The Dietary Guidelines for Americans recommend all people reduce sodium to 2,300 mg or less. For African Americans of any age, people who are 51 and older, or those with hypertension, diabetes, or chronic kidney disease, the sodium recommendation is 1,500 mg or less. Meeting these  low-sodium diet guidelines would be easier to monitor if you bought only fresh, whole foods and prepared them at home. In current times, that just doesn’t seem so doable. Enjoying the convenience of packaged foods and prepared meals as well as the pleasure of eating out at a restaurant mean you really don’t know how much sodium is in the food you consume.

One of the easiest ways to cut down on sodium intake is to pass up using table salt. It may take some getting used to, especially if it’s been a lifelong habit to add salt to foods—sometimes even without tasting first.

Always check the sodium content on food packaging and choose the lowest sodium options. Processed food contributes more sodium to modern-day diets than the salt shaker. Even foods that don’t taste salty can contain a fair amount of sodium. Keep in mind that nutrition labels will show the sodium amount for one serving. If you eat more than one serving, you will need to do the math to figure out how much sodium you’re really eating.

Avoiding foods that are obviously high in sodium, such as canned meats, deli meats, processed cheese, canned soups, chips and other salty foods is another way to pass on salt. Avoiding and limiting salt doesn’t mean you can never have a salty treat. Just make sure your other meals are very low in sodium to make up for a salty “cheat”.

Most of us are unaware of how much sodium we consume, even if doing the things suggested above. You can use the Nutrition Log in DaVita Diet Helper online kidney diet meal planner to track the foods you eat throughout the day. Not only will you know how much sodium you consume,  you’ll also see how much potassium, phosphorus, protein, calories, carbohydrate, fat, cholesterol, and fiber you are eating.

What’s your favorite low-sodium diet tip?

Kidney diet resources from DaVita.com

• Discussion Forums
• myDaVita.com Account and Newsletters
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

I grew up before the plethora of canned and bottled beverage choices. In our household thirsty kids had 3 beverage choices: water, home brewed iced tea or Kool-Aid®. Coca cola®, aka Coke® was an occasional treat. I preferred the orange or punch-flavored Kool-Aid over water or sweet tea.

Fast forward to 2013: water is enhanced with vitamins and minerals, including phosphorus; tea is available pre-made in cans and bottles, some brands with phosphate additives; Kool-Aid powder no longer gets clumpy, thanks to the calcium-phosphate additive. All are red flags for kidney patients who are following a kidney diet and avoiding phosphate additives.

Today I was pleasantly surprised to discover the new Kool-Aid® Liquid Drink Mix does not contain calcium-phosphate additives, plus it’s sugar-free. Each 1.67 ounce container has 24 servings of a liquid Kool-Aid concentrate you squirt into a bottle or glass of chilled water. Approximately 1/2 teaspoon makes an 8-ounce serving of Kool-Aid with zero calories, carbohydrate and phosphorus. Sodium is low at 0 to 10 mg a cup (all flavors are sodium-free except orange). Potassium is not provided but it is in the product since it contains acesulfame potassium (sweetener) and potassium sorbate (preservative).

Read more…

Have you noticed the changes occurring in our foods? I am amazed every time I walk through the grocery store. A few examples are:

Cool Whip® is no longer non-dairy; it now includes skim milk and light cream.

Cottage cheese, half and half and milk with expiration dates 1-2 months ahead.

Sugar and low calorie sweeteners are blended together.

Packaged gelatin and pudding mix and some canned or bottled sodas, lemonade and teas now contain phosphate additives.

Fresh pork and chicken may be injected with sodium-phosphate solution to maintain the fresh appearance while waiting for purchase.

Heat and eat foods extend beyond the grocery store deli section, and unfortunately, often provide half or more of the daily sodium target .

Can you think of other examples?  Read more…

Americans love celebrations and holidays! While many may think Cinco de Mayo was borrowed from our Mexican neighbors, there’s actually more to the story. May 5th is observed to commemorate the Mexican army’s surprise victory over the French Army at the Battle of Puebla on May 5, 1862, but is not a national holiday in Mexico. Celebrations in the United States were actually started during the American Civil War by Mexicans and Latinos living in California. They are credited with being the first to celebrate Cinco de Mayo in the United States.

No doubt, if you have Mexican heritage or live in an area with significant Latino population you may be attending or even planning a Cinco de Mayo celebration this weekend. Even if you have no connections to Latino communities, why not celebrate anyway? No worries about sticking to your kidney diet or dialysis eating plan, because we’ve compiled a list of DaVita’s Mexican-influenced kidney-friendly recipes. Excelente!

