Download Food for thought: Kidney Friendly Nutrition

Regional Nephrology System
Food for thought:
Kidney Friendly Nutrition
Prepared by the Dietitians of the Regional Nephrology System
March 2009
April 2009
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What’s Inside…..
Section
One
Two
Three
Four
Five
Six
April 2009
Content
General Information
• Why should I follow a kidney friendly diet?
• Why should I see a Dietitian?
• How to contact my Dietitian.
• The kidney friendly diet.
Phosphorous
• Targets and intro.
• What is a lower phosphorous diet?
• Food additives, what you need to know.
• Phosphate binders.
• High phosphorous foods.
• Low phosphorous foods.
• Milk substitutes.
Sodium (Salt)
• Targets and intro.
• High sodium food list.
• Spice it up your diet: tips for adding flavour.
• Salt substitutes and seasoning recipes.
• Soups and your kidney friendly diet.
Protein
• Targets and intro.
• Protein and your kidneys.
• How much protein do I need?
Page(s)
5-10
6
6
7
8-9
11-26
12-13
14-15
16-17
18-19
21-22
23-24
25-26
Potassium
• Targets and intro.
• Potassium and kidney friendly diet.
• Reducing potassium in potatoes.
• Low potassium pasta sauces.
• Potassium food lists-fruits.
• Potassium food list- vegetables.
Fluids
• Targets and intro.
• Should I limit my fluid intake?
• Caffeine.
• Alcohol.
• Nutritional Milkshakes/Supplements.
45-60
46
47-48
49-55
56-57
58-59
60
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28-30
31-32
33-35
36
37-38
39-44
40
41
42-43
61-65
62
63
63-64
64-65
65
2
What’s Inside…..
Section
Seven
Content
Diabetes
• Targets and intro.
Page(s)
67-68
68
Seven
Cholesterol and your kidneys
• Target and Intro.
• Fibre food choices that are kidney friendly.
• Omega -3 fats.
69-74
70-71
72
73-74
Eight
What’s for dinner?
• Eating kidney friendly in restaurants.
• Kidney friendly choices at Donut shops.
• Kidney friendly snacks.
75-80
76-78
79
80
Nine
Shopping
• Reading food labels.
• Grocery shopping suggestions.
81-90
82-86
87-89
Ten
Other Resources
• Cookbooks for kidney patients.
• Resources on the internet.
• Measurement chart.
91-96
92-93
94
95
Eleven
Exercise
• Targets and Intro.
97-98
98
Twelve
References
99-100
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General Information
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Why should I follow a kidney friendly diet?
Your nutrition plays an important role in the treatment of Kidney Disease.
Your kidneys can best be described as filters and a healthy kidney will work
to remove waste products from your blood. Waste in the blood is produced
from excess minerals and water from the foods and fluids we eat and drink
and the breakdown of food to provide energy and to build tissues like
muscle and bone. When kidney function decreases, waste products are not
removed and begin to build up in the blood. The build-up of some wastes
can cause complications; therefore what you eat can help prevent those
complications.
Why should I see a Dietitian?
Nutrition is a key part of your kidney care and your Dietitian is an important
member of your health care team. Kidney disease is progressive, meaning
there is no cure and as time goes on your kidney function will continue to
decrease. A kidney friendly diet can help you feel better and reduce the
chances of you developing other health problems. Following the
recommendations from your health care team, including eating a healthy
diet, can also help slow the progression of kidney disease.
The kidney diet can be confusing. Your Dietitian will help you determine
the best diet for you. Please let your Dietitian know if you are receiving diet
information from other health professionals to ensure that
recommendations are appropriate for you.
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As your kidney function changes your diet may need to also change. Your
Dietitian will monitor your kidney function and offer suggestions to you on
how to change your diet. Your Dietitian will review your blood work each
time it is done. You can expect to meet with the Dietitian at least twice per
year and the Dietitian is always available to meet with you and your family.
There are several Dietitians working within the Nephrology program.
How do I contact my Dietitian?
You can contact the Dietitians at 905-576-8711 ext 6968.
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The Kidney Friendly Diet:
There is a diet for chronic kidney disease and not all kidney patients will
follow the same diet. A kidney friendly diet is individually planned and
based upon your current results from blood tests. Your diet
recommendations are developed with you, based on how well your kidneys
are working, your likes and dislikes, your nutritional needs, and your blood
work.
Components of a kidney friendly diet:
A kidney friendly diet may have recommendations about the following;
; Minerals
; Vitamins
; Protein
; Calories
;
Minerals
Phosphorus, sodium and potassium are minerals that have several
important roles in your body. They come from the foods that you eat and
the fluids that you drink.
;
Vitamins
Vitamins are compounds found in food. They are needed to keep the body
healthy. Some vitamins need a healthy kidney to work. Depending on your
kidney diet you may not get enough vitamins. Speak with your Dietitian or
pharmacist about taking an over the counter vitamin supplement.
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;
Protein
Your body requires a certain amount of protein every day to stay healthy
and to fight infection. Dietary protein is found in almost all foods but is
highest in foods that come from animals. Eating too little protein can cause
poor health. If you eat too much protein, you will be placing added stress
on your kidneys and may further damage them. A kidney friendly diet is not
restricted or low in protein, but is planned to provide you with enough
protein for your health and current stage of kidney disease and treatment.
;
Calories(Energy)
Calories are the energy found in food. All food contains calories. It is
important that you eat a diet balanced in calories. Too many calories will
result in weight gain. Being overweight can affect your kidney function. It
is also important to note that too little calories will result in weight loss and
this will also affect your kidney function and overall health.
Each person with kidney disease has different nutritional
needs. There is no benefit to restricting your diet more than you need to.
Speak with your Dietitian if you have questions about your kidney diet.
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Phosphorus
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Phosphorous
Follow a reduced phosphorous diet and protect your;
• Bones
• Heart and lungs
• Arteries and veins
How is it measured?
•
Phosphorous is monitored by a blood test.
Phosphorous levels in blood:
 Target for pre-dialysis is 0.87-1.49.
 Target for patients on dialysis is less than 1.78.
Calcium-phosphorous product:
 If you multiply your phosphorus result by your calcium result it
should be less than 4.4.
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Phosphorous
Phosphorous is a mineral found in many of the foods we eat. It plays an
important role in bone health and helps with the function of your nerves and
muscles. A healthy kidney will keep phosphorous levels in the blood within
normal limits by removing excess phosphorous through the urine. As
kidney function decreases, it becomes more difficult for the kidneys to keep
phosphorous levels in the blood within the recommended range.
Avoiding high phosphorous foods can help prevent a build-up of
phosphorous in your body. This will help to protect your bones, heart and
lungs. When phosphorous levels in the blood are high, calcium will move
out of your bones, leaving the bones weak, brittle and painful. If
phosphorous and calcium levels are too high in the blood, the phosphorous
and calcium join and form calcium-phosphorous crystals. These crystals
can settle in arteries and veins, blocking blood flow, or settle in organs such
as your heart and lungs affecting their function. High levels of phosphorous
in your blood can also cause your skin to become very itchy.
A kidney friendly diet will reduce your daily intake of phosphorous to less
than 1000 mg per day. This provides the body with enough phosphorous to
maintain health, but will help to prevent a build-up. Each clinic visit your
phosphorous level will be checked and your calcium/phosphorous product
will be calculated. Calcium/phosphorous product is a way your healthcare
team can determine your chances of having calcium/phosphorous crystals
form in your blood.
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What is a lower phosphorous diet?
Choosing the right foods can help keep your phosphorous level under
control and prevent complications. Here are some helpful guidelines. A
more detailed list of high and low phosphorous foods can be found on
pages 21-24.
; Choose white or rye bread, 60% whole wheat or cracked wheat instead
of 100% whole wheat or multigrain.
; Choose low fibre cereals such as Special K®, Rice Krispies® or cream of
wheat instead of bran, granola or oatmeal. (Phosphorous is found in the
bran part of the grain.)
; Enjoy homemade waffles, pancakes, cakes, muffins and tea biscuits but
avoid ready made, frozen or mixes.
; Choose soft drinks/pops that do not contain phosphorous some
examples are non-cola pops such as gingerale, Sprite®, orange soda,
cream soda or 7-up® . Read the labels (see page 80-84) to make sure
that they do not contain phosphorous. Avoid cola pops such as CocaCola®, Diet Coke®, Pepsi®, and Diet Pepsi® or any other cola products
as these always contain phosphorous.
• Reduce your intake of milk products to 8 oz (250 ml) per day. Milk
products include the milk you drink, cream or milk in coffee or tea as well
as foods made from milk such as yogurt, ice cream or pudding.
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• Avoid eating large amounts of dried beans or peas eg: pinto, lima, navy,
lentil, kidney, blackeyed peas, split peas, white beans, garbanzo
beans/chickpeas, pea soup, baked beans, hummus.
• Avoid foods that contain chocolate such as chocolate bars, puddings,
cookies, muffins, cake, hot chocolate and candies. Chocolate is high in
phosphorous.
•
Avoid foods that contain nuts, peanut butter, almond butter or seeds.
• Avoid organ meats such as liver or kidney.
• Remove the bones from fish (salmon) and avoid fish that contain edible
bones such as sardines, herring and kippers.
• Avoid ultra low fat food items as phosphorous is often used to replace
fat.
• Avoid instant pudding mixes.
• Avoid hot beverages that contain added phosphorous such as hot
chocolate, mochaccino, Postum®, Ovalitine®, Melo®, Horlicks®, Caflib®.
• Avoid caramel candies.
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• Snack foods avoid: nuts, nut butters, seeds, cheese flavoured popcorn,
caramel popcorn, and whole wheat pretzels.
• Side items avoid white sauces and cheese sauces unless you count
them as part of your dairy milk allowance and weekly cheese allowance.
