Kidney Diet Tips

Corn or Flour: Which Tortilla is Best for a Kidney Diet?

Cinco de Mayo is a great time to celebrate the culture and cuisine of Mexico. Enjoy fish tacos: grilled fish over shredded cabbage with salsa blanca drizzled on flour tortillas served with ‘pickled’ red onions.

What’s the best type of tortilla?

I am often asked, what type of tortillas can I have? This is a great question, since a recent study shows grains are the top source of dietary phosphorus, followed by meat and milk products in the U.S. diet.1 The frequency of consumption makes grains, such as tortillas a top contributor to phosphorus.

Freshly made flour tortillas or uncooked flour tortillas (refrigerator section of the grocery store) heated for 30 seconds on a skillet are one of the best choices. Once you taste the flavor of fresh tortillas you won’t go back! Packaged shelf stable flour tortillas contain phosphates from baking powder (mono-calcium phosphate) and preservatives, although organic flour tortillas can be lower in phosphorus. One 6-inch packaged flour tortilla contains 45 to 65 mg phosphorus per 30 g serving. Organic flour tortillas are at the lower end.

Are corn tortilla off limits?

Corn naturally contains phosphorus that is increased during the processing of maize to make tortillas. Corn tortillas provide zinc and some B vitamins, but are not enriched with folic acid, making enriched flour tortillas the better choice. One 6-inch corn tortilla contains between 75 mg (organic corn tortillas) to 95 mg (regular) phosphorus per 30 g serving. The problem is many people eat more than one tortilla. If you are eating 4 to 6 regular corn tortillas at a meal the phosphorus is 380 to 570 mg, which is too much for a kidney diet. Choosing organic tortillas and limiting the number tortillas eaten is important.

Make a quick salsa blanca from mayonnaise and sour cream with fresh lime juice and your favorite salt-free seasoning blend. It’s is great way to add flavor and moisture to fish or shrimp tacos. Top with Mexican pickled onions (cebollas curtidas) made with lime juice, vinegar and sugar, to add salty flavor without sodium. It is delicioso!

Serve fish tacos with Watermelon Agua Fresca.  Buen provecho!

Try these DaVita recipes for Cinco de Mayo or any time.

Reference:

  1. McClure S et al. Dietary Sources of Phosphorus among Adults in the United States. Nutrients 2017; 1-10. http://www.mdpi.com/2072-6643/9/2/95
  2. Food and Agriculture Organization Corporate Document Repository: Ch. 5 Physical and chemical changes in maize during processing http://www.fao.org/docrep/T0395E/T0395E06.htm

Corilee Watters, MS, RD

Corilee Watters has been a dietitian for more than 20 years. She has worked providing renal education as part of dietetic internship and university programs, and has worked in acute care, long-term care and is now working in hemodialysis. Corilee is an editorial member of the Essential Guide for Renal Dietitians. She enjoys working with interdisciplinary colleagues to provide excellent care for patients and achieve optimal clinical outcomes.