• A-maze-ing Bean Dip
• Arroz Con Leche (Rice with Milk)
• Authentic Steak Tacos
• Beef Chipotle Burritos
• Chicken Fajitas with Pineapple Salsa
• Chile Colorado
• Chile Colorado Sauce (Basic Red Chili Sauce)
• Corn Tortillas
• Easy Chicken Enchiladas
• Easy Chorizo
• Enchilada Sauce
• Fantastic Pork Fajitas
• Fiesta Roll-Ups
• Fiesta Tilapia Ceviche
• Flour Tortillas
• Grilled Mexican Swordfish Fillets
• Huevos Rancheros
• Mexican Chorizo Sausage
• Mexican Coleslaw
• Mexican Rice
• Mexican Seasoning
• No Tomato Salsa
• Shrimp Quesadilla
• Soft Tacos with Mexican Seasoning
• South of the Border Meatballs
• Sweet and Spicy Tortilla Chips
• Taco Pasta Salad
• Terrific Tacos
• Tortilla Rollups

 A few words of caution. If you are limiting potassium, be aware guacamole is very high with approximately 180 mg for 2 tablespoons. Whole or refried pinto beans contain 370-470 mg potassium and 110-150 mg phosphorus for a 1/2 cup portion, so keep your portions very small. Other foods to limit include tomato salsa, chile sauce, cheese and too many tortilla chips.

For more Mexican food dining ideas read Kidney Friendly Foods from the Southwest and Lunches On-the-Go for the Dialysis Diet.

Kidney diet resources from DaVita.com

• Discussion Forums
• myDaVita.com Account and Newsletters
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Today is Earth Day, an extra special reason to plan a  Meatless Monday meal.  

Eating meatless for one day has a positive impact on your health by lowering your risk of cancer, heart disease, diabetes and obesity. If you already have one or more of these diagnosis, a meatless day can potentially benefit you by decreasing saturated fat and calorie intake. This is a healthy step for people with chronic kidney disease (CKD) or those at risk for CKD, because heart disease and diabetes are risk factors for kidney disease. Another plus for going meatless at least one day a week—less meat consumption is friendly to the environment. The more livestock we raise for meat sources, the more we use natural resources and produce waste that adds to land pollution.

If you are following a kidney diet, you may be limiting protein if you are in stages 3-5, non-dialysis. Many people with CKD find incorporation of meatless meals helps them stick to a lower protein diet.

 If you are following a dialysis diet, you may be eating more meat or high protein foods as your protein needs must replace protein lost in dialysis treatments and provide extra for your body. You can still participate in Meatless Mondays by choosing a non-meat entrée that  provides a healthy serving of high quality protein, or add a high protein shake or protein supplement to your meal.

Celebrate Earth Day and Meatless Monday by considering one of these kidney-friendly vegetarian recipes today or any day.

Armando’s Chiles Rellenos

Asparagus Cauliflower Tortilla

Confetti Omelet

Couscous with Vegetables

Crunchy Tofu Stir Fry

Eggplant Casserole

High Protein Berry Shake

Omelet with Summer Vegetables

Quick Pasta Primavera

Tempeh Pita Sandwiches

Kidney diet resources from DaVita.com

• Discussion Forums
• myDaVita.com Account and Newsletters
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

World Kidney Day is a time to recognize the extent of kidney disease throughout the world, learn about risk factors and screening for kidney disease and educate ourselves on kidney disease management. Kidney disease is the 8th leading cause of death and over 26 million Americans, or 1 in 10 people over age 20,  have  kidney disease. Many do not even know they are at risk. Some of the questions to ask yourself to measure your risk include:

• Do I have high blood pressure?
• Do I have diabetes or am I at risk for developing diabetes?
• Is there a history of cardiovascular disease in my family or have I been diagnosed with cardiovascular disease?
• Does anyone in my family have kidney disease?
• Do I have a history of kidney damage (kidney infections, kidney stones, past kidney trauma or injury,etc.)
• Am I in a minority group that is at higher risk for kidney disease? (African American, Asian American, Hispanic Americans, Pacific Islanders and Native Americans)
• Am I over the age of 55?
• Do I already have a diagnosis of chronic kidney disease?

If you answered yes to the above questions you are at risk for kidney disease. Early screening and treatment can alert you so you can educate yourself and take action to preserve your kidneys.

Go to DaVita.com to take the risk quiz and learn more about kidney disease. For kidney  screenings, you can contact The Kidney TRUST™,  an organization aimed at increasing awareness of kidney disease through public education and testing programs.

