Overcoming Diet Obstacles: Together We are Better

Overcoming diet obstacles may seem like an impossible challenge at times. When I am asked to give a nutrition talk, I often begin by asking the question “Who here enjoys following their diet?” and ask for a show of hands. Typically not one hand will be raised and some good-natured laughter follows. I point out to the class that I did not raise my hand either. While I do not have kidney disease, I have a strong family history of diabetes and heart disease and have been advised by my doctor to be mindful of my food choices and to exercise regularly. And I do my best to follow my doctor’s advice but I confess it is not always with a motivated, cheerful attitude.

Truthfully, most of us will come to a cross roads one day where we must choose to either (as the saying goes) “live to eat or eat to live.” And that is a very personal decision. Equally true is that the renal (kidney) diet is one of the most complex diets to follow and is often coupled with other diet restrictions such a diabetic and/or cardiac diet.  Even in the midst of all the restrictions, I have seen (over the course of my 30 years as a dietitian) many of my patients and their loved ones handle the challenges of the renal diet like champs. One common thread stands out in each of their cases: resourcefulness and a sense of community. I wish to share some of their stories here with the hope that others may find them helpful:

• One of the most touching and inspiring stories is that of a small group of patients’ wives who formed an informal support group of sorts in our waiting room. As they waited together during their spouses’ treatments, a beautiful bond of friendship was formed between them. One of them came to me and asked me to help her adapt some of her homemade recipes for the renal diet. She then made some of these adapted recipes and brought samples for the other wives to try. The other wives were appreciative and soon started making some of these recipes as well as other recipes I placed on the waiting room display table. Eventually, these ladies got the wonderful idea to have a “meal exchange” to decrease the amount of cooking they each needed to do for the week. Each would make a double batch of the renal dish they were preparing over the weekend. On Monday, they packed the dish over ice in coolers and brought them to dialysis where they exchanged these dishes in the parking lot at the end of their husbands’ treatments. Very awesome!

• Years ago, another patient of mine belonged to a gourmet food club. He and his buddies had formed this club years before and each took a turn preparing a gourmet food dish and hosting the others at their home to partake of the delicious food and enjoy lively conversation. When he needed to start dialysis, he felt quite disheartened because he thought his days as a gourmet food club member were over. I asked him where he got his recipes from and he brought in a magazine he used as a resource. Together, we looked at recipes in the magazine and decided which ones could be adapted for his renal, diabetic diet and mapped out a meal plan. With time, he got so adept at adapting that he no longer needed my help (but I still checked in to hear about the delicious food and lively conversation). His buddies came to appreciate the fact that he needed to follow certain diet guidelines and some adapted the recipes they prepared when hosting the event.

• Another gentleman did not have the same access to social support as did the folks in the above two scenarios. He had recently moved into a personal care home and had no family. The personal care home was able to accommodate some of his diet restrictions but not all of them and some of his lab values became elevated. He asked me what he could do. We considered his options and discovered that he was able to get two weeks’ worth of menus in advance from the personal care home. He brought the menus into dialysis where we reviewed the choices together and circled those that were the best for his nutritional needs. Some of his lab values were still out of goal on occasion, but overall they showed improvement. He benefited from making the most of the support and resources available to him.

Each of us is unique, as are the life circumstances that impact our ability or desire to face life’s challenges, including diet obstacles. This includes the challenge of “sticking to our diet.” Remember though that no one is meant to “go it alone”.  There is much to be said for trying things a new way and much strength to found in togetherness and community.