White Bread or Whole Wheat Bread on a Kidney Diet? Which Is Best?

Should I Eat Whole Wheat Bread On A Kidney Diet?

You may have heard not to eat whole wheat bread on a kidney diet, especially on dialysis or as you get closer to stage 5 kidney disease. Many parts of the kidney diet are confusing.  You might have heard how much better it is to get a high fiber diet from all the other sources of nutrition information you have that are not related to kidney diets, but sometimes this is not the best course for your kidney meal plan. You may have started to realize how much “unlearning” you now have to do in your meal planning since you have to avoid certain foods or eat more of others. In addition, these may be foods you once loved. Do you have to give up on wheat bread or not? Read on to learn more about potassium in whole wheat bread and how that affects what you should be eating.

If you want to start with some healthy meals, download our FREE 7 Days Of Easy Dinner Meals and Recipes with grocery lists.

Whole Wheat Bread On A Kidney Diet Is About Potassium and Phosphorus

The issues with bread are related to potassium and phosphorus. As your kidneys begin to decrease in function, their ability to process those two items can wreak havoc if not well controlled. You can usually eat potassium and phosphorus without a problem until your doctor tells you to decrease or limit your intake – if you are not on dialysis. If you are on dialysis, you will be told to limit them to a certain amount related to how your blood work looks.

Foods that are less processed retain much of their potassium and phosphorus naturally. So, the whole grain/ whole wheat bread product has more potassium and phosphorus. It depends on how much you eat and how much potassium and phosphorus your doctor said you should eat in a day. You can eat whole wheat bread without a lot of worries if you manage the rest of your diet without much potassium and phosphorus.  The amount of potassium in bread is listed below and you can see there is a difference in white bread and whole wheat bread.  

Something that people do not think about is how they are already reducing the amount of potassium and phosphorus in their diets when they start to restrict protein and sodium.  Foods that are higher in protein are also higher in potassium and phosphorus, so by eating smaller portions of those foods you are naturally reducing the potassium and phosphorus in the CKD diet.  Do you need to worry about the potassium in whole wheat bread?  Only if your provider told you that it's affecting your kidneys.  

Does It Matter How Much I Eat?

The other thing you should consider is knowing how much of the whole wheat bread on a kidney diet that you will be eating. If you eat ½ of a sandwich (1 slice), you won’t get as much potassium and phosphorus as you would with 2 slices of bread. So you can eat a smaller portion of bread to allow yourself to eat whole wheat. Otherwise, you should realize you will have to change to eating white bread most of the time if you need to manage the potassium and phosphorus in your diet.

One of the tricks that companies do is to make a “wheat” bread which is not whole wheat and not as nutritious.  The wheat bread that is not whole wheat bread is very similar nutritionally to white bread, so if you want to eat bread that is labeled “wheat” and not “whole wheat” you would count it the same as white bread. To be sure it’s not whole wheat, make sure it has less than 1 gm of fiber per slice. Whole wheat bread has 1-2 gm of fiber per slice.

What Are The Specifics For Nutritional Information?

Nutritionally, the breakdown of the slices is as follows –
White Bread (.88 oz/slice)
66 calories, 12.7 gm carbohydrate, 0.6 gm fiber, 1.9 gm protein, 170 mg sodium, 25 mg potassium, 25 mg phosphorus
Whole Wheat Bread (1 ounce/slice)
69 calories, 11.6 gm carbohydrate, 1.9 gm fiber, 3.6 gm protein, 132 mg sodium, 69 mg potassium, 57 mg phosphorus

You can see right away that whole wheat bread has more protein, potassium, and phosphorus per slice, but less sodium and carbohydrate. It’s a tradeoff, and if you are on dialysis, then it’s probably very important to consider. But prior to dialysis if your doctor has not recommended a low potassium or low phosphorus diet, you can continue to eat the whole grain wheat pieces of bread and get more fiber until you are told differently by your doctor.

If you need more information on following a kidney diet, check out our free recipes and meals tailored to your stage of kidney failure that is easy to follow and understand – with nutritional information included and more!  Even if you just need a low potassium diet, you can use these recipes because they are adjusted and tailored to be lower in potassium and phosphorus that people need as they move into Stage 4 CKD and Stage 5 CKD.

Get a free 7 day meal plan (no credit card required): Meal Plans For CKD

Also published on Medium.