I’ve discovered  a new line of spice blends and vinegars created with the kidney diet in mind. Jen Neese, CEO and Founder of The Delicious Dietitian, once worked as a dietitian in the renal community, plus her grandmother was a hemodialysis patient. Jen took her passion for flavor and her compassion for kidney patients and  created a line of kidney-friendly spice blends and wine vinegars. Each unique blend is intense in flavor, adding depth to vegetables, meats, salads, dressings, sauces and just about any other dish you want to try.

• Seafood: a blend with lemon zest, sweet paprika, onion and ginger
• Creole: Rich, warm Lousiana Bayou cooking flavors, including garlic, onion and thyme
• Italian Mediterranean: a hearty balanced blend of basil, oregano and thyme
• Southern All Purpose: a hint of French flavors with lavender
• Southwest: savory south of the border taste
• Thai: exotic Asian curry, ginger, garlic with additional herbs to balance the flavors

I tried the Southern All Purpose blend on sliced eggplant,  sauteed in olive oil until tender–excellent and tasty, no salt needed. If you have low potassium greens, like kale or turnip greens, add a splash of one of the fruit wine vinegars and a sprinkle of the Thai blend. For blackened fish or chicken, try the Creole. One word of caution–go light on the seasonings because a little bit goes a long way with these intense flavors!

The wine vinegars are produced from apple, muscadine and blueberry, giving a fruity mild flavor that lingers on the taste buds. I mixed the red muscadine wine vinegar with  extra virgin olive oil and the Italian Mediterraneon blend and served over spring mixed greens.

Jen is aware of the importance of regulating sodium, potassium and phosphorus in the kidney diet. Her products are not only free of sodium. There’s no potassium chloride or phosphate additives either. In addition, this dietitian made sure many people dealing with health issues could benefit from her product line. There’s no sugar, gluten, MSG or fillers added to any of the spice blends or vinegars.

If you are interested in trying these flavor enhancing products, visit The Delicious Dietitian website or download the TDD Flyer.

What are your favoite ways to use seasoning blends and vinegars?

 Kidney diet resources from DaVita.com

• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Unfamiliar with some of these greens? Go to Cooks Thesaurus foodsubs.com,  to see pictures.

Salad greens are naturally low in sodium, but the wrong dressing can really boost the sodium content. When selecting a salad dressing buy low sodium commercially prepared dressing. Better yet, homemade salad dressings are easy to make,  inexpensive and contain no additives. Try one of these DaVita.com salad dressing recipes:

Basic Salad Dressing

Cranberry Dijon Vinaigrette

Creamy Vinaigrette

Italian Dressing

Oil and Vinegar Salad Dressing

Tarragon Vinaigrette

 Kidney diet resources from DaVita.com

• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Kale belongs to the Brassica family and is a cruciferous vegetable like broccoli, Brussels sprouts, cabbage and collards. This group of green vegetables is low in potassium compared to spinach, beet greens and chard. One-half cup of cooked or raw kale contains 150 mg potassium, 18 mg phosphorus, 15 mg sodium, 1.2 g protein, 1.3 grams of fiber and 18 calories. Kale is an excellent source of beta-carotene and vitamin C.

Try one or more of these serving suggestions for kale:

• Steam or boil kale and serve with a sprinkle of red wine vinegar
• Sauté in olive oil and garlic
• Slice thin with stems removed and toss with vinaigrette dressing
• Coat with oil and pepper then bake for 15 minutes at 425°F to make kale chips
• Sauté shredded kale and add to pasta
• Replace spinach with kale in your favorite recipes

One word of caution if you take a blood thinner medication. Kale is very high in vitamin K and should be avoided.

Kidney diet resources from DaVita.com

• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

For those of you following the kidney diet I have a few tips to help you stick with a kidney-friendly diet and still join in St. Patty Day celebrations.

