Research on dieting for weight loss and what works for long term weight maintenance is extensive. One tool shown to help weight loss dieters maintain their weight is a food diary. This is a useful tool for dialysis patients or anyone on a kidney diet making new and long lasting changes in eating habits.

A food diary is a record of the amount of foods and liquids consumed. It may include additional information Read more…

A handful of grapes make a healthy snack for a kidney friendly diet—tasty, convenient and full of phytochemicals—amazing plant components that provide health benefits.  Anthocyanins are a polyphenol antioxidant that gives the red to purple color to grapes, grape juice and red wine.  Resveratrol is another polyphenol antioxidant found in grapes.

These and other phytochemicals in grapes protect against heart disease by keeping blood vessels relaxed, preventing inflammation and oxidation of free radicals.  This may be a benefit to anyone with kidney disease because cardiovascular disease and inflammation risks are greater in kidney patients as compared to the general public.  Phytochemicals have also been linked to cancer prevention and protection against nerve degeneration that occurs with aging.

Nutrients in Grapes

1/2 cup grapes contains 1 mg sodium, 88 mg potassium, 4 mg phosphorus
4 fluid ounces grape juice contains 4 mg sodium, 167 mg potassium, 14 mg phosphorus
4 fluid ounces red wine contains 5 mg sodium, 149 mg potassium, 27 mg phosphorus

What about raisins?  Raisins are dried grapes but caution–it’s easy to consume too much potassium from this or any dried fruit.  A snack-sized box of raisins (1.5 ounces or 1/4 cup) contains 315 mg potassium.  Stick with the miniature size box if you are on a low potassium diet (0.5 ounce or 1-1/2 tablespoons)—potassium 100 mg .

Serving Grapes

Grapes taste great frozen—and also help quench thirst for those on a fluid restriction.  In addition to eating grapes for a snack, try incorporating them into a meal.

DaVita.com has several recipes that include grapes or grape juice:
Fruited Curry Chicken Salad
Lemon Curry Chicken Salad
Chicken Fruit Salad
Purple Punch

Understanding food labels is even more important for those following a kidney diet. Since phosphorus is often missing from the Nutrition Facts, it’s important to know how to find hidden sources on the ingredient list.

Look for obvious sources of phosphorus in the ingredients: cheese, milk, yogurt, nuts, seeds, dried beans and peas, bran, whole wheat or whole grains, organ meats, peanut butter and chocolate.

One not-so obvious source of phosphorus is the leavening agent, baking powder. One teaspoon contains over 450 mg phosphorus and over 350 mg sodium. Products made with baking powder include biscuits, pancake mix, quick breads and many commercially prepared bakery products.

Cereals and cereal bars may be another phosphorus contributor. Many cereal boxes list phosphorus in mg or as a % of Daily Value (DV). Use these numbers to interpret:
50 mg or up to 5% DV is low phosphorus
51-150 mg or 5-15% DV is medium phosphorus
Over 150 mg or greater than 15% DV is high phosphorus

Another hidden source of phosphorus is enhanced meats. These products look like fresh meats but have been injected with a solution of water, sodium, potassium, phosphates and antioxidants to help retain fresh appearance, extend shelf life and retain moisture during preparation.

A growing number of foods are showing up with phosphate additives. Several years ago you could safely buy canned or bottled tea, punch or lemonade without worrying about phosphorus. Kidney patients were instructed to avoid colas due to phosphoric acid, but most other sodas were safe. Now some brands of soda, tea, punch and lemonade contain phosphate additives which are almost 100% absorbed. Manufacturers use phosphorus containing additives as buffers, dough conditioners, anti-caking agents, emulsifiers, texturizers, acidifiers and dietary supplements (most foods with added calcium contain calcium phosphate). It is extremely important to read the ingredient list of any processed food to identify hidden phosphorus. Look for terms like polyphosphate, phosphoric acid, calcium phosphate and pyrophosphate and avoid these products.

For more information on phosphorus and label reading check out this DaVita.com article:

Reading labels to control phosphorus in the dialysis diet

This Friday, July 4th is a time for all Americans to celebrate freedom and independence. Parades, picnics and backyard barbecues are a few favorite ways to spend the day. By planning ahead and following a few guidelines, people with chronic kidney disease and those on dialysis can join the holiday celebrations and still maintain control of their diets.

DaVita.com offers a great list of recipes tagged for your Independence Day event. Try the Honey Mustard Grilled Chicken or Lisa’s Awesome Burgers for an entrée. Wash it down with Minted Lemonade or Watermelon Summer Cooler and enjoy Red, White and Blue Pie for dessert. Check out the variety of salad and pasta recipes for additional side dishes.

For a list of healthy tips for fun social events, see DaVita Dietitian Maria’s article “Surviving summer socials on the dialysis diet”.

Keeping sodium, fluid, potassium and phosphorus intake within reason is the key to enjoying July 4th and feeling your best by the end of the red, white and blue holiday weekend.

The Daily Value (DV) on food labels was established for the general public to help determine if a food is a high or low source of specific nutrients.

