Building a Renal Diet Grocery List – Canned Vegetables vs. Fresh Vegetables – Which Is Better for My Renal Pre-Dialysis Kidney Disease?
If you live in an area where fresh vegetables are not readily available or affordable, you may feel your options are limited to canned vegetables. It may also be the case that fresh vegetables are not available at this time of year for you to choose. If this is the situation that you are facing, you must consider many factors when choosing these items.
With kidney disease, you must take care to limit your consumption of protein, sodium, potassium, and phosphorus. You may need to watch your carbohydrate intake if you have diabetes as well. Unfortunately, because of these factors, canned vegetables can be a little trickier to pick than fresh vegetables. Don’t forget you can choose frozen vegetables, and they are similar in nutritional content to what a fresh vegetable would be. So they may be a great compromise when you are really wanting to use fresh vegetables but they are not available. And remember, even though they may cost a little more, you will be eating less meat or protein so your grocery bill should be in a better place!
Generally, canned foods are high in sodium. Fortunately, these items also are required to list the sodium content on the nutrition label. This part of the label can be consulted to see if the item would be acceptable or not. The percent daily value (%DV) that is on the food label should be no more than 6-10% to stay within the limits of your pre-dialysis renal diet. Most canned foods are significantly higher than this amount. Look for items that are marked sodium free, very low sodium or low sodium. Items are marked as reduced sodium or light in sodium may be reduced to an acceptable level . Sometimes these canned foods are still are a sodium level that is too high for your intake.
Another tip – you can rinse canned vegetables and reduce the sodium content by an average of 35%. It’s a great way to use regular canned vegetables if you already have them in the house and don’t want to discard them.
Sometimes if there is no salt added, there may be added potassium. You can notice if this is the case by checking the ingredient list. One form of potassium that is often used as a salt substitute is potassium chloride. If this is added, usually the food is too high in potassium to consume. When reading the label, check for the word potassium in the ingredient listing – if it’s at the top, you probably have too much.
Potassium is not required to be marked on nutrition labels, yet some manufactures add it for certain products. If a food is under 200mg the RDA may label it as 6%. This is what is acceptable for you intake. If it is 100mg or 3% the RDA, this is a low potassium food. If the item is above 6% it is too high for your current intake.
If potassium is not listed, you still need to be careful. You must be aware of vegetables that are low in potassium. If you are not sure, it is better to make note of the vegetable and check before you risk it being high in potassium.
Labels are not required to post the phosphorus in foods either. If it is posted as an RDI (recommended dietary intake) make sure it is under 15%. These foods would be 150mg. If an item is 50mg (5%) or less it is a low phosphorus food. More than 15% is considered a high phosphorus food and should be avoided if your levels are high, which your doctor or dietitian can help you determine based on labs. Canned beans (black beans, re-fried beans, kidney beans) are particularly high in phosphorus and should be avoided. Canned green beans and mixed vegetables are lower in phosphorus.
Check out our listing of potassium and phosphorus levels of a lot of foods and a huge variety of foods right now – go to the store armed with the list! Click Here
Sometimes canned vegetables have added sugar. If you have diabetes, you should be particularly concerned with this value. One carbohydrate serving is considered 15g. This information can be found in the “total carbohydrates” category on the food label. Total sugar that is in a food is grouped into this value, making it a more accurate number to look for if you have diabetes. Fiber also is something that you should pay attention to on the nutrition facts label. The higher the fiber, the better it is for your blood glucose control. A good source is considered 10% of the %DV and a high source is 20% of the %DV.
Be careful to note what the serving sizes are in food since often they are much smaller than you would assume. If you are consuming double the serving size, it is important to note that you are consuming double the sodium, potassium, phosphorus and carbohydrate amounts and thus they can be above your restriction. The serving size is listed in the nutrition facts label.
It is rare that canned foods are better than fresh foods. There is much more to consider regarding canned vegetables. You still must be aware of which vegetables are high versus low in potassium and phosphorus. Yet, it is possible to include these items in your diet by taking note of certain items that may be added such as sodium or potassium.
You can choose fresh and frozen vegetables, which will be lower in sodium, but you still need to pay attention to the potassium and phosphorus amounts in them because they could be a product that is high in potassium or phosphorus naturally. Check out the potassium and phosphorus lists we have – Click Here – and go to the store with more information.
Renal Diet HQ supports the Month of June as we move into the full swing of Men’s Health Month and the great celebration of Father’s Day. We celebrate all the fathers and grandfathers who have become part of the foundation of our great country.