• Go for a hearty beef stew, roast lamb, salmon or Shepherd’s pie and steer clear of the corned beef, which has over 900 mg sodium for a 3 ounce serving. You can also cook a fresh brisket without the curing seasonings.
• If you plan a traditional Irish potato dish like Potatoes O ‘Brien,  Colcannon (a cabbage and potato dish), or plain old Mash (mashed potatoes),  you can reduce potassium in the potatoes by double boiling or soaking the potatoes, and limit to one serving.
• Save your vegetable choices for the day for your celebration meal and watch portions to avoid potassium overload.
• If you include beer, make it a root beer or a lower phosphorus  light beer (with green dye, of course).  Some of the best kidney-friendly choices are Bud Light® or Michelob Ultra Light®. Most other beers, including traditional Irish beers (even O ‘Doul’s®) contain almost 100 mg potassium and 140 mg phosphorus for 12 ounces. Always check with your doctor before including alcohol in your diet, and be aware of your fluid intake if you are on a fluid restriction.
• Look for kidney-friendly recipes on DaVita.com to help keep sodium, potassium and phosphorus in check.

St. Patrick’s Day Celebration

Choose a main dish from these kidney-friendly recipes on DaVita.com

Barley and Beef Stew

Easy Shepherd’s Pie

Honey Spice Rubbed Salmon

Roast Lamb

Choose a side dish

Boiled Cabbage

Country Soda Biscuits

St. Patrick’s Crinkle-cut Carrots and Green Peas

It’s-Better-Than-Potato Salad

Zesty Cucumber Salad

Choose a Dessert

Apple Cake

Lemon Pound Cake

Lively Lemon Tart

Sour Cream Apple Bread

Choose a beverage

Irish Coffee (6 ounces brewed Coffee, 1.5 oz Irish whiskey, whipped cream)

Irish cream (6 ounces brewed coffee and Irish cream flavored coffee nondairy creamer)

Minted Lemonade

An Irish Blessing for you

May the raindrops fall lightly on your brow.
May the soft winds freshen your spirit.
May the sunshine brighten your heart
May the burdens of the day rest lightly upon you.
And may God enfold you in the mantle of His love.

And an Irish Toast

May the sound of happy music, and the lilt of Irish laughter, fill your heart with gladness, that stays forever after.

An Irish Quotation

“St. Patrick’s Day is an enchanted time — a day to begin transforming winter’s dreams into summer’s magic.”~~By Adrienne Cook.~~

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Daily health tips will be shared with patients and co-workers at dialysis centers each day during March.  DaVita dietitians will provide interactive activities to their co-workers, such as the game “The Biggest Loser (of Poor Food Choices)” which includes fun activities to learn about portions “Don’t Super-size Me” and “The Size is Right”. An activity “Produce More with Produce” will provide a fun way to increase knowledge of the benefits of eating more fresh produce, and creative ways to plan more produce into work lunches and snacks.

For community projects, DaVita dietitians will participate in health fairs, community events, kidney awareness programs and attend local schools with activities such as “Fear Factor: Trying New Foods”, “Healthy Eating on a Budget”, “Get Your Plate in Shape”, “Food Demonstrations” and “Get in Shape Relay”.  Stepping out into the community to reach children, teenagers, adults and seniors provides an opportunity to promote good nutrition and preventative measures that hopefully, will have an impact on risk for chronic diseases such as kidney disease and diabetes.

In addition, Creating a Wave of Healthy Changes, provides DaVita dietitians an opportunity to align with DaVita’s strong vision for social responsibility, which is referred to as the Trilogy of Care. This vision encompasses caring for their dialysis patients, caring for each other, and caring for the community and the world.

Thanks, DaVita Dietitians!

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

I started with a couscous recipe I love from allrecipes.com. Here’s the original (and to give credit, it was created by Levedi, a cook who has shared several recipes.)