For people with healthy kidneys a high potassium intake is considered healthy. The daily goal is to consume enough high potassium foods to provide at least 3500 mg potassium.

Once the kidneys can no longer remove potassium (usually in later stage 4 and stage 5 CKD), and blood potassium values rise above normal (3.5-5.0 mEq/L) a lower potassium diet is usually prescribed.

Some but not all foods include potassium on the Nutrition Facts Label. An understanding of what to look for can help make grocery shopping easier. Here’s a general potassium DV guideline to help interpret the numbers when reading food labels:

• Up to 4 % DV = 0-140 mg, low potassium
• Up to 7 % DV = 141-250 mg, medium potassium
• Up to 14% DV = 251-500 mg, high potassium
• Over 20% DV = 700 mg or more, very high potassium

Each person has individual requirements for potassium depending on kidney function, lab values, appetite and type of dialysis treatment. It’s a good idea for people with chronic kidney disease to always check with their kidney care team rather than guess about their diet requirements for potassium.

6 Guidelines for Controlling Phosphorus
1. Follow a low phosphorus diet. Aim for 1000 mg or less each day.
2. Read food labels and avoid those with phosphate additives and high phosphorus ingredients.
3. Learn which foods are high in phosphorus and discover lower phosphorus substitutions.
4. Prepare meals at home using as many fresh, unprocessed ingredients as possible. Start a collection of kidney-friendly recipes.
5. Take phosphorus binders as prescribed each time you eat.
6. Be sure you are getting enough dialysis—it’s the only way to remove excess phosphorus from your blood.

Managing phosphorus is one of the biggest challenges for people with kidney disease. Levels may be normal in earlier stages, but as kidney failure advances more phosphorus accumulates in the body. Read more…

Choose a meal from the sea—fish provides high quality protein, a nutrient encouraged in limited amounts in a pre-dialysis diet and increased in a dialysis diet.

Fresh fish is naturally low in sodium, fat and cholesterol—even the fatty fish are low fat compared to many red meat cuts. Potassium and phosphorus content varies with the fish variety–catfish, cod, orange roughy, sea bass and sole are among the lowest. Salmon contains higher amounts of potassium and phosphorus but can still be worked into a kidney diet by combining it with lower potassium sides and adjusting phosphorus binders if needed. It’s best to avoid fish canned with bones—some salmon, sardines—because phosphorus is very high. Tuna fish is probably the most popular canned fish. Choose the low sodium canned or rinse in water for at least one minute to reduce sodium by 30 to 50%.

Salmon and other fatty fish like mackerel are high in omega-3 fatty acids, shown to protect against heart disease, stroke and possibly help decrease chronic inflammation when consumed 2-3 times a week.

Fish is easy to prepare—try it grilled, baked, microwaved, fried or poached.
Some popular fish recipes on DaVita.com include
Cilantro-Lime Cod
Crunchy Oven-Fried Catfish
Honey Spice Rubbed Salmon
Korean-style Fried Whitefish
Mahi Fish on the Green
Tuna Veggie Salad

Beef & Onion on Linguini with Fancy Green Beans	Chicken & Bowtie Pasta with Summer Veggies	Turkey On Cranberry Rice with Candied Carrots

A new company called Meals for Life is producing frozen meals low in sodium, potassium and phosphorus for people on dialysis. Three choices are available with more to come in the future.

Ann Valadez, the CEO and Founder of Meals for Life recognized the need for quick, healthy meals for people on a renal diet during the six years her own mother was on dialysis.

Currently these meals are available at Clark’s Nutrition and Fitness Centers in Riverside, Loma Linda and Rancho Mirage California for $6.99 each. Future plans include mail order delivery and placement in additional markets throughout the country.

For more information visit the website at www.meals-for-life.com or contact Ann at ann_valadez@sbcglobal.net

For information on availability at Clark’s stores visit their website at www.clarksnutrition.com. Look for Meals for Life under the New Items’ category.

Potassium restriction is not required by all people with chronic kidney disease (CKD). Usually those on hemodialysis or in late stage kidney failure, but not yet on dialysis are prescribed a lower potassium diet by their doctor or dietitian. People with early stage chronic kidney disease or daily dialysis may require a more liberal potassium intake unless their lab values are high.

This is often confusing when first diagnosed with CKD. Doctors and dietitians monitor potassium lab values to determine when their patient needs to start limiting foods high in potassium. As kidney function declines, more potassium is retained in the blood, so dietary intake must be reduced to prevent high potassium levels. Too much potassium is dangerous and can cause heart failure.

People who are unsure can check with their kidney doctor and dietitian to confirm an individual daily goal for potassium as well as other diet parameters.

DaVita.com has launched a Recipe Review and Rating system for users to post comments on website recipes they have prepared or tasted.

Post your own reviews on recipes you have made or read what others have to say. Here are reviews by users who have tried Easy Low Phosphorus Fudge: http://www.davita.com/recipes/desserts/a/293#readreview