Baking powder contains phosphorous. Its chemical name is
sodium triphosphate. Grocery store baked goods and baking
mixes (cake, cookies, pudding and biscuits) contain large
amounts of sodium triphosphate. You can lower the phosphorous in
favourite homemade baked goods by substituting regular baking powder
with the following:
½ tsp cream of tartar + ¼ tsp baking soda = 1 tsp regular baking powder
Food Additives….. What you need to know?
The Canadian diet is higher in phosphorous than ever before.
Phosphorous is now being used as an additive to help enhance the quality
and flavour of food. Processed meats (flavoured chicken breasts, ready to
serve entrees such as roast beef, chicken nuggets, hot dogs, and luncheon
meats); processed and spreadable cheeses, instant puddings, sauces and
marinades, refrigerated bakery products and some beverages contain
phosphorous based additives.
The type of phosphorous used in these products is not the same as the
phosphorous found naturally in food. This type of phosphorous is much
easier for your body to absorb and enter the blood than the natural
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phosphorous found in milk and unprocessed meats. A good rule to follow:
if a food has had some of the preparation done for you or needs little or no
preparation- check the label. It most likely contains phosphorous additives!
Be Aware…become a label reader
The phosphorous level of a food may not be listed on the food label.
Checking the list of ingredients can help identify if a food contains added
phosphorous. Ingredients containing words “phosphoric” or “phosphate”
such as phosphoric acid or ammonium phosphate can be indicators that
the food is high in phosphorous. Examples of some additives that contain
phosphate include;
Phosphoric Acid
Pyrophosphate
Polyphosphate
Hexametaphosphate
Dicalcium Phosphate
Monocalcium Phosphate
Aluminum Phosphate
Sodium Polyphosphate
Sodium Tripolyphosphate
Tricalcium Phosphate
Trisodium Phosphate
Sodium Phosphate
Tetrasodium Phosphate
Avoid meats with added sodium.
Also check labels of fresh and frozen meat products. If the product has
more than 95 mg of sodium per 85 gram serving it means it is also high in
phosphorous. Meats that have added phosphorous will often have terms
such as “seasoned, flavoured, and tenderized”. Meats that are selfbasting are also high in phosphorous.
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Phosphorous Binders (also called phosphate binders)
The best way to keep phosphorous in the blood at the recommended level
is to follow a low phosphate diet. If levels remain high, despite limiting high
phosphate foods, your health care team may suggest you take a
“phosphate binder” (eg. Tums® or calcium carbonate, Renagel®,
Fosrenol®). Phosphate binders act like sponges or magnets. And will soak
up the phosphorous from the foods you eat. This will then allow the
phosphate to pass out of your body when you have a bowel movement. For
binders to work it is important that you take them in the recommended
amounts and at the recommended times.
Some Phosphate Binder Tips
1. Take the number of binders your healthcare team recommends. Your
Dietitian can help make sure that the number of binders you take with
each meal and snack is appropriate for the amount of phosphorous you
usually have at that time of the day.
2. Phosphate binders should be taken with your meals.
3. If you find the calcium tablets hard to swallow, your can break them in
smaller pieces or grind them and mix with soft foods (e.g. applesauce). If
you take Renagel® or Phoslo® tablets, they must be swallowed whole.
4. Do not take binders on an empty stomach unless you are told to do so
by your healthcare team.
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5. Iron supplements should be taken at least 2 hours before or after you
take Calcium carbonate/TUMS®/ Phoslo®/Fosrenol®.
6. Calcium binders should not be taken with antibiotics. If you are
prescribed an antibiotic at the same time as your binders, discuss this
with your health care team.
7.
My binder prescription is:
BREAKFAST
LUNCH
DINNER
SNACK
TYPE OF
BINDER
NUMBER OF
BINDERS
Adapted from GTA working group “What is phosphorous and why do I need to limit it?”
by the Dietitians of the Regional Nephrology System 2006.
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High Phosphorous Foods
The following foods contain large amounts of phosphorous. It is
recommended that you avoid these foods whenever possible to reduce the
amount of phosphorous in your diet.
Milk and milk products:
Avoid
• buttermilk, chocolate, goats, and malted milk
• all instant, chocolate, and coconut puddings and yogurt beverages
• ice cream containing nuts or chocolate
• blue, goats, gruyere, tilset, swiss and processed cheeses.
Grain products:
Avoid:
• breads, buns, pitas, crackers, pasta, or cereals made from whole grain,
12 grain, multigrain, 100% whole grain, dark pumpernickel, dark rye,
ancient grain breads
• bread, cereals, crackers, buns, or other dishes made from corn meal
• bran cereals (bran flakes, all bran), or multigrain cereals (red river cereal
or instant cereals (oatmeal, or cream of wheat)
• foods that contain coconut, nuts, nut butters seeds or chocolate
• frozen pancakes, waffles
• pancake, waffle, tea biscuit mixes
• granola based cereals and bars
• brown rice
• buckwheat and whole wheat pasta
• cakes, muffins or other bakery products that are commercially made or
made from a mix
• commercially baked products like cakes, muffins, scones
Limit:
• cereals like Shreddies®, quick cook oats, Quaker Corn Bran® to 2-3 times
per week
Fruits:
• all fruits are low in phosphorous and are all ALLOWED (if you are
following a reduced potassium diet, see the low potassium sheets in the
potassium section)
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High Phosphorous Foods continued……..
Vegetables:
Avoid:
• legumes: navy beans, split peas, lentils, lima beans, black eye peas,
broad beans, chick peas, kidney beans, soya beans
Limit:
• broccoli, corn, green peas, mushrooms
Fats:
Avoid:
• salad dressings that contain milk, yogurt or cheese
Beverages:
Avoid:
• beer, hot chocolate, flavoured milk beverages (Rolo®, Coffee Crisp®, Kit
Kat®, Crispy Crunch®) or malted milk beverages (Ovaltine®, Postum®,
Milo®, Horlick®, Caflib®) colas (Coca-Cola®, Pepsi, Dr. Pepper®,Cool®),
ice tea/drinks, Sunny Delight®, tropical Punch (Hawaiian Punch®),
weight-loss beverages (Slim Fast®), flavoured water
Processed meats and meat products
Avoid:
• processed, smoked, marinated, flavoured or cured meats, liverwurst or
pate
• foods that contain fermented soya such as miso soup
• organ meats (liver, kidney etc.)
• nuts and nut butters (peanut butter, almond butter)
• fish in which you eat the bones (sardines, anchovies). Remove edible
bones from salmon
• oysters, clams, mussels, caviar, and fish roe
Other
Avoid
• macaroni and cheese dinners
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;
Low phosphorous food list
Here are some examples of low phosphorous foods; your Dietitian can help
you with choose kidney friendly food.
Milk and milk products
Limit to a total of 8 oz (250 ml) per day:
• milk 2% & 1% or skim, coffee cream, whip cream, sour cream, yogurt,
homemade puddings, ice cream (no nuts, not chocolate)
Limit hard cheese to 3 oz per week
• cheddar, mozzarella, marble, parmesan, romano, harvarti, colby, dry curd
cottage cheese, monterey, bocconcini, brie
Grain products
Choose
• white bread,/buns, light rye, 60% whole wheat breads, cracker wheat bread,
brioche, challah, egg bread, english muffins, matzon, crumpets
• Corn Flakes®, puffed rice, cream of wheat, cream of rice , Special K®,
Crispix®, Just Right®, puffed wheat®, Rice Krispies®, Rice Chex®, rice flakes,
Alphabets®, Applejacks®, Captain Crunch®, Froot Loops®, Frosted Flakes®,
Vanilla Rice Krispies®
• white rice, white pasta
• homemade pancakes and waffles
• homemade cakes, muffins or tea biscuits
• graham crackers, matzo (plain or egg and onion), melba toast (plain), soda
crackers (unsalted)
• animal crackers, arrowroots, butter cookies, sugar wafers, short breads,
social teas, sugar cookies
Limit to 2-3 times per week:
• cereals like Shreddies®, quick cook oats, quaker corn bran
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;
Low phosphorous food list continued……..
Fruits:
• All fruits are low in phosphorous and are all ALLOWED (if you are following
a low potassium diet, see the reduced potassium sheets in the potassium
section)
Vegetables:
Choose
• Carrots, green and yellow beans, lettuce, peppers, radishes, celery,
cabbage, onions, green onion, tomatoes, spinach, squash, beets,
cauliflower, potatoes, sweet potatoes, turnip, zucchini
Limit:
• broccoli, corn, green peas, mushrooms.
(if you are following a reduced potassium diet, see the low potassium sheets
in the potassium section)
Fats:
Choose
• butter, margarine, mayonnaise, vegetable oils
Protein, Meats and Meat products
Choose
• fish (cod, haddock, salmon* bones removed, snapper, trout)
• unseasoned beef, pork or poultry
• shrimp, lobster, crab, scallops
• egg whites
• tofu
* look for low sodium versions
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Milk Substitutes:
Limiting your intake of milk products to 8 oz (250ml) per day will help
reduce your total intake of potassium and phosphorous. Milk substitutes
are products you can use instead of milk that are low in phosphorous and
potassium. These products do contain calories. Discuss with your Dietitian
how much of these products you can use.
Rice Dream® (original)
• Located in the “coffee” aisle.
• Choose the original or vanilla flavoured.
• Do not use the enriched products.
• Do not use Soy Dream®.
Dairy Free®:
• Can be hard to find – try the “health food” section at the grocery store
• Look for it at ;
•
Real Canadian Superstore or Loblaw’s.
Go Natural Health and Nutrition,
121 Brock St. N. Whtiby (905) 668-2661
122 Simcoe St. N (905) 436-2661
www.gonaturalcanada.com
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Coffee Rich®:
• Located in the frozen food section of the grocery store.
If you like or need:
heavy cream
half and half
sweetened condensed milk
1 cup of butter milk
1 cup of whole milk
1 cup skim milk
Then use this:
Coffee Rich®
Mix 1 cup of Coffee Rich® with 1 tbsp
of white vinegar
Mix ½ cup Coffee Rich® and ½ cup of
water
4 tablespoons of Coffee Rich® with ¾
cup of water
Milk substitute recipe: Well liked by many patients.