Directions

1. Place the couscous and cranberries in a heatproof bowl. Pour in the boiling water, and stir with a fork. Cover the bowl with plastic wrap, and set aside 5 to 10 minutes.
2. Fluff the couscous with a fork, and fold in the cucumber and feta cheese. Season to taste with balsamic vinaigrette and salt.

Makes 2 servings.

Nutrients (my calculations–used 1/4 tsp salt for the recipe)

243 calories, 6 g protein, 40 g carbohydrate, 6 g fat, 13 mg cholesterol, 455 mg sodium, 175 mg potassium, 116 mg phosphorus, 91 mg calcium, 2.9 g fiber.

The feta cheese, salad dressing and salt to taste–all full of flavor and sodium, were my challenges. Additional challenges–the mushy cuccumber I had planned to use, and an almost empty bag of dried cranberries, plus keep it kidney-friendly with low potassium and low phosphorus ingredients. Needless to say, my creation was a bit different from the original recipe, but ended as a pleasant culinary surprise.

Here’s my low-sodium rally recipe:

Couscous, Apple and Carmelized Onion Salad 

 Ingredients

• 2 cups thinly sliced white onion (Maui or other sweet onion variety)
• 1 tablespoon balsamic vinegar glaze
• 2 teaspoons honey
• 1 small apple, cut, cored and thinly sliced (leave the skin on)
• 1/3 cup water
• 1 tablespoon unsalted sweet butter
• 1/3 cup couscous
• 1 teaspoon cinnamon

Directions

1. Spray a nonstick skillet with cooking spray and cook onions over medium heat, stirring often. When the onions are translucent and soft, cover with a lid and continue to cook until carmelized, about 15 minutes. Stir about every 3-4 minutes and adjust heat if needed.
2. In a separate nonstick skillet sprayed with cooking spray, cook apple slices over medium heat until tender. Reduce heat to medium low and cover with a lid. Continue cooking until soft and slightly browned, about 10 minutes.
3. Add balsamic glaze and honey to caramelized onions and stir.
4. Boil the water, add butter and stir until melted. Pour over couscous in a bowl. Cover and let set for 5-10 minutes.
5. Sprinkle cinnamon over couscous and stir with a fork to mix.
6. Add onions and stir until well mixed; add apples, toss and serve.

Tip: Serve hot or cold–it’s great both ways!    

Makes 2 servings

Nutrients:

230 calories, 4 g protein, 37 g carbohydrate, 6 g fat, 15 mg cholesterol, 7 mg sodium, 155 mg potassium, 66 mg phosphorus, 32 mg calcium, 3.4 g fiber.

I loved participating in this challenge. Sodium Girl has not only proven you can live with and enjoy a low sodium, salt-free diet, she has also prompted a whole group to create and prove there is flavor without salt. Thank you Sodium Girl!

What’s next? March is National Nutrition Month. Find out what the DaVita Dietitians are doing to celebrate!

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Food Labels

The most obvious nutrient source is the food label, available on all packaged foods. Many grocery stores provide nutrient information for fresh produce, and soon fresh meat will require a nutrition label. The drawback is that potassium and phosphorus are optional on food labels and these are among the most important ones you need to know if you have chronic kidney disease or if you are on dialysis.

Food Composition Books

Any bookstore has a variety of food composition books that list nutrients in foods. Your dietitian most likely has a copy of “Bowes and Church’s Food Values of Portions Commonly Used”, a comprehensive nutrition data book with thousands of foods, now in its 18^th edition.

Other food composition books vary in the nutrients included. A few on my shelf include “The Complete Book of Food Counts and Vitamin and Mineral Counter”, both by Corrine Netzer, and “The Calorie King Calorie, Carbohydrate and Fat Counter” from dietitian Alan Borushek. If you still prefer a book over an electronic reader or computer, these resource books are a good investment. Some are available to download an electronic version. An extensive list of food composition resources is available from the USDA National Agriculture Library.

On a smaller scale, you can order a pocket guide from the American Association of Kidney Patient. It gives potassium, phosphorus, sodium and protein values for many commonly eaten foods.