Oklahoma City, OK (I-Newswire) June 13, 2013 – Renal Diet Headquarters announces it’s support for Men’s Health Month in the month of June and the great day of Fathers Day, June 16th. Men’s Health Month has a goal to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. This month gives all persons the opportunity to encourage boys and men to get regular check ups for disease and heighten awareness of any injury among men and boys in sport or at work.
CEO Mathea Ford was quoted at the beginning of June, saying “Healthy Diet Menus For You and Renal Diet HQ are proud to support the efforts of the Men’s Health Network and celebrating Fathers Day. The employees of our company strive to motivate and move our business forward and men are a huge part of Renal Diet HQ and Healthy Diet Menus For You, LLC. Our plan and mission is to see all males in our population continue to obtain high quality health services and wellness and a large part of that is eating the correct diet especially for those with pre-existing health conditions.”
Renal Diet HQ and Healthy Diet Menus for You, LLC will continue to expand the meal plan and nutritional education offerings with emphasis on renal pre-dialysis and renal diabetes. These two areas of concentration are key to mens health and wellness. All men should continue to watch their nutrition and should be encouraged to visit their primary care provider at least once a year for regular check ups and lab work. Many conditions are preventable and most are controllable with the guidance of proper medical care and oversight.
Renal Diet HQ consists of a monthly subscription plans that include weekly meal plans for renal patients from stage 3 kidney disease through kidney dialysis. Healthy Diet Menus For You, LLC works with cardiac, diabetic and gestational diabetic patient on diet and meal planning solutions. Each meal plan solution consists of recipes, nutritional information, and full grocery lists. Recipes provide full ingredient lists and complete instructions as well as specific nutritional information by recipe for our customers. The nutritionals include: calories, fat, saturated fats, sodium, carbohydrates, fiber, sugar, protein, cholesterol, phosphorus, and potassium, all of which are important to a person needing a special diet. Grocery lists are provided for meals individually and also for the entire seven day plan so you can go to the grocery store and get an entire week of meals or send someone for you.
Renal Diet HQ is committed to bringing the utmost quality and service to it is client base through it’s website and toll free phone number. Specializing in this very complicated and unique group of patients, Renal Diet HQ is proud to be a superb resource that can be relied upon by it’s clients to meet the demands that our client’s desire.
Renal Diet HQ and Healthy Diet Menus For You, LLC are located in Oklahoma City, Oklahoma and operated by the principals Mathea Ford RD/LD MBA and Chief Executive Officer and Donovan Ford, Chief Operations Officer. Healthy Diet Menus For You, LLC was launched in January 2011 as the brain child of Mathea Ford who is also currently serving as CEO of this start up. Healthy Diet Menus For You, LLC provides meal plans for diabetic, gestational diabetic, renal, renal diabetic and cardiac patients.
Oatmeal is one of the healthiest foods you could eat for diabetes or heart disease diets. This month we are spreading the word about how oatmeal can be a game changer in your life and improve your health.
Oklahoma City, OK (I-Newswire) January 2, 2013 – Healthy Diet Menus For You, LLC, Renal Diet HQ and CEO Mathea Ford, RD/LD announces their support of National Oatmeal Month by releasing a blog series on oatmeal and related topics. Over 40 years of research has shown that consuming 3g of soluble fiber a day can reduce bad cholesterol and can help reduce the risk of heart disease. What a better way to get the soluble fiber than with oatmeal?
The topics of discussion included in the blog series are as follows: Benefits Of A Good Breakfast, Heart Disease, Diabetes Management, Weight Management and Cholesterol. Both general information and in-depth articles will be published via the blog during the January 2013 month in conjunction with National Oatmeal Month. We also will be adding oatmeal recipes to the blog that fit right in with your special diet, whether it’s kidney disease, heart disease or diabetes. Did you know that more oatmeal is consumed in January than any other month of the year?
Healthy Diet Menus for You, LLC provides diet and nutrition expertise along with meal planning for cardiac patients and the heart conscious as well as meal planning and diets for diabetes management. The Healthy Diet Menus for You, LLC website provides valuable information for all types of cardiac and diabetic patients through an extensive information library of articles and a fully functional blog written by the CEO and Registered Dietitian, Mathea Ford. Healthy Diet Menus for You, LLC is committed to bringing the utmost quality and service to it is client base through it’s website and toll free phone number. Specializing in this very complicated and unique group of patients, Healthy Diet Menus for You, LLC is proud to be a superb resource that can be relied upon by it’s clients.