Mix 1 cup coffee rich + ½ cup whipping cream + 1 cup cold water
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Sodium
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Sodium (Salt)
Follow a reduced sodium diet and protect your;
• Kidneys
• Heart
How is it measured?
Sodium level is not measured by blood work. Some patients will experience
swelling when they eat too much sodium. A diet high in sodium can be
harmful to the heart and kidneys.
All kidney patients should reduce the amount of sodium they
eat.
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Sodium (Salt)
An important step towards better health includes limiting
foods and beverages that are high in sodium. Health
Canada now states that all Canadians would benefit from
reducing their sodium intake. Today’s Canadian diet can provide up to 2-3
times more sodium than what is recommended.
When kidney function decreases, the build up of sodium can interfere with
the body’s ability to regulate its water content resulting in excess fluid in
your body. The build up of fluid may cause an increase in blood pressure,
swelling of the feet/hands/face as well as shortness of breath. Since high
blood pressure can further damage your kidneys, it is recommended that
you limit your sodium intake to less than 2300 mg per day.
Most of the sodium we consume is hidden in the foods we eat!
The salt shaker will provide about 10 % of our sodium intake while
processed foods contribute about 80%. Be aware that “salt is sodium”.
Table salt, kosher salt and sea salt are all sodium!
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Tips to reduce sodium in your diet:
• Avoid adding salt during cooking and do not salt food at the table.
• Avoid table salt and seasonings that contain salt (e.g. garlic salt).
• Do not use salt substitutes such as: “No Salt®” if you are following a
reduced potassium diet.
• Avoid processed meats such as bacon, ham, sausages, hot dogs, lunch
meats, canned meat.
• Avoid processed foods such as heat and serve meals. Avoid salty
snacks such as salted crackers, nuts, chips.
• Avoid canned soups, frozen dinners, instant noodles, instant rice mixes.
• Avoid bottled sauces, pickles, olives and MSG (found in some Chinese
foods).
ƒ If choosing frozen foods look for ones with 600 mg of
sodium or less.
ƒ Choose sauces, salad dressings, condiments or snack
foods with 150-200 mg of sodium/serving or less.
ƒ Read labels; Sodium Reduced/Low Sodium products are
often high in potassium. Potassium chloride is often used
to replace sodium in food products. If you are following a
reduced potassium diet, it is important you avoid these
products.
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High Sodium Food List
The following is a list of high sodium foods. It is recommended that you
avoid eating these foods. There are many lower sodium choices in the
grocery store. If you are following a reduced potassium diet read the food
labels to avoid added potassium. Potassium is often used to replace
sodium.
Processed
Seasonings
Canned Goods Other Foods
Meats
• Accent®
• bacon
• bouillon
• sauces
• back bacon
• BBQ sauce
• broth
• vegetables
®
• bologna
• Bovril
• Cheez Whiz®
• soup
• baking soda
• chips
• chicken
• consommé
• celery salt
• chinese food
• corned beef
• dry soup
• chili sauce
• cottage cheese
• devilled ham
• gravy
• garlic salt
• frozen waffles
• ham
• sauerkraut
• ketchup
• frozen/instant
• hot dogs
• spaghetti
pancakes
sauce
• onion salt
• liverwurst
• olives
• tomato paste
• mock Chicken • MSG
• meat tenderizer • tomato sauce • packaged rice & pasta
• paté
mixes
• tomato juice
• prepared
• pastrami
®
• pickles
mustard
• V8
• pepperoni
®
• Clamato juice • pickled Beets, onions
• relish
• roast beef
• pizza
• Garden
• salt
• salami
®
Cocktail
• pretzels
• smoked meat • sea salt
• processed cheese
• soy sauce
• turkey
• ready-to-eat cereal
• steak sauce
• sausage
®
• salad dressing
• steak spice*
• Spam
®
• salted nuts and seeds
• Shake & Bake
• salted crackers
• taco sauce
• smoked, salted or
• tamari sauce
dried fish (anchovy,
• teriyaki sauce
caviar,
• worcestershire
smoked salmon,
sauce
pickled herring,
sardines)
• tea biscuits
• TV dinner/frozen meal
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Watch for new food items in the grocery store.
Many food manufactures are now offering “reduced in sodium”, “low
sodium” or “no added salt” versions of their products.
Look for;
; no added salt canned vegetables.
; *low sodium V8®.
; *reduced in sodium tomato juice.
; low sodium or no added salt canned salmon or tuna.
; low sodium or no added salt butter or margarine.
*these foods are high in potassium. Avoid if you are following a low
potassium diet.
If you are following a reduced potassium diet read the ingredient
list on label. Manufacturers will often lower sodium by replacing it with
potassium chloride; while this will lower your sodium it will increase your
potassium.
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Spice Up Your Diet: Tips for adding Flavour
Adapted from the National Kidney Foundation
Giving up sodium does not mean giving up flavour! Learn to season your
food with herbs and spices. Be creative and experiment for a new and
exciting flavour.
What kind of spices and herbs should I use instead of salt to add flavour?
Try the following spices with the foods listed:
Spice
Use With
Allspice
beef, fish, beets, cabbage, carrots, fruit
Basil
beef, pork, most vegetables
Bay Leaf
beef, pork, most vegetables
Caraway
beef, pork, green beans, cauliflower, cabbage, asparagus,
and dips and marinades
Cardamom
fruit and in baked goods
Curry
beef, chicken, pork, fish, green beans, carrots and in
marinades
Dill
beef, chicken, green beans, cabbage, carrots, and in dips
Ginger
beef, chicken, pork, green beans, cauliflower and eggplant
Marjoram
beef, chicken, pork, green beans, cauliflower and eggplant
Rosemary
chicken, pork, green beans, cauliflower and eggplant
Thyme
beef, chicken, pork, fish, green beans, beets and carrots
Sage
chicken, pork, eggplant and in dressing
Tarragon
fish, asparagus, cabbage, cauliflower and in marinades
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Other Suggestions:
Food
Types of spices
Fruit
allspice, cinnamon, cloves, mint, cardamom, ginger and
nutmeg
Beans
basil, cayenne, chili powder, cloves, coriander, cumin,
marjoram, oregano, paprika, rosemary, savory, thyme and
tumeric
Beef
coriander, basil, garlic, parsley, cumin, horseradish,
marjoram, dried mustard, oregano, paprika, rosemary,
savory and thyme
Carrots or
allspice, anise seed, cardamom, cinnamon, cloves, cumin,
Winter Squash dill, ginger and tarragon
Eggs
basil, chili powder, cumin, curry, dill, marjoram, paprika,
tarragon and thyme
Fish
cumin, basil, chives, chives, fennel, dried mustard, garlic,
dill, ginger, oregano, paprika, saffron, tarragon and thyme
Potatoes
basil, cayenne, curry, dill, horseradish, oregano, paprika,
rosemary and tarragon
Poultry
coriander, allspice, basil, garlic, cumin, curry, dill, ginger,
marjoram, dried mustard, paprika, rosemary, saffron,
sage, tarragon, thyme and tumeric.
Vegetables
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basil, cumin, ginger, paprika and tarragon
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y Purchase spices and herbs in small amounts. When they sit on the
shelf for years they lose their flavour.
y Use no more than ¼ tsp of dried spice (¾ tsp of fresh) per pound of
meat.
y Add ground spices to food about 15 minutes before the end of the
cooking period.
y Add whole spices to food at least 1 hour before the end of the cooking
period.
y Combine herbs with oil or butter, let set for 30 minutes to bring out their
flavour, and then brush on foods while they cook, or brush meat with oil
and sprinkle on herbs 1 hour before cooking.
y Crush dried herbs before adding to foods.
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Can I use salt substitutes?
Caution! Some salt substitutes are a mixture of table salt such as Half
Salt® while others contain potassium such as No Salt®. If you are on a
reduced potassium diet, avoid using salt substitutes.
Seasoning Blend Recipes
Seasoning blends such as Mrs. Dash® are a great way to season foods
without salt. You can make you own seasoning blends. When using the
following seasoning blend recipes, make sure to blend well. Place in a
shaker. Experiment and create your own seasoning containing those
spices that you like.
American Favourite
Spicy Seasoning
5 tsp onion powder (not onion salt)
1 Tbsp garlic powder
1 Tbsp paprika
1 Tbsp dry mustard
1 tsp thyme
½ tsp white pepper
½ tsp celery seeds
3 Tbsp celery seed
1 Tbsp onion powder
1 tsp garlic powder
2 Tbsp crushed thyme
1 ½ tsp ground bay leaf
1 ½ tsp black pepper
1 ½ tsp ground cloves
Yield: about ¼ cup
Yield: about ½ cup
Seafood Herb Mix
Mix equal parts:
Chives
Marjoram
Parsley
Savory
Tarragon
Spice Blend for Meats
Mix equal parts:
Celery seeds
Crushed red pepper
Dill seeds
Garlic powder
Ground black pepper
Ground white pepper
Mustard seeds
Thyme
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Soups and Your Kidney Friendly Diet
Most canned and dried soups are high
in sodium. Most restaurant soups are also
very high in sodium. Whenever you can,
avoid these products. If you do eat some high
sodium soup, avoid other salty foods for the rest of that day.
Avoid
• Tomato based soups.
• Dried Soups mixes.
• Soups that contain legumes (split pea, kidney beans, lentils, navy beans
etc.), cheese or mushroom as these are high in phosphorous.
• Dried onion soup mix or bouillon cubes or powders in recipes.
Choose
; Reduced sodium soups containing less than 500 mg of sodium per bowl.
Luda “No Added Salt instant bouillon mix”
This product is not high in potassium and is reduced in sodium. This
product contains 330 mg of sodium in a tablespoon compared with 1200
mg of sodium in a regular bouillon cube or 1060 mg of sodium in 1 tbsp of
dried onion soup mix.
