Kidney Diet Tips

Going Mediterranean on Your Kidney Diet

One of the hottest diet topics over the last few years has been the Mediterranean Diet. In fact, May has been designated as International Mediterranean Diet Month! Fortunately, this is one of the few diet trends actually supported by science. The Mediterranean Diet is not really a “diet” but a way of living, long enjoyed by people living in countries near the Mediterranean Sea.

What is a Mediterranean Lifestyle?

Characteristics of this lifestyle include eating a lot of fresh fruits and vegetables, whole grains, beans, nuts, seeds, fermented dairy products, fish, eggs and poultry.  In addition, the Mediterranean way of living strives to create a balance of work, relaxation and exercise.

The focus of this post is on healthy foods and exercise as part of the Mediterranean lifestyle. Heart disease, stroke, obesity, Type 2 diabetes and other chronic diseases are shown to be greatly reduced by following this lifestyle.

Which Foods are on the Mediterranean Diet?

Fruits & Vegetables:  The less cooked and processed, the healthier.  Many of the vitamins and minerals are conserved when the produce is washed, cut and eaten all at one time.

Bread: Unprocessed bread is the healthiest. You can buy bread with no preservatives or unnecessary added ingredients. Making your own bread may be intimidating, but it is much healthier and it tastes better! Try Mediterranean Black Olive Bread or No Need to Knead Garlic Bread.

Whole Grains, Cereals, Pasta:  Again, the less processed a food, the better. You can add olive oil and fresh or steamed vegetables to make a delicious dish.

Extra Virgin Olive Oil:  This is the preferred fat and is one of the healthiest to enjoy.

Cheese, Yogurt & Milk:  Greek and plain yogurt are good choices. Serve with fresh fruit for a sweet treat after a meal. Small portions of natural cheeses are enjoyed with fresh fruit, vegetables and a few nuts for a small meal. Milk is included but only in small amounts.

Walnuts, Seeds, Olives:  Provide healthy fats and offer variety to a meal. Toasted walnuts are  a good addition to a pasta dish or green salad.

Poultry/Fish/Eggs:  One or two servings of poultry, a couple portions of fish and 2 or more eggs per week provide protein and variety to the meals.

Legumes (beans, lentils, peas):  Another great source of protein and fiber.

Meats (beef, lamb, pork):  Red meat is considered an occasional treat and a very small portion is enjoyed with fresh vegetables and fruit.

Desserts:  Cookies, cakes, candy are eaten about as often as red meat. Just one or two times a week, for special occasions.

For a wealth of healthy eating information visit

What About the Kidney Diet?

You are probably wondering why I’m writing about a diet or lifestyle that encourages you to eat foods that are not always acceptable on the basic kidney diet. It may take a little effort, but it is relatively easy for someone on dialysis to follow this diet with just a few adjustments.

  1. Phosphorus: The most difficult phosphorus to avoid with the typical American diet is the phosphorus in processed foods.  Less phosphorus is absorbed from foods with naturally occurring phosphorus. Therefore it is less likely to cause spikes in your phosphorus levels. Making your own bread and baked goods greatly reduces the phosphorus laden preservatives that allow for a long shelf-life. These few changes may allow you to include small portions of nuts, beans, cheese and yogurt and still keep phosphorus levels in control.
  2. Protein: It is important for most dialysis patients to consume a minimum of 60 grams protein and some up to 100 grams protein per day. It will take some planning to ensure enough is eaten, but you can do it. Remember, the decreased intake of processed foods allows for an increase in nuts, beans and lentils and low-fat dairy, which all provide protein.
  3. Potassium: The main sources of potassium are fruits and vegetables.  It will be important to monitor your blood level of potassium and increase or decrease your intake of high potassium fruits and vegetables.  How much potassium to eat is based on your lab results and stage of kidney disease. People in earlier stages of chronic kidney disease (CKD) often do not require a low potassium diet. It won’t take long to figure out the foods you can eat every day versus a few times per week.
  4. Water: The recommendation for following the Mediterranean lifestyle is to drink a minimum of 6 to 8 glasses of water per day. This is too much for most dialysis patients who must limit fluid intake to 32 ounces (four 1-cup glasses) per day.
  5. Alcohol: Although the Mediterranean Diet suggests wine in moderation, check with your doctor to determine if it is safe for you to consume alcohol and how much is acceptable with your diet. Most nephrologists encourage their patients to avoid alcohol.

Part of what makes this lifestyle so appealing is the way the food is enjoyed.  Most meals, in this part of the world, are eaten slowly and enjoyed with family and friends. It is very different from our way of living where many meals are eaten in front of the television or while driving from one place to another! Try to slow down and enjoy the flavors and textures of the food.

Here is a tasty Green Pesto Pasta recipe featuring fresh basil and garlic  to get you started.

What about exercise? 

I am not talking about exercise like the kind you get when you go to the gym or walk a track for 45 minutes. I’m talking about just moving around. Walk to the store, or around the block, ride a bike to see a friend or just to enjoy the park. Think about ways you can increase small amounts of movement so that you feel less stiff or sore.

The benefit of the Mediterranean Lifestyle is a result of the healthy foods, increased movement, stress management and relaxation. If you are interested in giving it a try, do a little research about the lifestyle and talk to your clinic dietitian about the changes you want to make to your diet. It will take some effort, but if it helps you feel better, feel more relaxed and enjoy your life, it’s worth the work!

Are you ready to get started? Talk to your dietitian and try these DaVita dietitian approved Heart Healthy Mediterranean Recipes.

Shelley Munch, MBA, RDN, LD

Shelley Munch, MBA, RDN, LD

Shelley has been a registered dietitian for many years with over 15 years in renal (Acute, CKD 3-5, Dialysis, Transplant). She is an adjunct professor at Park University and teaches Human Nutrition and Nutrition for Health Sciences for undergraduates. She loves helping people connect what they eat with how they feel. Shelley has a husband and two daughters that keep her running.