Low Cholesterol, Diabetic, And Pre-Dialysis Diet

If you’ve been recommended a pre-dialysis diet that is also low cholesterol and diabetic, it’s easy to get overwhelmed, throw your hands into the air and say, “How do I do that? I’m not a dietitian!”

You can learn the guidelines here on how to get started.

Pre-Dialysis Diet:  Low Protein and Low Sodium

A pre-dialysis diet is one that saves your kidneys from working at filtering the wastes from the body. It can help preserve the kidney function you still have while reducing symptoms such as itching, nausea and fatigue. A pre-dialysis diet is low in protein and low in sodium.

How much protein should you eat? Generally, about 0.6 to 0.75 grams protein/kilogram of body weight.  This is equivalent to 27 to 34 grams protein for every 100 pounds body weight, or 0.27 to 0.34 grams protein for every pound you weigh. Thus, if you’re 145 pounds, your protein needs for the day would be 0.27 x 145 = 39 grams as the minimal amount, and 0.34 x 145 = 49 grams as the maximum.

The 49 grams protein can be further divided into ounces, which is easier to plan your meals. Forty-nine grams protein would next be divided by 7 grams protein in one exchange to give you a total of 7 ounces protein for the day. An exchange is equal to 1 oz protein from beef, lamb, duck, chicken, turkey, pork and wild meats, 1 large egg, and 4 oz milk or yogurt.

Since you most likely eat three meals a day, the 7 ounces would have to be divided between all your meals.-Pre-Dialysis Diet

This is quite easy, since there are really many options:
• Breakfast – 1 egg, Lunch – 2 oz chicken, Dinner – 2 oz beef,  Snack- 1 cup milk
• Breakfast – 4 oz milk, Lunch 2 -½ oz pork, Dinner – 2-½ oz lamb, Snack – 3 oz yogurt
• Breakfast – 1 egg and 1 oz chicken, Lunch 2 oz beef, Dinner – 2 oz turkey, Snack – ½ cup milk

Setting up your protein needs first is the easiest way to plan your meals. This takes care of your protein needs but there are other criteria to follow, such as low sodium. By cutting out excess sodium by removing processed meats and canned goods with sodium, and not adding salt to your foods, you will most likely lower your sodium level to about 2000 mg per day.

Diabetic Diet Criteria Added

That takes care of the pre-dialysis diet requirements, but there are more to add in. Let’s determine what to do about the diabetic part of the diet. With diabetes, the protein requirements are a little higher, and a low protein diet is not especially recommended because of the need to fight infections. Also, if the protein levels are low, then the carbohydrate level would be too high, contributing to insulin resistance in those with Type 2 Diabetes.

Adding more protein would not be harmful as long as the kidney damage has not progressed to a high level.

Let’s increase the protein levels to about 1.0 gram/kilogram, which is equivalent to 45 grams protein per 100 pounds body weight. If someone weighs 145-150 pounds, their protein needs would be 67 – 67.5 grams daily, of 9.6 oz protein per day.

• Breakfast – 1 egg, Lunch – 3-½ oz chicken, Dinner – 3 oz beef,  Snack- 1 cup milk
• Breakfast – 8 oz milk, Lunch 3-½ oz pork, Dinner – 3 oz lamb, Snack – 4 oz yogurt
• Breakfast – 1 egg and 1 oz chicken, Lunch 3 oz beef, Dinner – 3 oz turkey, Snack – ¾ cup milk

Next we’ll have to make sure there is plenty of fiber in the Pre-Dialysis Diet, which binds cholesterol. An apple provides 3.7 grams fiber; a pear, 4 grams. One half cup black beans provides 8.5 grams fiber and 20 Brazil nuts, 4.2 grams. A good fiber cereal will have 5.0 grams fiber/serving.

Let’s build the three days of diets:
• Breakfast – 1 egg, ½ cup beans
Lunch – 3-½ oz chicken, ½ cup cabbage, ½ cup brown rice, 1 apple
Dinner – 3 oz beef, 2 cups spinach salad, 1 tomato, ½ cup okra, ½ cup green beans, 1 whole grain bread roll
Snacks- 1 cup milk, 20 Brazil nuts, 1 pear

• Breakfast – 8 oz milk with 1 serving bran cereal
Lunch – 3-½ oz pork, 1 slice whole grain bread, ½ cup yams, 1 cup green beans
Dinner – 3 oz lamb, ½ cup applesauce, 1 teaspoon mint jelly, 2 cups romaine lettuce salad with dandelion greens, cherry tomatoes, and ⅔ cup broccoli
Snacks – 4 oz yogurt, 20 Brazil nuts, 1 pear

• Breakfast – 1 egg and 1 oz chicken, onions, garlic, leeks, 1 slice whole grain toast
Lunch 3 oz beef tacos with lettuce, tomato, avocado, ½ cup black beans
Dinner – 3 oz turkey, 1 small red potato cooked the day before and served cold, ½ cup lentils with tomatoes
Snack – ¾ cup milk, 1 apple, 1 pear, 20 Brazil nuts

For the low cholesterol part of the diet, you’ll trim visible fat from meats, and limit eggs to three times weekly. Avoiding oxidized fats is more important, since research studies have shown that arterial plaque is composed of oxidized fats, which includes hydrogenated fats as well as vegetable oils.

As you can see, it gets pretty complicated, and you may want to use a service to write menu plans for you.

What Should You Limit Overall?-Pre-Dialysis Diet

Eating a healthy diet doesn’t mean it doesn’t have to be tasteless. By limiting carbohydrates from sugars and processed foods, your taste buds will adapt in about a week. As you begin incorporating more unprocessed foods, you’ll feel more energetic and look forward to meals with new flavors. You’ll see that the use of herbs, which is allowed on your diet, makes food taste better than ever.

The examples given here don’t mean to imply that you can only eat those foods. You aren’t limited to apples and pears as the only fruits to eat. All low Glycemic Index foods are allowed on your diet, but sometimes it becomes a choice of what to eat that will provide more fiber. Starchy vegetables such as potatoes, corn, peas, and sweet potatoes are limited, as they often cause a higher Glycemic response than non-starchy vegetables.

You will want to study the Glycemic Index and find out more about what foods cause high blood sugar levels and contribute to high Hemoglobin A1c levels.

Diabetes Control Vs. Renal Control

When you’re on a low cholesterol, diabetic, pre-dialysis diet, every food you eat counts. It counts towards how long you can live a higher quality of life without going on dialysis. You must do everything you possibly can to prevent diabetic complications from progressing.

Diet is a big start but exercise is just as important, and evaluating your lifestyle habits can also prevent kidney disease from progressing. Don’t give up; there’s a lot you can do!