Nutrition Databases

As a USA taxpayer, you have invested in a nutrient database that is available to anyone without charge. You can download the USDA nutrient database directly to your computer desktop and easily look up foods. Almost all the foods in this database contain potassium and phosphorus values, and it is updated once a year. One drawback is you won’t find  brand name and restaurant foods, but many generic descriptions can be found. I keep the most recent version right on my computer desktop so it is easy to access and use.

Another quick look-up tool is the Food Analyzer on DaVita.com. Keep this tool in your favorites to easily look up thousands of food. This special database has a filter to only include items with potassium and phosphorus, a feature missing from many online food analysis tools.

Looking for more? DaVita Diet Helper is a no-charge online meal planner with already planned menus, a Food Analyzer and Nutrition Log. You can  track the foods you eat and instantly see nutrient totals, including calories, protein, carbohydrate, sugars, fat, saturated fat, cholesterol, fiber, sodium, potassium, phosphorus and calcium. Your data is saved and automatically broken down into meals, snacks and daily total. There are other online meal planners, but Diet Helper has two features that are missing from other planners. It is based on protein, potassium, sodium and phosphorus instead of calories to provide customized meals for kidney diets; plus all the foods in the database contain values for all the above nutrients, unlike some programs that do not include potassium and phosphorus for all foods.

Nutrition Software Programs  

You can purchase nutrient software programs that have additional features like diet and exercise analysis, scoring systems, weight trackers, menu planners, and recipe features. These programs usually include the USDA database as well as generic, brand name and restaurant foods. There are many simple, easy to use programs, such as Dine Healthy, or a number of other software programs at the Nutrition and Food Web Archive. You can get more bells and whistles from larger programs like The Food Processor  or Compu Food Analysis. A Google search will reveal many options and information on nutrition software programs.

There’s an App for That

In addition to the above resources you can find many apps for your smartphone or other devices. These apps make it much easier to track your food intake throughout the day and to have real-time data to help make decisions about what to eat on your kidney diet. Kidney Diet offers an app secifically for people following a kidney diet with a focus on protein, potassium and phosphorus.  

Regardless of the source you use to find out the nutrients in your food, learning and sticking to a kidney diet is easier when you have tools and resources to help you choose the best foods for your health.

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Kidney diets always include chocolate on the limit or avoid list because the potassium and phosphorus in chocolate can add up quickly. If you decide to keep your chocolates, be aware of how much each piece contributes to your daily potassium and phosphorus intake.

Consider these tips:

• Limit chocolate candy to a 1/2 to 1 ounce serving in a day. If you’re too tempted to eat more, it’s probably better to re-gift the chocolates.
• Select dark chocolate-it has more heart protecting flavonoids, and the phosphorus is lower compared to milk chocolate.
• Give the chocolate covered nuts and chocolate covered dried fruit away—too much phosphorus and potassium in a small serving and it’s tempting to eat more!
• Plan a dessert with a small portion of chocolate chips or chocolate dessert topping instead of chocolate candy, cake or pie.
• Chocolate covered candies are lower in potassium and phosphorus than solid chocolates. Compare your favorite chocolates on the chart below.

Berries and cherries are also popular desserts for Valentine’s Day. Find your favorites in the DaVita Valentine’s Day recipe collection.

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

Low dietary fiber intake is a chronic problem in most Westernized diets. Our love of refined grain products, juices instead of fresh fruit, processed and fast foods, sweets and salty snacks, limited vegetable intake and narrow use of whole grains, beans, nuts and seeds has resulted in a fiber intake around 10 to 14 grams of fiber a day. In comparison, the Institute of Medicine recommends 14 grams for each 1000 calories, which is around 25 grams for females, 38 grams for males and 19 to 25 grams for children each day.