Renal Diet HQ specializes in renal diets and meal planning both for pre-dialysis and dialysis patients. The Renal Diet HQ website provides valuable information for all types of kidney disease patients through an extensive information library of articles and a fully functional blog written by the CEO and Registered Dietitian, Mathea Ford. Renal Diet HQ is committed to bringing the utmost quality and service to it is client base through it’s website. Specializing in this very complicated and unique group of patients, Renal Diet HQ is proud to be a superb resource that can be relied upon by it’s clients.
Renal Diet HQ and Healthy Diet Menus For You, LLC are located in Oklahoma City, Oklahoma and are operated by the principals Mathea Ford RD/LD MBA and Chief Executive Officer and Donovan Ford, Chief Operations Officer. Healthy Diet Menus For You, LLC was launched in January 2011 as the brain child of Mathea Ford who is also currently serving as CEO. Healthy Diet Menus For You, LLC provides meal plans for diabetic, gestational diabetic, renal, renal diabetic and cardiac patients.
About Healthy Diet Menus for You, LLC:
Healthy Diet Menus for You provides people with set weekly menus. Each menu is specifically targeted towards particular health requirements. Save time by subscribing to our easy to use menu plans.
Company Contact Information
Healthy Diet Menus for You, LLC
PO Box 6554
Did your doctor just tell you that you have stage 3 kidney disease and you have no idea where to start? I want to tell you that is unusual, but it’s not. I know it’s not what you want to hear, either.
Listen, though. I know that you are ready to start making some changes and that is all it takes to turn it around in the right direction. I hear lots of people saying, “When will my kidney disease progress? Or How Long Until I Start Dialysis?” Don’t think about it that way! You can slow the progression down with some simple changes.
What Are The Basics To Follow?
First of all, you should see a nephrologist. It’s no longer a good idea to stick your head in the sand and figure it out later. Now is the later you have been waiting for. A nephrologist helps you to get your medications and disease process under control so you don’t continue on the downward spiral to dialysis. If you are willing and able to make some changes, the time is now. Nephrologist’s have studied kidneys and kidney disease extensively, and can guide you down the right path that your general practitioner cannot.
Next, nutrition is key to improving your kidney function. Yes, there may be some medications that are affecting your kidneys and you should change them (that’s what the nephrologist does). You may even need to take more medications but they will improve your kidneys as well. But because the kidneys are key to removing the waste in your blood and make urine, you need to provide less of the food that contributes to damage to the kidney. Did that make sense? It will…
1. Calories are important to understand. You might have diabetes or heart disease, so you worry about other parts of your diet. But as your kidney stage advances you will find it more difficult to eat right and keep your weight up. You will consume fewer calories just because you don’t feel very well. It’s exhausting for your body to be going through this, and you feel the fatigue.
2. Protein is the 2nd most important component in a healthy kidney diet. Protein maintains your muscle tissues, helps heal wounds, and create your bones, skin and blood. Whew! That’s a lot for them to do. When you eat more protein than you need, it breaks down into waste products in your blood stream that are difficult for your body to process. So you are putting an extra burden on your kidneys. You should eat a moderate amount of protein – probably in the range of 6-7 ounces of meat or poultry or fish daily. You might eat that much at one meal, but now you need to spread it out between your entire day. It’s a portion size issue.
3. Speaking of portion size, a three ounce portion of meat is about the size of a deck of cards – that is height and length and width. So, it’s not huge. Sources of protein are everywhere. Mainly in your meats, fish, and poultry. Some better choices for meat to get less protein are egg substitutes, shrimp, tofu, roasted chicken and stews. Make your sandwiches with thinner slices of meats and add lots of vegetables to the sandwich to make it more filling. (By the way – in dialysis you eat more protein because the process of dialysis loses protein)
4. Fat can add calories but you want to make sure it’s the right kind of fat. Not saturated fat. You are at higher risk for heart disease as someone with kidney disease, so you need to eat the unsaturated fats – like olive and canola oils. You don’t want to eat trans-fats either. Saturated fats are in red meats, whole milk, butter and lard. Better choices are corn oil, safflower oil, olive oil, peanut oil and canola oil. So, if you are in need of additional calories to keep from losing too much weight, you should find ways to add healthy fats to your meals to increase the calories but not stop your heart!
5. Sodium adds to your issues, so watch it carefully. Sodium is found in some of the strangest foods. It causes your body to retain fluid and puts extra strain on your heart and kidneys. Reading the food labels is great – look for items with less than 10% of your daily value listed. You should try to limit your intake to 1,500 mg or less per day. In addition to regular table salt, sodium is found in regular canned vegetables, hot dogs, packaged starches, frozen vegetables with sauces, frozen meals, canned soup, tomato sauce and many snack foods. Use alternative seasonings – like a lemon juice (always my favorite with oil for salad) or herb seasoning. Just steer clear of the “salt substitutes” that contain potassium chloride.
