • Lower phosphorus intake may help preserve kidney function in earlier stage CKD patients.
  • In patients with early CKD a lower phosphorus diet is linked to better parathyroid hormone (PTH) control. Excessive levels of this hormone contributes to bone disease and calcification.
  • Studies of phosphorus and  dialysis patients show that high phosphorus levels above 5.5 mg/dL  are linked to greater risk of hospitalization and death.
  • The use of phosphate additives in foods has sky-rocketed over the past 10 years, contributing an additional 1000 mg of extra phosphate a day, and this type of phosphate is absorbed 90-100% compared to 40-60% absorption form phosphates naturally occurring in food.
  • Almost all fast foods and 50% of the most popular grocery items have phosphate additives (start reading the ingredients on everything you buy).

The reason phosphorus stays normal until later stages of CKD is the hormone FGF-23 takes action to increase phosphorus excretion in the urine. This usually starts when glomerular filtration rate (GFR) is around 60-80. As FGF-23 increases so does risk of death for people with CKD.

FGF-23 can be reduced by low phosphorus intake and avoidance of phosphate additives.  Vegetarian diets or, for meat eaters, eating less meat and replacing meat with plant proteins also helps lower FGF-23.

Checking PTH and FGF-23 levels may become more important than looking at phosphorus levels in the future for patients with early CKD. But more evidence is building up to support following a lower phosphorus diet even when phosphorus is normal on the lab report.

Stay tuned as we learn more about FGF-23 and phosphorus control in early kidney disease.

Kidney diet resources from DaVita.com


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