Luda can be purchased at the following stores:
Loblaw’s- 481 Gibb St. Oshawa and 1792 Liverpool Road, Pickering
Real Canadian Superstore, 30 Kingston Road, Ajax
20 Taunton Road, Whitby
It may also be ordered on line at:
www.ed-foods.com/onlineorders_soups_C.html
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Remember that milk adds both potassium and phosphorous to
your diet. If you are on a reduced potassium diet, avoid soups containing,
potassium chloride, are tomato based or contain other ingredients high in
potassium.
Check your local grocery store for lower sodium ready made
soups. A lower sodium soup contains less than 500 mg per 250 mL (1 cup)
serving.
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Protein
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Protein
Follow the suggested amount of protein and protect your:
ƒ Kidneys
ƒ Your body health
How is it measured?
•
Albumin level in the blood monitored by a blood test.
Albumin level in blood:
 Target for all patients is 35-45 g/L.
Dietitians may also ask you to complete a diet history to assess the
amount of protein you are eating.
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Protein and Your Kidneys
Protein is a nutrient found in many foods. The best quality proteins are
found in animal products. Protein is important for the growth and
maintenance of body tissue. Protein also plays a role in fighting infection,
healing of wounds and provides a source of energy for the body. It is
important to eat the right amount of protein each day. Your protein needs
will vary depending on your body size and how well your kidneys are
working. Protein foods also contain fat. Choose lean protein foods and
adding little or no added fat.
Examples of Protein foods:
Best Choices
;
;
;
;
;
;
;
;
;
;
;
;
;
Hard Cheese (limit to 3oz/week)
Chicken
Duck, Goose, Quail
Eggs (limit to 3 egg yolks per
week)
egg substitute
Fish –fresh, frozen, canned*
(remove the bones)
Lamb
Lean Beef –steak, roast, ground
beef
Pork –roast, loin, chop
Shellfish –crab, lobster, shrimp,
Turkey: fresh (avoid self pasting)
Veal
Wild Game –rabbit, venison
Avoid high in phosphorous and
sodium
• Bacon/ back bacon
• Hot dogs
• Luncheon meats (ham, bologna,
salami, corned beef)
• Salted or pickled meats (pork,
herring, salt cod)
• Sausages
• Salted, smoked, cured or
canned meat
• Organ meats (liver, brain,
kidney)
• Legumes and dried peas and
beans ( hummus, tahini, dahl,
falafel, split peas, bean soup)
• Processed cheeses(cheese
spread, slices)
*Choose low sodium or no added salt products when ever possible. Avoid tenderized,
preseasoned or marinated meats as these contain sodium and added phosphorous.
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How much protein do I need?
Your Dietitian will help you determine how much protein you need to eat
everyday.
Measuring Tip: 1 egg is equal to 1 ounce of protein and 3 ounces of
protein is about the size of a deck of cards. 1 oz is a slice of meat the size
and thickness of a CD. The following chart describes cooked meat.
I need each day: ___________oz/day
1 oz (30g)
2 oz (60 g)
• 1 large egg (limit to 3
yolks per week)
• 1 inch cube hard cheese
or 3 Tbsp grated cheese
(limit to 3 oz per week)
• 1 slice cooked meat
(4"x2"x1/4")
• 1 chicken wing
• 1/4 cup dry curd cottage
or ricotta cheese
• 1 small lamb chop
• 1/4 cup canned fish (no
bones)
• 3 medium shrimp
• 1/4 cup crab, lobster,
shrimp
• 1/3 cup tofu
• 1 chicken thigh or
drumstick
• 1 small pork chop
• *2 slices low sodium
meat
• ½ cup cooked lean
ground meat
• 1/2 cup canned fish (no
bones)
• 1/2 cup dry curd cottage
cheese
• 1/2 cup crab, lobster,
shrimp
3 oz (90g)
Size of deck of cards
• 1 small chicken leg
(thigh and drumstick)
• 1 medium pork chop
• 1 small boneless
chicken breast
• 1 medium fish fillet
(3"x2"x1")
* read labels avoid potassium chloride if you are following a low potassium
diet.
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When Choosing Protein Foods
Choose:
; Unmarinated, unseasoned fresh or frozen meats: beef, pork, veal, lamb,
venison, rabbit, goat. Avoid precooked, preseasoned / flavoured or
prepared meat products.
; Eggs – egg whites are an excellent source of protein. You may eat as
many eggs whites as you wish. Egg yolks are high in phosphorous, limit
your intake of egg yolks to 3 yolks per week.
; Hard cheeses such as cheddar or mozzarella are high in salt,
phosphorous and fat. Limit to 3 oz per week.
; Lower fat cuts of meat and trim any visible fat.
; Low fat cooking methods: bake on a rack, broil, BBQ, grill or fry with
cooking spray or water.
Avoid
• Meats that are marinated, self-basting, seasoned or tenderized.
• Avoid all processed cheese products such as cheese slices and
spreadable cheese products such as Cheese Whiz®.
If you follow a vegetarian diet, ask your dietitian to help you
include appropriate choices in your meal plan.
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April 2009
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Potassium
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Potassium:
I currently need a reduced potassium diet.
YES
Date: ______________
NO
Date: ______________
Follow the suggested amount of potassium and protect your:
• Heart
Too little or too much potassium can be very hard on the heart. You should
only restrict your potassium if it is suggested to you. Restricting potassium
when it is not needed will NOT help the kidneys!
How is it measured?
• Potassium level is monitored by lab tests.
Potassium levels in blood:
 Minimum of 3.2 to 3.5 mmol/L depending on the lab you visit.
 Maximum of 5.0 to 5.5 mmol/L depending on the lab you visit.
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Potassium and the Kidney Friendly diet.
Potassium is a mineral that the body uses for the regulation
of muscle activity, including the heart muscle. Healthy kidneys ensure the
right amount of potassium is kept in the blood and the extra potassium is
filtered out. When the kidneys are not working properly, potassium levels
may begin to build up in the blood.
Why is this important to monitor potassium levels?
Too high or too low potassium can cause irregular heart beats and may
even cause the heart to stop. Keeping potassium within a normal range is
very important.
Your potassium level is monitored at each clinic appointment by the health
care team. A simple blood test helps us keep track of your potassium level.
If your potassium level is high, you will need to restrict your intake of high
potassium foods. If your potassium level is low, you will need to eat more
high potassium foods.
Where does Potassium come from?
Potassium is found in most foods. Foods such as fruits, vegetables, milk
and milk products and grains have higher levels of potassium. A list of high
and low potassium foods is available on pages 58-60.
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All foods contain some potassium, but some contain larger
amounts than others. Serving sizes matter. Eating large portions of low
potassium foods can cause a high potassium level in your blood.
How much Potassium do I need?
A kidney friendly diet contains 2000-3000 mg or less of potassium each
day.
Should I just avoid vegetables and fruits?
It is important to include vegetables and fruits in your diet every day. They
are important sources of vitamins and minerals needed to keep you
healthy.
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Reducing potassium in potatoes
Potatoes are naturally high in potassium. You can reduce the amount of
potassium in some vegetables by soaking them. This works particularly
well with potatoes, sweet potatoes, winter squash and pumpkin.
There is no need to soak all vegetables to lower potassium. Soaking will
remove other important vitamins and minerals.
Soaking or leaching can reduce the potassium in potatoes by almost half.
There are a few different soaking methods:
1.
2.
3.
Soaking and boiling.
Double boiling.
Soaking only.
Each method is described; choose the one that fits your lifestyle. Each
method has a specific set of instructions. It is important to follow the
instructions for each method closely to ensure reduction in potassium. It is
important that you throw the water away, do not save it for making soups or
gravies.
Soaking and Boiling
This is the most common method taught to kidney patients. You may
already be following this method.
1. Peel and cut the potato into 4 slices per potato, place in a large pot.
2. Cover with a large amount of water and soak the potato in warm water
for at least 2 hours.
3. Drain the water off, add fresh water and boil the potatoes until done.
4. Mash or fry the potatoes as desired.
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Double Boiling
This method results in a very soft potato that is, really only good for
mashing. This method is quicker than the other methods.
1. Peel and cut the potato into 4 slices per potato.
2. Cover well with water and bring to a boil.
3. Drain this water off and repeat step #2.
4. Cook potatoes until done.
Soaking Only Method
The key to this method is to make sure the potatoes are cut into small
pieces and that a large amount of water is used.
1. Peel potatoes and cut-up into small pieces (½ inches or smaller).
2. Rinse in warm tap water.
3. Place potatoes in a large pot of water- the amount of water is very
important to ensure the potassium will be reduced. For every 1 cup of
cut potatoes add 10 cups of water.
4. Soak for 4 hrs.
Once soaked for the 4 hours, the potatoes can be added to any of your
favorite recipes or cooked in whatever way you wish (baked, boiled, fried,
and scalloped).
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Low Potassium Potato Recipes
The following pages are some examples of low potassium potato recipes.
These recipes are from the Davita web site (www.davita.com)
Almost mashed potatoes
Makes 6 servings, each serving is ½ cup, each serving has 198 mg of
potassium
Ingredients:
6 cups of cauliflower (1 medium head)
4 oz of cream cheese (light or regular)
1 tsp minced garlic
½ tsp black pepper
Preparation:
1.
Cut cauliflower into pieces and rinse with water.
2.
Place cauliflower pieces in a microwave safe dish, cover and cook
on high for 8-10 minutes or until soft.
3.
Drain off any liquid.
4.
Add cooked cauliflower to blender and blend until smooth.
5.
Add remaining ingredients and blend until smooth. Serve hot.
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Garlic mashed potatoes
Makes 4 servings, each serving is ½ cup, each serving has 161 mg of
potassium.
Ingredients:
2 large baking potatoes
2 garlic cloves peeled
¼ cup of margarine
½ cup of nondairy creamer
Preparation:
1. Soak potatoes.
2. Once soaking is complete, throw away soaking water and refill pot
with water, add garlic to potatoes and water. Boil until soft
3. Drain.
4. Add remaining ingredients to drained potatoes and garlic whip with
mixer and serve.
