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.

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.