Kidney Diet Tips

Squash: A New Pasta Alternative

Pasta is an excellent low-phosphorus and low-potassium choice when following a kidney diet. However, it is important for people with diabetes and chronic kidney disease (CKD) or on dialysis to manage their blood sugars by limiting foods high in carbohydrate. Pasta is a higher carbohydrate item and a food that some may find it easy to overindulge in. Whether watching calorie intake or managing blood sugars, zoodles or spaghetti squash can be a fun alternative!

What are Zoodles?

Zoodles are zucchini made into faux-pasta. Or you can use yellow crookneck squash. Spaghetti squash is also used to make faux-pasta. Once you make these pasta substitutes you can dress them up the same way you normally dress up pasta!

One half a medium zucchini with skin contains 256 mg potassium and a cup of spaghetti squash contains 180 mg. Use these amounts to stay within a kidney-friendly range.

Follow these simple steps to make a balanced zoodle or spaghetti squash meal.

Step 1: Choose Your Faux-pasta Squash

  • Zoodles: Using a spiralizer (a kitchen tool used to transform veggies into pasta-like spirals), push the zucchini through to make pasta shaped cuts. Drizzle olive oil over the zoodles and cook in a frying pan for a few minutes until tender.
  • Spaghetti squash:  Cut a spaghetti squash in half. Scoop out the seeds. Lightly oil the inside of the squash and bake, face down on a baking sheet, for about 45 minutes at 400 F°. Remove the squash, let cool for 15 minutes, then use a fork to scrape out the insides and create your “spaghetti.” Tip:  Before cutting the squash you can microwave for 6 minutes, then cool. This makes it easier to cut the squash in half. For added safety, hold the squash with a kitchen towel when cutting.

Step 2:  Pick Your Protein

Squash pasta alternatives are low in calories and carbohydrates so they may leave you feeling hungry. Add one of these suggested protein sources to add more calories, protein and nutrients.

  • Chicken (cooked and diced)
  • Ground turkey or beef meatballs
  • Salmon
  • Shrimp
  • Veggie crumbles (soy replacement for ground meat)

Step 3: Pick Your Sauce

Tomatoes are a high potassium food and marinara sauces are tomato-based, so if you are limiting potassium use tomato sauces in small portions or choose lower potassium sauces. Here are some ideas:

Step 4: Add More Vegetables 

Vegetables contain fiber and important nutrients that are good for the body and leave you feeling full longer. Low potassium options are best. Remember to count the squash noodles, vegetable-based sauce and added vegetables as part of your daily allowance. Even though summer squash and spaghetti squash are low in potassium compared to winter squash, portion is still important. You may need to limit fruit and vegetables at other meals or snacks if including more than 2 vegetable servings.

  • Broccoli
  • Brussels Sprouts
  • Kale or raw spinach
  • Mushrooms
  • Onion
  • Red or green bell peppers

Experiment with different sauces and protein combinations. Here are some suggestions:


Daneille DeGroot, MS, RDN, LDN

Daneille DeGroot, MS, RDN, LDN

Danielle has been a registered dietitian for four years. Her hobbies include running, yoga and spending time with her two dogs.