Freeze these in individual servings to enjoy any time.
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Low potassium fried potatoes
Makes 2 servings, each serving is 8 pieces, each serving has 181 mg of
potassium.
Ingredients:
2 medium potatoes
½ cup of canola oil
1/8 tsp ground cumin
¼ tsp paprika
1/8 tsp ground pepper
8 tsp ketchup
Preparation:
1.
Slice each potato into 16 wedges.
2.
Rinse potato slices and place in a pot with 3 liters of water- soak
for 4 hrs.
3.
Heat oil in skillet, add potatoes to hot oil and cook for 10-12 mins
or until golden brown.
4.
Once potatoes are cooked remove from oil, sprinkle with
seasoning mixture, and serve with a small amount of ketchup (2
tsp of ketchup per serving of potatoes).
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Low potassium Scalloped potatoes
Makes 4 servings, each serving is ½ cup, each serving has 161 mg of
potassium.
Ingredients:
2 cups soaked and diced potatoes
½ cup of nondairy creamer
1/8 tsp of pepper
2 tbsp of margarine or butter
2 tsp of all purpose flour
Preparation:
1.
Place soaked potatoes in sauce pan add 4 cups of water and boil
until soft.
2.
Drain, add ½ cup of hot water, nondairy creamer, pepper and
margarine, and bring to a boil.
3.
Combine flour with 1 tbsp of cold water, add to potato mixture and
stir until thick. Serve hot.
Add onion or garlic to potatoes while boiling to add extra flavour.
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Whipped Cauliflower and Potatoes
Makes 5 servings, each serving is ½ cup, each serving has 178 mg of
potassium.
Ingredients:
1 cup of soaked potatoes
3 cups cauliflower
1 tbsp margarine or butter
¼ cup non dairy creamer
Preparation:
1.
In medium size pot, boil cauliflower and soaked potatoes until
soft.
2.
Drain and place in food processor. Add remaining ingredients
blend until smooth. ( can also be whipped using electric mixer)
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Low potassium pasta sauces
Another high potassium food is tomatoes. All tomato products are high in
potassium (tomato, tomato sauce, tomato past and tomato soup) a ½ cup
of tomato sauce has 450 mg of potassium in it. The following recipes are
lower potassium alternatives to pasta or tomato sauce.
Low Potassium Pasta Sauce
Ingredients:
7 roasted red peppers- pureed
1 fresh red pepper- chopped
1 large onion
2 – 6 cloves of garlic
1 eggplant- cubed
1 zucchini- cubed
¾ teaspoon salt
2 teaspoons sugar (optional)
1 – 2 teaspoons dry oregano
Chopped fresh basil and sage to taste.
Preparation:
1.
In a large pot add all ingredients and simmer for 1-11/2 hours.
For increased protein, add meatballs or 1 pound cooked ground
meat.
2.
Add water to sauce if too thick.
Sauce can be pureed and frozen to use for pizza and lasagna.
To roast red peppers: Place on aluminum foil and broil in oven
until blistered. Place peppers in a plastic bag to sweat them, and
then remove skins.
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Chester's Roasted Red Pepper Sauce
Ingredients:
8 fresh or frozen red peppers, whole
3 tablespoons vegetable oil
2 whole onions, chopped
4 cloves garlic, chopped
2 fresh basil leaves, chopped
2 tablespoons sugar
2 tablespoons lemon juice
2 tablespoons balsamic vinegar
SEASON WITH PEPPER TO TASTE
Preparation:
1. Roast whole red peppers and peel skins off. (To roast peppers,
place peppers on aluminum foil and broil in oven until skin blisters.
Place peppers in a plastic bag and allow to cool. Remove pepper
from bag and peel off skin.
2. Heat oil in pan. Sauté onions and garlic. Add peppers and
remaining ingredients and simmer for 1/2 hour, stirring
occasionally.
3. Puree ingredients using a blender or food processor.
Use sauce for pasta, lasagna, or on pizza.
For a high protein sauce add meatballs or cooked ground meat.
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Potassium food lists
The following pages are a list of low, medium and high potassium fruits and
vegetables. If it has been suggested that you follow a reduced potassium
diet, choose foods from the low and medium lists. If it has been suggested
to you to increase your potassium choose from the medium and high lists.
If you are following a low potassium diet, limit the following foods to lower
your potassium level
• Milk products intake limit to no more than 8oz (250 ml) per day.
• Cheese (avoid processed cheese) limit to 3 oz per week.
Remember to count milk used in coffee, tea, puddings, yogurt,
cream sauces, and soups as part of your milk intake for the day.
Other foods high in potassium that should be avoided
• Dried fruit or foods that contain dried fruits.
• Nuts and nut butters (peanut butter, almond butter).
• Foods containing nuts (breads, cookies, cakes).
• Chocolate or foods that contain chocolate.
• Whole grain, multigrain or dark breads.
• All bran or natural bran.
• Whole grain or multigrain crackers, cookies, or pastas.
• Foods made with tomato, such as soups, BBQ sauce, ketchup.
• Foods made with fruit puree such as steak sauce.
• Maple syrup.
• Pure licorice.
• Molasses.
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Potassium food lists: FRUITS
Fresh, frozen or canned: 1 serving = ½ cup or 1 small fruit (size of a
tennis ball). Remember to DRAIN CANNED FRUIT
_________ SERVINGS PER DAY
Low Potassium
(Less than 100 mg)
Applesauce (90)
Blueberries (65)
Boysenberries(90)
Cranberries (35)
Lemon
(80)
Lime
(70)
Passion Fruit (60)
Raspberries (95)
Rhubarb
(75)
Watermelon (95)
Medium Potassium
(101-200 mg)
Apple
(160)
Blackberries
(140)
Cherries
(120)
Clementine
(131)
Figs, Canned - 5 (145)
Fruit Cocktail
(120)
Grapes
(150)
Grapefruit** - 1/2 (175)
Lychees
(170)
Mandarins,canned(165)
Peaches, canned (120)
Peach, fresh
(170)
Pears, canned
(120)
Pear, ½ med fresh(105)
Pineapple
(135)
Plum - 1
(115)
Strawberries
(125)
Tangerine
(130)
JUICES:
cranberry cocktail (25) Apple Juice
Lemonade
(20) Grape Juice
Pineapple Juice
High Potassium
(more than 200 mg)
Apricots – 3
Banana
Breadfruit
Canteloupe - ¼
Dates
Figs, dried – 5
Guava
Honeydew - ¼
Jackfruit
Kiwi
Mango
Nectarine
Orange
Papaya
Persimmon
Plantain
Pomegranate
Prickly Pear
Prunes
Raisins
Soursop
Tamarind
Carrot Juice
Orange Juice
Prune Juice
*Tomato or V8®Juice
**Check with your doctor or pharmacist – may interact with some
medications.
* Also high in Sodium.
April 2009
(150)
(170)
(170)
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(315)
(450)
(470)
(370)
(540)
(665)
(255)
(345)
(300)
(250)
(320)
(290)
(250)
(780)
(270)
(360)
(400)
(230)
(350)
(560)
(310)
(380)
(360)
(215)
(355)
(270)
59
Potassium food lists: VEGETABLES
Choose fresh, frozen or no added salt canned. 1 serving = ½ cup
_________ SERVINGS PER DAY
Low Potassium
(Less than 100 mg)
• Alfalfa Sprouts (10)
• Bean Sprouts
• Cabbage
(75)
• Chives
• Cucumber
(75)
• Endive
(80)
• Green Beans (85)
• Leeks
(95)
• Lettuce
(80)
• Peppers
(115)
• Radicchio
(60)
• Watercress
(55)
• Yellow or Green
String Beans
• Yellow Wax Beans
Medium Potassium
(101-200 mg)
• Asparagus
(145)
• *Broccoli
(230)
• Carrots
(180)
• Cauliflower
(150)
• Celery, stalk
(115)
• Collards
(170)
• *Corn
(120)
• Dandelion Greens(120)
• Eggplant
(120)
• Green Onions
(140)
• *Green Peas
(150)
• Kale
(150)
• Okra
(190)
• Onions
(125)
• Potato if prepared as
suggested on next
page
(~200)
• Radishes
(105)
• Snow Peas
• Summer Squash –
Crookneck, Scallop or
Spaghetti Squash (130)
• Turnip
(105)
• Zucchini
(160)
High Potassium
(more than 200 mg)
Artichoke -1 med
(1060)
Avocado
(1480)
Bamboo Shoots
(320)
*Baked Beans
(453)
Beets
(260)
Beet Greens
(655)
*Blackeye Peas
(320)
Bok Choy
(315)
*Broad Beans
(310)
*Brussel Sprouts
(250)
Cassava
(765)
*Chick Peas
(240)
*Kidney Beans
(360)
*Lentils
(365)
*Lima Beans
(480)
*Mushrooms
(280)
*Navy Beans
(380)
Parsnips
(285)
Potato
(510)
Pumpkin
(280)
*Soya Beans
(445)
Spinach
(420)
*Split Peas
(355)
Squash (Winter) – acorn,
butternut, hubbard
(445)
Sweet Potato
(330)
Swiss Chard
(480)
*Tofu
(300)
Tomato
(335)
Tomato Paste
(1230)
Yams
(455)
*Also higher in phosphorus.
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Fluids
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Fluids
I currently need to reduce the amount of fluid I drink:
YES
Date:______________
NO
Date:______________
Follow the suggested amount of fluid and protect your:
• Heart
How is it measured?
Each visit the nurse and doctor will check for swelling. If you are
experiencing swelling you may be asked to limit the amount you drink.
Unless you are instructed to limit your fluids, just drink to quench your
thirst. Drinking extra fluids will not “flush out” the kidneys or improve your
kidney function.
