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Kidney Diet Tips

July 21, 2014

Is sea salt or kosher salt better than table salt?

SaltSea salt features a coarse texture and stronger flavor compared to table salt. Sea salt is made from evaporated seawater, so sea salt contains traces of additional minerals and is natural instead of processed. Kosher salt has large crystals and contains no preservatives. Kosher salt can be derived from seawater or underground sources. Table salt has fine granules and is mined from underground salt deposits. Table salt is processed with anti-caking agent to prevent clumping. Some table salts are fortified with iodine, a mineral important for thyroid hormones.

While there are textural and processing differences in sea salt, kosher salt and table salt, all of these salts share one thing in common; all are high in sodium. While none of these salts is lower in sodium, due to the size of the sea salt and kosher salt crystals, a measured teaspoon will contain less sodium compared to the fine granules in table salt.  When following a low sodium diet, all salt should be limited. However, using larger textured sea salt and kosher salt may help reduce sodium by a very small amount.

Resources from DaVita.com:

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…

June 14, 2013

Kidney Diet Tip: Please Pass Over the Salt

 The Dietary Guidelines for Americans recommend all people reduce sodium to 2,300 mg or less. For African Americans of any age, people who are 51 and older, or those with hypertension, diabetes, or chronic kidney disease, the sodium recommendation is 1,500 mg or less. Meeting these  low-sodium diet guidelines would be easier to monitor if you bought only fresh, whole foods and prepared them at home. In current times, that just doesn’t seem so doable. Enjoying the convenience of packaged foods and prepared meals as well as the pleasure of eating out at a restaurant mean you really don’t know how much sodium is in the food you consume.

One of the easiest ways to cut down on sodium intake is to pass up using table salt. It may take some getting used to, especially if it’s been a lifelong habit to add salt to foods—sometimes even without tasting first. 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…

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

 

February 24, 2012

Kidney Diet Tips: A new recipe for Sodium Girl’s Low-Sodium Recipe Rally

This week I’m stepping up to the challenge. Sodium Girl, who blogs on living salt-free and who has first hand experience dealing with kidneys, has challenged her readers to take a salty recipe and replace the high-sodium ingredients with low-sodium substitutes, creating a low-sodium dish full of flavor. I found out about the challenge a day ago, so had little time to to stew on what to create. Last night my hubby kept popping into the kitchen to check on the end result of the yummy smells and clanging pots.

I started with a couscous recipe I love from allrecipes.com. Here’s the original (and to give credit, it was created by Levedi, a cook who has shared several recipes.)

Couscous, Cranberry and Feta Salad

Ingredients                  

  • 1/3 cup couscous
  • 1/3 cup dried cranberries
  • 2/3 cup boiling water
  • 1/2 cucumber, diced
  • 2 tablespoons crumbled feta cheese
  • 2 teaspoons balsamic vinaigrette salad dressing, or to taste
  • salt to taste

Directions

  1. Place the couscous and cranberries in a heatproof bowl. Pour in the boiling water, and stir with a fork. Cover the bowl with plastic wrap, and set aside 5 to 10 minutes.
  2. Fluff the couscous with a fork, and fold in the cucumber and feta cheese. Season to taste with balsamic vinaigrette and salt.

Makes 2 servings.

Nutrients (my calculations–used 1/4 tsp salt for the recipe)

243 calories, 6 g protein, 40 g carbohydrate, 6 g fat, 13 mg cholesterol, 455 mg sodium, 175 mg potassium, 116 mg phosphorus, 91 mg calcium, 2.9 g fiber.

The feta cheese, salad dressing and salt to taste–all full of flavor and sodium, were my challenges. Additional challenges–the mushy cuccumber I had planned to use, and an almost empty bag of dried cranberries, plus keep it kidney-friendly with low potassium and low phosphorus ingredients. Needless to say, my creation was a bit different from the original recipe, but ended as a pleasant culinary surprise.

Here’s my low-sodium rally recipe:

Couscous, Apple and Carmelized Onion Salad 

 Ingredients

  • 2 cups thinly sliced white onion (Maui or other sweet onion variety)
  • 1 tablespoon balsamic vinegar glaze
  • 2 teaspoons honey
  • 1 small apple, cut, cored and thinly sliced (leave the skin on)
  • 1/3 cup water
  • 1 tablespoon unsalted sweet butter
  • 1/3 cup couscous
  • 1 teaspoon cinnamon

Directions

  1. Spray a nonstick skillet with cooking spray and cook onions over medium heat, stirring often. When the onions are translucent and soft, cover with a lid and continue to cook until carmelized, about 15 minutes. Stir about every 3-4 minutes and adjust heat if needed.
  2. In a separate nonstick skillet sprayed with cooking spray, cook apple slices over medium heat until tender. Reduce heat to medium low and cover with a lid. Continue cooking until soft and slightly browned, about 10 minutes.
  3. Add balsamic glaze and honey to caramelized onions and stir.
  4. Boil the water, add butter and stir until melted. Pour over couscous in a bowl. Cover and let set for 5-10 minutes.
  5. Sprinkle cinnamon over couscous and stir with a fork to mix.
  6. Add onions and stir until well mixed; add apples, toss and serve.

