In this month’s episode we are talking about how to Eat Right Bite by Bite for chronic kidney disease. It’s a great topic for this month because March is not only National Kidney Month, it is also National Nutrition Month® and Social Work Month. Dr. Melissa Prest is joined by Bri Zabala, RD to discuss how the diet changes as kidney disease progresses.
Stages 1 and 2:
Focus on reducing sodium intake and incorporating the DASH diet for blood pressure management. The DASH diet (Dietary Approaches to Stop Hypertension) includes increasing consumption of foods that are rich in potassium, magnesium and calcium (fruits, vegetables, nuts, legumes, whole grains, and low fat dairy) as they help lower blood pressure. It is also a good time to get familiar with phosphorus additives and reduce your intake. How do you know if something has a phosphorus additive? Look for the word PHOS on the food label in the ingredient list. You can limit phosphorus additives by cooking from scratch more often and choosing whole foods that have been minimally processed.
Stage 3 and 4:
Reduce the amount of animal proteins (beef, chicken, fish, turkey, pork, eggs) consumed and increase intake of plant proteins (beans, legumes, nuts, tofu). A good rule is to do no more than half of the size of your palm with an animal protein at a meal and go for a few meatless meals in a week. For some people, choosing lower potassium foods is important to keep serum potassium levels in normal ranges.
May include reducing intake of fluid as urine production decreases and fluid retention may occur.
Stage 5 Dialysis:
Continue to choose lower potassium foods, limit salt, limit fluids, and limit phosphorus. The big difference now is that you eat more protein. Some protein is lost during dialysis treatments and you have to replace the protein lost through diet. In addition, calcium intake is reduced and dairy foods should be limited to ½ cup serving per day. Water soluble vitamins are also lost during treatment and sometimes your nephrologist will prescribe a kidney specific vitamin.
Focus on food safety to reduce food borne illnesses. Now that you can “normalize” your diet, focus on choosing whole foods that are minimally processed and balance your plate by filling half with fruit and vegetable, ¼ with protein and ¼ with grains/starchy vegetable. Always follow recommendations of your team to manage any other health conditions.
Apple, Broccoli and Cranberry Salad
Serves 4 (1 cup serving)
• 3/4 cup low fat plain Greek yogurt
• 2 tablespoons honey
• 2 tablespoons apple cider vinegar
• 1 medium apple
• 4 cups fresh broccoli florets
• 1/2 cup red onion
• 1/2 cup dried sweetened cranberries
• 1/4 cup walnuts
1. Dice unpeeled apple into small bite size pieces. Trim and cut broccoli florets into small bite size pieces.
2. In a large bowl whisk together the yogurt, honey and vinegar.
3. Combine the broccoli, apples, onion, cranberries and walnuts in a large bowl and coat with the yogurt dressing. Refrigerate to chill. Stir immediately before serving.
Nutrition content per serving: Calories 276, Total Fat 5.5 g, Protein 8 g, Sodium 48 mg, Phosphorus 69 mg, Potassium 479 mg, Calcium 105 mg, Carbohydrates 48 g, Dietary Fiber 6g