If you are asked to limit your fluids the amount is:
 1 Litre per day + amount you void.
Following a low sodium (salt) diet will help reducing swelling.
Eating too much sodium will make you thirsty.
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Should I limit my fluid intake?
A fluid restriction is not usually necessary during the early stages of kidney
disease. As kidney function declines, you may need to limit the amount of
fluids that you drink. If a change to your fluid intake is needed, your
healthcare team will let you know. Increasing or decreasing your fluid
intake on your own will not help your kidneys. Some things you may want
to consider limiting are caffeine, alcohol and nutritional milkshakes
(supplements).
Caffeine:
Caffeine is found naturally in coffee, tea, chocolate guarana and yerba
mate. It is also added to foods such as energy drinks and cola-type
beverages.
Consuming too much caffeine can be harmful to your health. High intakes
of caffeine can cause sleeping problems, headaches, irritability and
nervousness. As well, many foods that contain caffeine are also sources of
potassium and phosphorous. A strong cup of tea (no milk added) has the
same amount of potassium as a 125 ml (½ cup) of blueberries. Adding milk
or cream would add extra potassium and phosphorous.
Health Canada recommends that all Canadians should limit their caffeine
intake to no more than 400mg per day.
How much is 400mg?
Food item
brewed coffee 250 ml (8oz)
tea 250ml (8oz)
cola or diet cola 1 can 355 ml (12oz)
Chocolate
decaffeinated coffee
April 2009
Amount of caffeine
135mg
50 mg
46mg
20mg
5mg
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These numbers are just guides, the stronger you brew the coffee or steep
the tea the more caffeine it will contain. Most coffee shop cups are larger
than 8 oz.
Limit your coffee/tea intake to 3 servings of– 250ml (8oz) each per day
Remember to count milk or cream added as part of your daily milk
allowance.
Avoid specialty coffees, mochaccino, cappuccino, lattes, café au lait or
coffee powders (International coffees) these are high in potassium and
phosphorous.
Coffee alternatives such as Milo®, Postum®, Caflib®, Ovaltine®, Horlicks®
are also high in phosphorous.
Alcohol:
If your doctor has approved the use of alcohol, please remember to use
moderation. Health Canada recommends the following:
No more than 1 to 2 alcoholic beverages per day for men.
No more than 1 alcoholic beverage per day for women.
One drink is 3.5 ounces wine, 1.5 ounces spirits or 12 ounces of beer.
Drinks are non-transferable. If you do not have a drink all week
that does not mean you can have all of them in one night.
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The following are some things to consider:
y Ales and lagers are high in potassium and phosphorous.
y Liquors and spirits are lower in potassium and phosphorous. However,
mixes such as; orange juice, tomato juice, clamato juice are high in
potassium and colas are high in phosphorous.
y Red and white wine are not high in phosphorous but contain potassium
(~140mg/glass).
y Drinks with milk or cream are high in phosphorous and potassium
(Brown Cow, Pina colada, cream based liquors).
Nutritional Milkshakes (Supplements)
There are many nutritional milkshakes available. Many of these contain
added potassium and phosphorous. If you are not able to meet your
nutritional requirements by food alone, a supplement may be
recommended.
Your Dietitian will let you know if a supplement would be of benefit to
you and will recommend which one will best meet your needs and be
friendly to your kidneys.
Not all supplements are kidney friendly so ask your Dietitian
before buying any over the counter supplements or diet products.
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April 2009
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Diabetes
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Diabetes
Follow and manage your diabetes and protect your:
• Kidneys
• Heart
• Circulation
How is it measured?
By two blood tests.
• A1C - determines your average blood glucose level for the past 3
months.
• Finger prick blood glucose (your meter) tells you what your blood
glucose level is right now.
Targets for blood glucose:
 A1C 7% or less
Blood glucose testing with your meter;
 Fasting 4-7 mmol/L
 2 hours after a meal 5-10 mmol/L
;
Test your blood glucose often, at least twice per day.
;
Test your blood glucose at different times (fasting, before
meals and 2 hours after a meal)
;
April 2009
Write these down and bring to your clinic visits.
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Cholesterol
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Cholesterol
Follow a low fat diet and protect your:
• Kidneys
• Heart
• Circulation
How is it measured?
•
A blood test, at least once per year.
Targets:
 Are individualized, speak to your healthcare team about what
your cholesterol and lipid levels should be.
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Cholesterol and your kidneys
Kidney patients have a higher risk of developing heart disease and are
often instructed to follow a cholesterol-lowering diet. Eating a heart healthy
diet while following a kidney friendly diet is challenging. For example a
heart healthy diet suggests you eat high fibre foods such as 100% whole
wheat breads, yet your kidney friendly diet is low in phosphorous and
recommends that you avoid these products! The Dietitian can help you plan
a heart healthy kidney friendly diet. Here are some heart healthy, kidney
friendly suggestions;
Choose
; High fibre kidney friendly foods (page 72).
; Low fat such as low fat breads, cereals and grains.
; Healthy fats such as non hydrogenated margarine, olive oil.
; Omega 3 fats (page 73).
; 1%, 2% milk or less milk products and yogurt.
; Lean fresh meats, such as skinless chicken breast, pork tenderloin, and
extra lean ground beef. Cook without adding oil or other fats.
•
Limit hard cheeses to 3 oz per week (look for light or skim milk).
• Exercise regularly, a heart healthy exercise regime includes both
cardiovascular exercise (walking, swimming) and resistance training
(weight lifting). Ask your dietitians for more information regarding kidney
friendly exercise.
• Take your cholesterol medications as suggested by your health care
team.
• Speak to your health care team before taking a cholesterol lowering
agent over the counter or herbal remedies.
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Fibre Food Choices for Kidney Patients
Aim for at least 5 servings of fruits and vegetables daily. Choose the fresh
fruit or vegetables rather than juice to get the benefit of fiber. Remember to
take note of the portion size to avoid eating too much potassium and
phosphorus.
Food Group
Fruits and
Vegetables
GOOD FIBRE CHOICE
(<3g fibre per serving)
• ½ cup canned pear
BEST FIBRE CHOICE
(>3g fibre per serving)
• Fresh apple with skin
• ½ cup fruit cocktail
• Fresh pear with skin
• *1 cup canned mandarins
• ½ cup fresh
• ½ cup canned peaches
blackberries
• Medium fresh peach
• 1 cup fresh blueberries
• *1 small tangerine
• ½ cup fresh raspberries
• 1 cup fresh strawberries
• 1 cup applesauce
• 1 medium plum
• ½ cup frozen boiled
• ½ cup canned pineapple
• ½ cup asparagus
• ½ cup boiled cauliflower
broccoli
• 1 medium stalk broccoli
raw
• ½ cup boiled green/yellow beans
• 1 cup stewed rhubarb
• 1 cup raw snow peas
• ½ cup boiled green
• 1 cup raw zucchini
• ½ cup boiled cabbage
• 1 cup raw savoy cabbage
peas
• 1 cup boiled white
turnip
• ½ cup boiled corn
• ½ cup boiled carrots
• ½ cup frozen mixed veggies
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Omega – 3 Fats
Omega 3 fats have become famous for being helpful in a number of
health conditions. The best known reason to increase your intake of
omega – 3 fats is to decrease your risk of heart disease. Other reasons
include; reducing your risk of some cancers, treating arthritis and macular
degeneration of your eyes.
Some sources of Omega- 3 fats are also high in potassium and
phosphorous and thus need to be avoided. These include; flaxseeds
(whole or ground), sardines, anchovies and pickled fish such as mackerel
and herring.
One of the best sources of Omega-3 fats is fish. It is recommended by the
Heart and Stoke foundation that Canadians aim to eat fish at least 3 times
per week.
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Kidney friendly Omega- 3 choices
Atlantic salmon – fresh or
frozen
Canned salmon
Tuna – fresh
Tuna – canned
Rainbow Trout
Bluefish
Mackerel – fresh or frozen
Flaxseed Oil
Omega 3 enriched eggs
Omega pro egg substitute
Omega 3 enriched milk
Omega 3 enriched cheese
Fish Oil Pills
April 2009
• Do not use smoked salmon as it is high in
sodium and does not contain much omega – 3
• Atlantic salmon contains less mercury
• Wild is better than farmed
• Pink salmon is better than sockeye for omega
–3
• Look for lower sodium versions
• Remember to take the bones out
• Choose bluefish, not yellow fin
• Choose albacore or white
• Choose one that is canned in water
• Look for lower sodium ones
• Pacific and Jack are higher in potassium
• Atlantic mackerel is fine
• Whole flaxseed and ground flaxseeds are
higher in potassium and phosphorus but the oil
is fine to use and contains the same amount of
omega – 3 as Atlantic salmon (fish is still
believed to be more effective though)
• By using the egg substitute, you are also
cutting down on fat and cholesterol
• If you use these products, remember to only
use them in the amounts suitable for your
kidney diet
• Speak with your doctor or pharmacist first.
• Generally it is suggested to use 1 gram of fish
oil daily. You may also need to take 200 IU of
vitamin E with it ( need to check with
pharmacist about this)
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What’s for dinner!
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Low Potassium, Low Phosphorous, Low Sodium Fast Food Tips
Adapted from the National Kidney Foundation.
When pressed for time we often choose food from fast food restaurants.
There are so many items to choose from but which ones fit into your kidney
diet?
• Choose meats served without sauces or gravies. Broiled, steamed or
grilled items are better then deep fried foods. Trim the fat and remove
skin before eating. Most batters or coatings are high in salt. Avoid
smoked or processed meats such as hot dogs, sausages, pepperoni
and cold cuts like salami and pastrami.
• Remember that french fries and baked potatoes are high potassium
foods. Why not try rice, noodles, or side salad. Onion rings are a low
potassium alternative to choose occasionally (high in sodium and fat).
• Keep in mind that ketchup, BBQ sauce and pickles are high in sodium.
Keep condiments, special sauces and dressings to a
minimum by requesting these to be served on the
side. This will let you control how much you use.
