Milk: Is it Bad for People on Dialysis?
Even with the ever increasing foods in the market, milk and dairy products still top the grocery list. After all, most of us know from school and television commercials that milk helps build muscles and strong bones. An 8-ounce cup has 8 grams of protein and 295 mg calcium. High calcium helps build and preserve bones, and decreases the risk of osteoporosis. Then why is milk a concern for people on dialysis?
When I tell my patients to decrease their intake of milk, some of them tell me they are only drinking 1% fat milk. Regardless or the fat content, one cup has an average of 230 mg of phosphorus and 365 mg of potassium. Some products are protein fortified or contain additional milk solids and may be even higher in protein, calcium, potassium and phosphorus. The challenge is that people on dialysis have to delicately balance calcium, phosphorus and potassium in their diet. As most people on hemodialysis need to stay within 800-1,000 mg of phosphorus and 2,000 mg of potassium daily, a cup of milk can quickly add up to the total daily allowance and exceed the limit. Also, it counts as fluid, which is limited for those on dialysis.
Even with all these nutrient constraints, most people on dialysis can still include 4-ounces of milk or yogurt once a day. You can:
- drink it plain
- use it for cereal
- eat plain or Greek yogurt as a snack
- use it for making a sauce base for your vegetables
- make a protein powder smoothie
- braise a roast in a slow cooker with a small amount of milk for added flavors
Remember to count the servings in one portion. For example, a recipe with 2 cups of milk that serves one person has 4 servings of milk in it. A recipe with 2 cups of milk that serves four people has 1 serving of milk for each portion.
Knowing about your individual diet recommendation will help you make the right food choices. If your dietitian has recommended you not to drink milk at all, then you can try alternatives like unenriched almond, rice or soy milk. In addition to finding substitutes at your local store, check out recipes on Davita.com for almond and rice milk. Additionally, non-dairy creamers without phosphorus additives may be used. However most nondairy creamers now contain phosphate additives. To know the recommended brands for these products, you can consult your renal dietitian.
Below are some delicious recipes which include one serving or less of milk or yogurt. How much do you drink and what works for you?