Tip: Serve hot or cold–it’s great both ways!    

Makes 2 servings

Nutrients:

230 calories, 4 g protein, 37 g carbohydrate, 6 g fat, 15 mg cholesterol, 7 mg sodium, 155 mg potassium, 66 mg phosphorus, 32 mg calcium, 3.4 g fiber.

I loved participating in this challenge. Sodium Girl has not only proven you can live with and enjoy a low sodium, salt-free diet, she has also prompted a whole group to create and prove there is flavor without salt. Thank you Sodium Girl!

What’s next? March is National Nutrition Month. Find out what the DaVita Dietitians are doing to celebrate!

Kidney diet resources from DaVita.com

February 17, 2012

Kidney Diet Tips: Finding Nutrients in Food

Where do you go for help when you want to find out the nutrients in your food? Knowing  protein, carbohydrate, fat, sodium, potassium, phosphorus and calcium content of food helps you make better decisions…and may influence how closely you stick to your kidney diet. There are several sources to consider.

Food Labels

The most obvious nutrient source is the food label, available on all packaged foods. Many grocery stores provide nutrient information for fresh produce, and soon fresh meat will require a nutrition label. The drawback is that potassium and phosphorus are optional on food labels and these are among the most important ones you need to know if you have chronic kidney disease or if you are on dialysis.

Food Composition Books

Any bookstore has a variety of food composition books that list nutrients in foods. Your dietitian most likely has a copy of “Bowes and Church’s Food Values of Portions Commonly Used”, a comprehensive nutrition data book with thousands of foods, now in its 18th edition.

Other food composition books vary in the nutrients included. A few on my shelf include “The Complete Book of Food Counts and Vitamin and Mineral Counter”, both by Corrine Netzer, and “The Calorie King Calorie, Carbohydrate and Fat Counter” from dietitian Alan Borushek. If you still prefer a book over an electronic reader or computer, these resource books are a good investment. Some are available to download an electronic version. An extensive list of food composition resources is available from the USDA National Agriculture Library.

On a smaller scale, you can order a pocket guide from the American Association of Kidney Patient. It gives potassium, phosphorus, sodium and protein values for many commonly eaten foods.

Nutrition Databases

As a USA taxpayer, you have invested in a nutrient database that is available to anyone without charge. You can download the USDA nutrient database directly to your computer desktop and easily look up foods. Almost all the foods in this database contain potassium and phosphorus values, and it is updated once a year. One drawback is you won’t find  brand name and restaurant foods, but many generic descriptions can be found. I keep the most recent version right on my computer desktop so it is easy to access and use.

Another quick look-up tool is the Food Analyzer on DaVita.com. Keep this tool in your favorites to easily look up thousands of food. This special database has a filter to only include items with potassium and phosphorus, a feature missing from many online food analysis tools.

Looking for more? DaVita Diet Helper is a no-charge online meal planner with already planned menus, a Food Analyzer and Nutrition Log. You can  track the foods you eat and instantly see nutrient totals, including calories, protein, carbohydrate, sugars, fat, saturated fat, cholesterol, fiber, sodium, potassium, phosphorus and calcium. Your data is saved and automatically broken down into meals, snacks and daily total. There are other online meal planners, but Diet Helper has two features that are missing from other planners. It is based on protein, potassium, sodium and phosphorus instead of calories to provide customized meals for kidney diets; plus all the foods in the database contain values for all the above nutrients, unlike some programs that do not include potassium and phosphorus for all foods.

Nutrition Software Programs  

You can purchase nutrient software programs that have additional features like diet and exercise analysis, scoring systems, weight trackers, menu planners, and recipe features. These programs usually include the USDA database as well as generic, brand name and restaurant foods. There are many simple, easy to use programs, such as Dine Healthy, or a number of other software programs at the Nutrition and Food Web Archive. You can get more bells and whistles from larger programs like The Food Processor  or Compu Food Analysis. A Google search will reveal many options and information on nutrition software programs.

There’s an App for That

In addition to the above resources you can find many apps for your smartphone or other devices. These apps make it much easier to track your food intake throughout the day and to have real-time data to help make decisions about what to eat on your kidney diet. Kidney Diet offers an app secifically for people following a kidney diet with a focus on protein, potassium and phosphorus.  

Regardless of the source you use to find out the nutrients in your food, learning and sticking to a kidney diet is easier when you have tools and resources to help you choose the best foods for your health.

 

Kidney diet resources from DaVita.com

 

July 8, 2011

The reality of following your kidney diet: thoughts from the renal dietitian

I’ve noticed some confusion around what to include and exclude on the renal diet for dialysis and chronic kidney disease, especially when it comes to including some of the higher sodium, phosphorus or potassium containing foods. In today’s post I want to give you my thoughts on the realistic side of following a kidney diet and diet goals. Read more…

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