• Drink sizes are usually large or extra large and
can contribute to fluid overload if you have a
problem with swelling and must limit your fluids.
Order a small drink and remember to avoid cola pops to limit your intake
of phosphorous. If you choose milk, count it as part of your milk
products allowance for the day.
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• Choose white or 60% whole wheat breads or light rye breads or rolls.
plain bagels, sourdough, french, or italian breads are also good choices.
• Avoid: premade macaroni, potato salads, bean salad and creamy
dressings. These are very high in sodium and potassium.
• Italian Foods - choose plain pasta and meats served without cream or
tomato sauces. A pesto sauce is lower in potassium. Limit pizza to one
slice and add bread and salad to complete the meal. Stick to lower
potassium, lower sodium toppings such as
pineapple, peppers, chicken, and ground meat.
Avoid pepperoni, sausage, tomatoes,
mushrooms and anchovies. Ask for pesto sauce
to be used instead of tomato sauce on your
pizza. If this is not available request a small amount of tomato sauce to
be used.
• Chinese/ Thai/Japanese Food - Look for restaurants that do not use
MSG. Avoid using extra soy sauce. Avoid dishes that contain nuts. If you
are reducing potassium, be aware that many Chinese greens such as
bok choy are high in potassium. Choose steamed rice instead of fried to
reduce sodium.
• Sandwich/Sub Restaurants – What a perfect place for a kidney diet. You
can custom order your sandwich with roast beef, turkey, chicken, tuna
and lower potassium ingredients such as lettuce, peppers, onions,
cucumbers or pineapple. To limit sodium, avoid BBQ, sub sauce, pickles
and hot peppers. Many sub shops now offer salads as well, remember
to choose low potassium vegetables (avoid tomatoes).
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• Burger Places – Many have healthier menus now. Choose the grilled
chicken or grilled burger on a bun or flat bread and skip the fries, bacon
and tomato. To limit sodium use small amounts of
toppings such as ketchup, and relish. Use pickles and
hot peppers sparingly. Have a side salad (with
dressing on the side) or as a treat, enjoy a small
order of onion rings (high sodium and fat).
• Donut Shops – Choose yeast raised donuts that do not contain
chocolate, nuts or high potassium fruits. Bagels are also great choices
(avoid whole wheat, raisin or nuts). Many coffee shops now offer
sandwiches and soup. Be aware that soups are high in sodium and may
contain high potassium ingredients. Follow the same guidelines above
for sub restaurants.
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Kidney friendly choices at Donut shops
The following choices are allowed in moderation.
Although these choices are lower in potassium,
they are higher in phosphorous, sodium, fat and
calories.
Bagels
• Plain
• Blueberry
• Onion
• Cinnamon raisin (avoid if following a
low potassium diet)
Cream Cheese
• Plain light or regular
• Strawberry
• Herb and garlic
• Garden vegetable
Baked Goods
• Plain croissant
• Apple danish
• Cherry cheese danish
• Blueberry cheese danish
Yeast Raised Donuts And Tim Bits
• 3-4 Tim Bits = 1 donut
• Apple fritter
• Blueberry fritter
• Dutchie
• Honey dip, honey crueller
• Strawberry filled
• Blueberry filled
• Raspberry filled
• Lemon filled
April 2009
Sandwiches
For all sandwiches
; White NOT multigrain bread
; Regular size NOT large
; No tomato
• Turkey breast - avoid dressing ask
for mayo or mustard instead.
• Tuna salad
• Chicken salad
• Egg salad
Soups (10 oz serving)
Still HIGH in SALT
These are lower in potassium
Chicken noodle
• Turkey & rice
Beverages
• Coffee
• Decaffeinated coffee
• Tea
• Apple juice
• Milk (remember to count as part of
your daily milk products)
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Kidney Friendly Snack Choices
The following are some low phosphorous, low potassium and low sodium
ideas for between meals snacks.
; pretzels, unsalted (1c)
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
;
popcorn, plain (1½ c)
bread Sticks (2)
english muffin (1/2)
plain bagel with 1tbsp cream cheese (1/2 bagel)
graham crackers/wafers (4 squares)
rice or corn chex cereal (1c)
fruit cocktail (1/2c)
apple (1 small)
blueberries (1c)
oatmeal♣ or cream of wheat cereal- not instant (1/2c)
vanilla wafers (4)
shortbread cookies or vanilla sandwich cookies (4)
grapes (15 small)
fruit pie (1/8 pie)
yeast raised donut (1 plain)
cereal: rice krispies, cornflakes, special K (1c)
angel food cake (1 med slice)
pound cake, unfrosted (1 med slice)
popsicle (1 bar)
frozen fruit juice bar (1bar)
sorbet (1/2c)
raw veggies with low fat dip (1/2c)
fresh fruit (1 small piece or ½ c)
yogurt (1/2c)- remember to count as part of your milk products
allowance for the day
plain rice cakes (2)
cracked wheat or light rye bread with jam (1 slice)
jello
rice krispies squares
♣ limit oatmeal to 3 times per week to limit your phosphorous intake
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Shopping
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Reading Food Labels
The following information will help you read the new labels and decide
which foods you can include as part of your kidney friendly label diet.
Ingredient List
The list of ingredients is mandatory. All of the ingredients for a food are
listed in descending order by weight with the largest listed first.
Serving Sizes
The serving size is what a single portion of a food is. The information
stated on the label is based on the serving size. Be aware that the serving
size on the label may not be the same as the portion you are going to eat.
Calories
Calories tell you the amount of energy found in a serving of the food
Percent of Daily Value (% Daily Value)
This puts the nutrients on a scale of 0% to 100%. This scale tells you if
there is a little or a lot of a nutrient in a serving of this food. See page 86
what % of each nutrient is best for your kidneys.
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Fat and Cholesterol
Many patients with kidney disease are also following a diet to lower their
cholesterol. Look at fat and cholesterol daily values to choose heart
healthy foods. You can lower your blood cholesterol level by limiting the
amount of cholesterol, and saturated fats you eat. Look for foods with less
than 10% of daily value of saturated fat and less than 7% daily value of
cholesterol per serving. Choose lean meats and trim visible fat.
Trans Fats
Trans fat (also called trans fatty acids) is formed when liquid vegetable oils
go through a chemical process called hydrogenation, a process that makes
oils more solid. Hydrogenated vegetable fats are used by food
manufacturers because they allow longer shelf-life and give food desirable
taste, shape and texture.
The majority of trans fat can be found in shortenings, stick (or hard)
margarine, cookies, crackers, snack foods, fried foods (including fried fast
food), doughnuts, pastries, baked goods, and other processed foods made
with or fried in partially hydrogenated oils. Some trans fat is found
naturally in small amounts in various meat and dairy products. To lower
your intake of trans fats, avoid hydrogenated oils or food prepared with or
that contain hydrogenated fats.
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Sodium
Sodium is another word for salt. Patients with kidney disease should limit
their intake of sodium. In general look for foods that have no more than 610% of the daily value for sodium. Many low sodium products have added
potassium. If you are following a reduced potassium diet, read labels and
avoid low sodium products that contain potassium chloride in the ingredient
list.
Carbohydrates, Sugars and Fibre
If you have diabetes, this information is important for you. The total
carbohydrate grams per serving will help you with carbohydrate counting
and balancing your meals. Every 15 grams of carbohydrate equals one
bread/starch portion for a diabetic diet. Remember that foods with high
levels of fibre – at least 10% of the daily value will most likely be high
sources of phosphorous.
Protein
Protein is very important for keeping you healthy. Proteins are used by your
body to maintain and build tissues and cells. Label’s list the grams of
protein found in each serving. Each 7 grams of protein listed equal one
ounce of protein or one meat serving.
7 grams of protein = 1protein serving
14 grams of protein = 2 protein servings
21 grams of protein = 3 protein servings
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Potassium
Potassium may be listed as percent daily values, but it is not mandatory on
the food label. If potassium is not listed, it does not mean that the food is
low in potassium. If percent daily values for potassium are listed, you can
use them to help with your diet. Percentages for potassium are based on
the reference standard of 3500mg. Your kidney friendly diet provides
approximately 2000-3000 mg per day.
In general:
Potassium low
Potassium medium
Potassium high
<100 mg
101-200 mg
More than 200mg
<3%
3-6%
6% or higher
Phosphorous
Phosphorous may or may not be listed on the label, as it is not mandatory
on the food label. If phosphorous is not listed it does not mean the food is
low in phosphorous. Your kidney friendly diet is low in phosphorous, aiming
for 1000 mg or less per day. Foods that are described as “whole grain”,
“100% whole wheat” or those that contain bran, wheat germ, nuts, seeds,
or chocolate will also have higher levels of phosphorous.
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85
PULLING IT ALL TOGETHER
What you need to look for on a food label to determine if the food is kidney friendly
Type of Food
Breads/Cereals/
Cookies/Muffins/
Snacking crackers
Milk/Dairy Products
Serving Size
1 slice bread
2 cookies
8-10 crackers
½ cup
Fat and cholesterol
Sodium(salt)
Target: 65 gm fat and
300 mg cholesterol /day
Target is less than
2000-3000mg per
day
6% daily value
150 mg
Total fat less than 20%
of daily value
Saturated fat-10% or
less of daily value
Cholesterol 7% or less of daily value
Fruits
½ cup or
1 small piece
Potassium ( if you
need to restrict)
Target is less than
1000 mg per day
3 % daily value
10-100 mg
Phosphorous
Target is less than
1200mg/day
5-8% daily value or
less
60-120mg
3% daily value
60 mg
6% of daily value
200 mg or less
10% daily value or
less
125mg or less
0 mg
5-7% of daily value
160-240 mg
1% or less of daily
value
16 mg or less
Vegetables
1% daily value
23 mg
½ cup
5-7% of daily value
160-240 mg
5% or less daily
value
60 mg or less
Protein – meat/fish/
Chicken/eggs/cheese
7 grams =
1 ounce/serving
See list below
1% daily value
25 mg
2% of daily value
80 mg
(30 grams)
Fats – margarine,
mayonnaise
Keep added fats( oil,
margarine, mayo etc..) to 36 tsp per day
Frozen dinners
(for a main meal)
1 tsp
1 each
8% or less daily
value
80 mg or less
Choose oil and
margarines with
saturated fat- 10% or
less of daily value
30% or less of daily
value
20 grams
1% of daily value
50 mg
2% or less of daily
value
50 mg or less
Under 20% of daily
value
500 mg
27% of daily value
950 mg or less
50% or less of daily
value
Less than 600 mg
April 2009
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Grocery List Suggestions
The following pages contain a grocery list to get you started on your kidney
friendly diet. If you don’t see a food you are wondering about, ask your
Dietitian.