Kidney diet resources from DaVita.com

• Discussion Forums
• myDaVita.com Account and Newsletters
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

 Happy Registered Dietitian Day to all you dietitians reading the Kidney Diet Tips blog! Registered dietitians around the nation are honored today as they are recognized for their service to improve nutrition and quality of life in their patients and communities.

According to the   Academy of Nutrition and Dietetics  (formerly the American Dietetic Association) Registered Dietitian Day was created to increase the awareness of registered dietitians as the indispensable providers of food and nutrition services and to recognize RDs for their commitment to helping people enjoy healthy lives.

The DaVita Dietitian Team is made of over 1600 dietitians who educate and assess DaVita patients, review new lab results and counsel on diet, nutrition and medications, help develop and initiate a plan of care for each patient to reach optimal nutrition goals, and develop relationships with their patients and their caregivers. They also support each other and work as a team to create education materials,  develop kidney diet tools and resources, and  plan and carry out initiatives to help improve their patient’s outcomes.

For the second year Davita Dietitians are taking their expertise out to local communities during March, which is also National Nutrition Month. they have created presentations and activites and are going to schools, grocery stores, community centers and multiple events to promote healthy eating and lifestyle changes that improve health in their communities.

Did you know these facts about dietitians?

• Registered Dietitians are the food and nutrition experts who can translate the science of nutrition into practical solutions for healthy living.
• Registered Dietitians have degrees in nutrition, dietetics, public health or a related field from well-respected, accredited colleges and universities, completed an internship and passed an examination.
• Registered Dietitians use their nutrition expertise to help individuals make unique, positive lifestyle changes.
• Registered Dietitians work throughout the community in hospitals, schools, public health clinics, nursing homes, fitness centers, food management, food industry, universities, research and private practice.
• Registered Dietitians are advocates for advancing the nutritional status of Americans and people around the world.

Take a minute to recognize your own dietitian today. If you do not have a dietitian, go to www.eatright.org and click on “Find a Registered Dietitian” to search for a dietitian in your area. Dietitians who specialize in diabetes and kidney management are noted in the search information.

Kidney diet resources from DaVita.com

• Discussion Forums
• myDaVita.com Account and Newsletters
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

DaVita Dietitian Julia from Ohio is today’s guest blogger with some great kidney diet tips about phosphorus.

Phosphorus by the Numbers

• 250 mg to 1,000 mg of phosphorus is the amount removed in a dialysis treatment
• 800 mg to 1000 mg of phosphorus per day is the typical daily target for a low phosphorus kidneydiet
• 85% of fast food entrees and side dishes contain phosphate additives
• 28% to 100% – a recent review of frozen chicken products revealed that the frozen chicken contained 28% to 100% more phosphorus than unenhanced fresh or frozen chicken.
• 40% to 60% of the phosphorus that NATURALLY occurs in foods is absorbed into the bloodstream.
• 90% to 100% of the phosphorus that is ADDED to foods, as a food additive, is absorbed into the bloodstream.
• 100% of dialysis patients will benefit from avoiding foods with phosphate additives!

Just knowing that because your kidneys cannot remove phosphorus you need to avoid phosphate additives is the first step.  Knowing where these additives are found and how to avoid them is the all important next step.  Think of this article as your G.P.S. for phosphorus additives (G.P.S. – “great phosphorus saver”). Read more…

You may have heard or read a recent news report on the benefit of being overweight or obese.

The January 2013 issue of the Journal of the American Medical Association published findings from an analysis of data from 97 research studies to determine risk of death based on body mass index (BMI). Surprisingly, the results show that people who are overweight (BMI 25-<30 kg/m2) and mildly obese (Grade 1 obesity, BMI 30-<35 kg/m2) had a lower risk of death compared to people with normal BMI (18.5-<25 kg/m2). This finding exists in people with heart attacks, strokes and heart failure.

The obesity paradox is not new to the kidney care community. In 2003 Dr. Kamyar Kalantar-Zadeh proposed the term reverse epidemiology to describe a protective survival benefit observed in hemodialysis and heart failure patients who were overweight and mildly obese. Higher cholesterol levels were also associated with reverse epidemiology.

So does this mean your weight does not matter when you have kidney or heart disease? Here’s some food for thought before you abandon your current eating plan. Read more…

Food lists can make deciding what to buy for your kidney diet easier, but can also be a source or confusion. Squash is one example, since it appears on both low and high potassium food lists. Today’s post gives you some squash facts to help select the best choices for your kidney diet.

Squash varieties fall into 3 major categories—Asian squash, summer squash and winter squash. Read more…