6. Potassium – it works in mysterious ways but mainly it’s used by your muscles to work. When your blood level is too high (serum level over 5.0) you should limit your intake of high potassium foods so you can keep from adding to the problem. Some high potassium foods are oranges, melons, bananas, potatoes and tomatoes. Low potassium foods are apples, cranberries, pears, strawberries, pineapple, and boiled cauliflower. Don’t bother limiting potassium unless your labs indicate it’s too high, though. You need to focus on protein and sodium first!
7. Make sure you know your labs – phosphorus levels especially – so you can limit it as well if you need to. Phosphorus is very hard to limit because it’s in almost everything. So try to manage what you can with it and if your doctor tells you to limit phosphorus, ask about phosphorus binders to help. High phosphorus foods include: milk, cheese, yogurt, beans, nuts, dark colas, and processed meats. Foods that are low phosphorus that you can eat instead are: non-dairy creamer, rice, sherbet, popcorn, rice cereal, clear sodas and rootbeer.
I know it’s a hard transition. I have created a meal planning system that helps – and each month you get a new guide that goes in depth to provide the needed information to help you get through that stage and make better decisions. If you are interested, read more about a predialysis meal plan here.
How Does Secondary Hyperparathyroidism (SHPT) Affect My Kidney Disease Diet?
First, let me explain what SHPT is. Your parathyroid glands are responsible for keeping your bones and calcium levels in your blood at a healthy range. They are located in your neck on the back of your thyroid gland. Most of the time, you don’t even know they are there. They are near your thyroid gland, but work separately and produce PTH (Parathyroid hormone). PTH is responsible for maintaining the correct amount of calcium in the blood and bones, as well as ensuring calcium is absorbed from the digestive system, and finally controlling how much is excreted in the urine. (That is the connection to kidney disease). The amounts of other minerals that are part of bone growth – phosphorus and Vitamin D – are also critically important to the parathyroid. Doctors measure the amount of PTH as an indicator of bone disease.
Secondary Hyperparathyroidism (SHPT) as related to kidney disease is an overproduction of PTH. This is caused by the changes in the kidneys affecting other mineral levels in the blood and causing the body to overproduce PTH. In persons with CKD starting in stage 3, damage to the kidney affects the functioning amount of kidney and cause these changes to possibly occur.
What Causes The Body To Produce More PTH?
While that is a complicated question, I would like to answer it in a way that is easier to understand. Please remember – I am not your doctor!
Initially, your functioning kidney mass is decreased. This happens because of the damage over time to the nephrons in your kidneys. Your doctor may have told you a percentage of your kidneys that are still functioning. Once the amount of your kidneys that are working is decreased beyond a certain level (not exactly clear how much and it varies by individual), 2 things happen.
1. Kidneys are responsible to activate the Vitamin D in our body so it works. With less functional kidney, lower amounts of vitamin D3 are available in the blood stream.
2. Kidneys also excrete the phosphorus in our bodies, and with a lower capacity to produce urine, phosphorus builds up in the blood stream.
Those two events that happen together bring about a decrease in serum (blood level) calcium. A decrease in the amount of calcium, plus a decrease in the amount of Vitamin D3 and an increase in the amount of phosphorus in the blood cause your body to think you need more PTH (because it needs to increase the amount of calcium in your blood stream to a normal level).
What Does Vitamin D Do In Our Body?
PTH works to “normalize” the amount of calcium available in your bloodstream. Calcium is used for many things in your body, and it needs to be available to your cells. So, an increased amount of PTH will cause your bones to be broken down more quickly so that the calcium is available in your bloodstream.
Vitamin D3 happens to be very important in the actions and levels of PTH in our body. You may be aware that our bodies can “make” vitamin D by exposing our skin to sunlight for 10-20 minutes every day. That vitamin D our skin makes has to be transported to the kidney to be changed into the “active” form our body uses. It keeps us from overdosing on Vitamin D with too much sunlight.
Once vitamin D becomes activated, it can work in our bodies. It stimulates some other hormones that tell the parathyroid we have enough PTH. It also decreases PTH indirectly by increasing the amount of calcium we absorb in our “gut” through our intestines. This increases the amount of calcium in our blood stream, and keeps the amount of PTH at a normal level. But once you have a decreased level of vitamin D in your body, it does not work to increase the level of calcium in your blood stream as efficiently (you don’t absorb as much) so your body starts increasing the amount of PTH to accommodate your calcium needs.