April 2009
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87
…
…
…
…
…
…
…
…
…
…
…
…
…
…
Meat/Protein Foods
Lean beef
Skinless chicken
Eggs
Egg Substitute
Fish
Lamb
Lobster
Pork
Shrimp
Canned salmon (low
sodium
Tuna (low sodium)
Turkey
Veal
Wild Game
Fruits
… Apple Juice
… Apples
… Applesauce
… Blackberries
… Cherries
… Cranberries
… Cranberry Juice
… Cranberry Sauce
… Fruit Cocktail
… Grape Juice
… Grapes
… Lemon
… Lemon Juice
… Lime
… Lime Juice
… Loganberries
… Lychees
… Peach
… Peach Nectar
… Pears (canned)
… Pear Nectar
… Pineapple
… Plums
… Raspberries
… Strawberries (½c)
April 2009
Vegetables
… Alfalfa Sprouts
… Arugula
… Asparagus
… Cabbage
… Carrots
… Cauliflower
… Celery
… Chili Peppers
… Chives
… Coleslaw
… Corn*
… Cucumber
… Eggplant
… Endive
… Garlic
… Ginger root
… Green Beans
… Leeks
… Lettuce
… Mixed Vegetables
… Mushrooms*
… Onions
… Parsley
… Peas*
… Pimentos
… Radicchio
… Radishes
… Summer Squash
(crookneck, zucchini)
… Sweet Peppers (green,
red, yellow, orange)
… Turnip (purple one)
… Water Chestnuts
… Watercress
… Yellow Beans
Grain Products
… Bagels (White, 60% whole
wheat, light rye)
… Bread (white, Italian,
French, Light Rye,
cracked wheat)
… Bread Sticks
… Cereal, plain
… Cream of Wheat
… Couscous
… Crackers (unsalted)
… English Muffins
… Hamburger Bun
… Macaroni
… Melba Toast
… Noodles
… Pita Bread
… Pasta (white)
… Popcorn (unsalted)
… Pretzels (unsalted)
… Rice (white)
… Rice Cakes
… Rolls
… Spaghetti
… Tortillas (flour)
Dairy/Dairy Substitutes
… Non Dairy Creamers
(Coffee Rich®)
… Non Dairy frozen dessert
topping (Cool Whip ®)
… Rice Milk (not brown rice)
*High in Phosphorous
Regional Nephrology System
88
Beverages
… 7-up
… Sprite
… Gingerale
… Cream Soda
… Lemon-Lime
… Orange Crush
… Juice (apple, cranberry,
grape)
… Lemondade
… Mineral Water
… Tea
… Coffee
Fats
… Butter
… Cream Cheese
… Margarine
… Mayonnaise
… Miracle Whip®
… Non dairy creamers
… Salad Dressings
… Vegetable oil
April 2009
Seasonings and Spices
… Allspice
… Basil
… Bay Leaf
… Caraway Seed
… Chives
… Cilantro
… Cinnamon
… Cloves
… Cumin
… Curry
… Dill
… Extracts (almond, lemon,
lime, maple, orange,
peppermint, vanilla)
… Fennel
… Garlic powder
… Ginger
… Horseradish (root)
… Lemon Juice
… Mrs. Dash®
… Luda no added salt
instant bouillon mix
… Nutmeg
… Onion Powder
… Onion Flakes
… Oregano
… Paprika
… Parsley
… Pepper
… Pimentos
… Poppy seed
… Rosemary
… Saffron
… Sage
… Savory
… Sesame Seeds
… Tarragon
… Thyme
… Turmeric
… Vinegar
Regional Nephrology System
Desserts/Snacks/Sweets
… Animal Crackers
… Cake (angel food, butter,
lemon, pound, spice,
white, yellow)
… Chewing gum
… Cinnamon Drops
… Cookies (shortbread,
sugar, vanilla wafers)
… Donuts
… Fruit Ice
… Graham crackers
… Gumdrops
… Gummy Bears
… Hard candy
… Jell-O®
… Jelly Beans
… Jolly Ranchers®
… LifeSavers®
… Lollipops
… Marshmallows
… Pie (apple, berry, cherry,
lemon, peach)
Other
… Apple butter
… Corn Syrup
… Honey
… Jam
… Jelly
… Sugar (white or brown)
Adapted from “Grocery List
Suggestions for Dialysis
Patients” Abbott
Laboratories, 2004
89
April 2009
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90
Other Helpful
Resources
April 2009
Regional Nephrology System
91
Cookbooks for the Kidney Patient
Cookbook
Cooking For
David:
A Culinary
Dialysis
Cookbook.
Author(s)
Sara Colman
RD, CDE and
Dorothy
Gordon, BS,
RN
Cost
$25.95US
+tax/shippin
g
Ordering Details
www.culinarykidneycooks.com
The Renal
Gourmet
Mardy Peters
$31.00 US
(Includes
shipping)
www.kidney-cookbook.com
$15.00 CDN
(includes
shipping
and
handling)
www.multi-med.com/renal
$10.00 US
(includes
shipping
and
handling)
National Kidney Foundation of
Northern California
611 Mission St, 3rd Floor
San Francisco, California, USA
415-543-3303
415-543-3331 (fax)
The Renal
Family
Cookbook
Renal Family
Inc (1983)
A Taste of
Asia:
Cookbook for
Renal Patients
National
Kidney
Foundation of
Northern
California
April 2009
Regional Nephrology System
Culinary Kidney Cooks
P.O Box 468
Huntington Beach, CA 92648
Fax: 714-842-4694
e-mail:
orderinghelp@culinarykidneycoo
ks.com
Emenar Incorporated
13n625 Coombs Rd
Elgin, Illinois, 60123
Multimed Publications
66 Martin St
Milton, ON
L9T 2R2
1-888-834-1001
92
Cookbook
Chinese
Renal
Kitchen,
Cookbook for
People Living
with a Special
Diet for
Kidneys
Creative
Cooking for
Renal Diets
Author(s)
BC Chinese
Nutrition
Consultants
St. Paul’s
Hospital,
1999 – 2nd
Edition
Creative
Cooking for
Renal
Diabetic Diets
Cleveland
Clinic
Foundation
(1985)
The Kidney
Helper
Cookbook
Bob and
$24.95 US
Nathalie Lutfy + $4.00
shipping
Patricia Ellis,
MS, RD
Cost
Ordering Details
$43.00 CDN St. Paul’s Hospital, Clinical
Nutrition
Room 4000 Providence
Building
1081 Burrard Street
Vancouver, BC
V6Z 1Y6
604-806-9011
$17.95 US
www.patientsupport.net
+ shipping
Book Masters
30 Amberwood Parkway
Ashland, Ohio, USA 44805
1-800-247-6553
$17.95 US
(+shipping)
www.patientsupports.net
Book Masters
30 Amberwood Parkway
Ashland, Ohio, USA 44805
1-800-247-6553
www.consumermedhelp.com
/KHMECookbook.html
Consumer MedHelp Inc.
2437 Bay Area Blvd #128
Houston, TX , USA 77058
1-877-248-2331
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Internet Resources
The following are recommended internet sites that offer safe kidney friendly
nutrition.
y The Kidney Foundation of Canada
www.kidney.ca
y The Kidney Foundation of Canada –Ontario Branch
www.kidney.on.ca
y The Kidney Foundation of Canada –Northern Alberta & The Territories
Branch
www.kidney.ab.ca
y IKidney
www.ikidney.com
y Kidney Directions
www.kidneydirections.com/us/recipe
y DaVita –Dialysis and Kidney Disease Information at Your Fingertips
www.davita.com
y National Kidney Foundation
www.kidney.org
y Epogen – 2 Free Kidney cookbooks to download
www.epogen.com
y Culinary Kidney Cooks
www.culinarykidneycooks.com
y American Association of Kidney Patients
www.aakp.org
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Measurement chart
Conversions:
2 tablespoons =
1 ounce (oz)
= 30 ml
½ cup
=
4 oz
= 125 ml
¾ cup
=
6 oz
= 200 ml
1 cup
=
8 oz
= 250 ml
2 cups
=
16 oz
= 500 ml
4 cups
=
32 oz
= 1000 ml (1 Litre)
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Exercise
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Exercise
Follow an active lifestyle and protect your;
• Overall Health
How is it measured?
• Keep a record of your physical activity.
Target
 Be active every day.
 Increase the number of minutes you are active slowly over time
Overall goal
 Ultimate activity goal from the National Kidney Foundation,
Kidney Disease Outcome Quality Initiative is moderate intensity
for 30 minutes most, if not all, days per week.
Speak to a member of your health care team about how you can
increase your daily activity.
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References
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References
Kidney Diet Booklet. Association of Nephrology Dietitians of Eastern
Ontario/Western Quebec 1997
The Renal Diet: A Guide to Eating Healthier for Hemodialysis
Patients. VCU Health System, MCV Hospitals and Physicians, The
Hume-Lee Transplant Centre 2006
Kidney Friendly Comfort Foods: A Collection of Recipes for Eating
Well with Chronic Kidney Disease. Shire Pharmaceuticals, 2006
“Grocery List Suggestions for Dialysis Patients” Abbott Laboratories,
2004
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