What’s the Scoop on Whole Grains?
If you have been following a kidney diet for years you may be confused about the new trend towards including whole grains. In the past whole grain products were limited due to higher phosphorus and potassium contents when compared to refined grains such as white bread. Today’s kidney diet appreciates the many benefits of whole grains. Newer diet guidelines encourage including some whole grains in the kidney diet.
Whole Grains Benefits
One reason for the change to include whole grains is so those on a kidney diet 
can have the benefits whole grains offer.
- Whole grains are included in a wide variety of overall healthy food choices for the kidney diet. Because of this today’s kidney diet encourages a greater variety of food choices and improves meal satisfaction and quality of life.
- The addition of whole grains to the renal diet provides increased fiber and micronutrients which can help improve blood glucose, cholesterol control and prevent or treat constipation.
- In recent years, more research became available regarding phosphorus and the factors that impact absorption from the intestinal tract into the blood.
About Phosphorus
Phosphorus is a mineral found naturally in many foods. It is also added to processed foods in the form of phosphate additives. When kidney fail the body is unable to get rid of excess phosphorus. As a result, bone disease and deposits of phosphorus in soft tissues may occur. Legumes and whole grains have been limited in the kidney diet due to higher phosphorus levels. That limit has been more liberal in today’s kidney diet because we have learned more about phosphorus absorption.
- Phosphorus in plant foods, including whole grains, is less than 50% absorbed.
- Phosphorus in animal foods is approximately 70% absorbed.
- Phosphorus from additives such as phosphoric acid and calcium triphosphate is almost 100% absorbed.
This is why it is important to read ingredient labels carefully and look for any words that contain “phos”. Some, but not all of the phosphorus additives you may find on food labels include:
- Phosphoric Acid
- Sodium Polyphosphate
- Pyrophosphates
- Sodium Trypolyphosphate
- Tricalcium Phosphate
- Hexametaphosphate
About Potassium
Potassium is a mineral that helps muscles and nerves to work properly. One major muscle is the heart. When potassium levels run high or low it can affect the way the heart beats. Controlling potassium levels depends on your stage of chronic kidney disease (CKD) as well as the dialysis modality you have chosen.
Researchers are still studying the effects a higher fiber and higher fruit, vegetable and whole grain intake have on potassium levels. It appears there are more factors besides potassium content that determines blood potassium levels.
Here are some suggestions on how to keep potassium in normal range:
- Attend all dialysis treatments and access appointments
- Increase your knowledge of foods that contain potassium
- Enjoy dairy products up to 1/2 cup or 1 ounce daily
- Eat 3 to 5 servings (1/2 cup) of a variety of lower potassium fruits and vegetables per day (or the amount recommended by your dietitian)
- Consider soaking or double-boiling potatoes to lower potassium content
- Avoid salt substitutes and low sodium products that contain potassium chloride
- Ask your dietitian for help working whole grains into your meal plan.
Recipes
Many recipes that contain refined grain products can be made with whole grain products. Try using whole grain pasta in one of these DaVita.com recipes:
- Chicken and Watercress with Gratin Pasta
- Feta Pasta with Chicken and Asparagus
- Linguine with Garlic and Shrimp
- Colorful Pasta Salad (Ensalada de Pasta Colorida)
- Homestyle Macaroni Salad
- Tuna Pasta Salad
- Caraway Cabbage and Rice (Repollo con Carvi y Arroz)
Questions about healthy food choices? Remember to speak with your dietitian. They can help you individualize the amount and frequency of whole grains based on your lab values, food preferences and other individual considerations.
Additional Kidney Diet Resources
Visit DaVita.com and explore these diet and nutrition resources:
DaVita Kidney-Friendly Recipes
This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.
References:
Potassium: Goal, Why How (From DaVita Pt Education resources)
Phosphorus information from DaVita education resources
DaVita Dietitian resource guide
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