The  Renal and Urology News article cited a recent analysis published in Kidney International that looked at fiber and inflammation data from over 14,000 participants from the third National Health and Nutrition Examination Survey (NHANES). C-reactive Protein (CRP), a marker that indicates a person’s degree of system-wide inflammation, was compared to dietary fiber intake from a 24-hour diet recall. In patients with chronic kidney disease and glomerular filtration rate (GFR) below 60, for each 10 grams of increased fiber intake there was a 38% decreased chance of having elevated CRP (above 3 mg/L). In other words, higher fiber intake is associated with lower inflammation. In non-CKD participants there was an 11% decrease chance of having elevated CRP. The CKD group also had lower mortality with higher fiber intake.

Some reasons suspected that higher fiber intake may reduce CRP and inflammation are:

• Fiber may lower the glycemic load of carbohydrates that are digested and absorbed rapidly.
• Adiponectin, a hormone made in fat cells, helps regulate glucose and fat metabolism, and has anti-inflammatory properties. A high fiber intake has been linked to higher levels of this hormone in the blood.
• Bacteria in the gut produce toxins such as phenols, indoles, and amines that can contribute to inflammation. People with kidney disease have higher levels of these toxins because the kidney is no longer excreting them. A high fiber diet may decrease the amount of these toxins produced and absorbed into the bloodstream.
• Fruit and vegetable provide a source of alkali and may help decrease a condition called acidosis, often seen in dialysis and CKD patients.

Despite following a kidney diet, you can still find ways to increase fiber in your diet. Be sure you eat the suggested number of fruit and vegetables recommended in your meal plan. Include an apple with the peeling. Look for a breakfast cereal that contains at least 4 grams of fiber. Snack on unsalted popcorn. Try high-fiber white bread. Ask your dietitian for suggestions on ways you can increase fiber intake.

For more information on fiber and inflammation, you might be interested in the article Fiber in the Kidney Diet and Inflammation and Chronic Kidney Disease from DaVita.com.

Try some of my favorite higher fiber, kidney-friendly recipes:

Apples Baked in Cider

Apple Cranberry Slaw with Celery Seed Dressing

Artichoke Relish on Toasted Pita

Carrot and Jicama Salad

Ratatouille

Strawberry Spinach Salad

Sugar and Spice Popcorn

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks

The Joslin study researchers identified two protein receptors, Tumor Necrosis Factor Receptor 1 and 2 (TNFR1 and TNFR2) that are elevated in people with Type 1 and Type 2 diabetes. The presence of these markers in the bloodstream can predict your risk of kidney function loss as much as 10 years in advance. That’s huge considering many people are unaware they have kidney problems until they are in the later stages of chronic kidney disease. There are no other tests like this available today, but in the future TNFR may become a routine part of your diabetes care. Currently,  doctors use hemoglobin A1C, blood pressure, GFR and the presence of protein in the urine (proteinuria) to screen people with diabetes for decline in kidney function. The researchers indicate a diagnostic test to measure TNFRs in blood will be developed soon and available for patients.

 What this means from the kidney diet standpoint is early detection gives you a chance to make diet and lifestyle changes earlier. Our health-related behaviors and actions are more likely to change when we know personal risk is greater. You can protect your kidneys and preserve kidney function.  The diet goals for kidney disease differ with each stage. To learn more check out these articles on diet and stages of CKD.

What to eat when you have stage 1 or 2 chronic kidney disease

Diet and nutrition goals for people with stage 3 chronic kidney disease

Finding the right diet and nutrition solutions that work with your individual needs is important. In early CKD you can slow the progression and protect your kidneys by blood pressure control, blood glucose control and eating the healthiest way for the stage of CKD you are experiencing. Ask your doctor for a referral to a renal dietitian for additional help with your kidney diet.

Kidney diet resources from DaVita.com

• Review and rate recipes
• Discussion Forums
• Monthly Recipe Alerts
• DaVita Diet Helper
• Phosphorus Challenge^TM
• Food Analyzer
• DaVita Cookbooks