How Do Our Bodies Handle Phosphorus?
When the eGFR decreases to less than 60 ml/min, your ability to remove phosphorus from your blood via your kidneys becomes altered. The part of your nephrons that are still working compensate by increasing the removal of phosphorus because your blood levels are increased. This helps to maintain normal phosphorus levels in your blood stream.
Once you progress further in kidney disease, your nephrons eventually become unable to excrete enough phosphorus to compensate, and that is when you start to notice hyperphosphatemia. (elevated blood phosphorus). So, as the amount of phosphorus increases in your blood, PTH is secreted to compensate. Calcium can bind with phosphorus (if they are out of balance) in the blood stream and form particles that then are deposited in organs and blood vessels. As phosphorus levels increase, this risk is higher, so your body reacts by breaking down bones and increasing the calcium levels in the blood stream to even out the levels. This causes the bones to be weakened over time, and calcium particles (those bound with phosphorus) to deposit in areas of the body such as the heart.
What Are The Goals Of Treating A Patient With SHPT?
Overall, the goal is to normalize the levels of the hormones and vitamin D so that the body is not breaking down bone to compensate for increased phosphorus levels. Preventing bone disease, called renal osteodystrophy, is key to the management of the disease. Patients with kidney disease are at a higher risk of cardiovascular disease, and calcium deposited in the heart can cause further problems.
In stage 3, it is very possible that the levels will be normal, but your body is working overtime to compensate and ensure that you are kept in that normal range. National KDOQI guidelines recommend that all patients with a eGFR < 60 ml/min/1.73m2 undergo an evaluation of serum calcium, phosphorus and PTH levels. KDOQI guidelines recommend testing once per year starting with the onset of Stage 3 CKD. PTH should be the key test for patients because of the way the body adjusts to keep calcium, Vitamin D, and phosphorus levels in the normal range by increasing the levels of PTH.
Management And Treatment of PTH and SHPT
KDOQI guidelines have recommended target ranges for PTH and calcium levels in patients with Stage 3 – 5 kidney disease. Based on those target ranges, the first course of action to improve the health of a patient with SHPT and suppress the levels of PTH is thought to be Vitamin D therapy. As vitamin D plays such a role in our absorption of calcium, if a person can take in and absorb appropriate amounts of “active” vitamin D (doesn’t have to be processed by the kidneys), their calcium absorption rate should also improve.
In addition to Vitamin D, dietary therapy includes reduction of high phosphate foods. Foods that are high in phosphate content include dairy products, meats, beans, dark sodas, beer and nuts. Many of these foods are great sources of protein, so it is important to be cautious when eliminating foods. You should focus on removing foods that are high in phosphate yet lower in protein, such as dark colas, cheese, milk, ice cream and beer.
You have to be careful about sources of protein because that can lead to malnutrition which affects outcomes once people start on dialysis. Also, dietary phosphate restriction may not be adequate since most of our food contains phosphates. Many doctors also recommend the use of phosphate binders as well.
Phosphate binding agents are taken with foods, up to 3-4 times per day, and attach to phosphate in the foods we eat causing it to remain in the digestive system and be excreted through stool. They have to be taken with food or they don’t work effectively, yet it is difficult for people to be consistent and remember to take the medications. Sometimes doctors use several different types of binders to achieve success. Some phosphate binders can be found over the counter such as calcium carbonate and aluminum hydroxide. But, you should talk to your doctor about it prior to initiating any additional intake.
What Should I Do About My SHPT?
First of all, discuss what it means with your doctor. Develop that relationship so you can ask. If you cannot, consider finding another doctor who will work with you. If you need to make a longer appointment, you should tell the person booking the appointment that you have a lot of questions and request a longer appointment time. That will keep your physician from feeling rushed.
At this point – if you have CKD Stage 3, it is recommended that you work with a nephrologist. They are experts and will manage your kidney disease very well. You may also want to find a local dietitian or check into a meal plan that meets your nutritional needs. Decreasing the amount of phosphate in your diet, in addition to treatment with an active vitamin D medication can provide a great deal of improvement and reduce your risk of bone and cardiac complications.
Thanks for sticking with me through this entire article. I enjoyed finding out what would help you and steering you in the right direction. If you enjoyed this article, you might enjoy one of my meal plans – Click here now to read more about Stage 3 or Stage 4 kidney meal plans.