Fast Foods and the Dialysis Diet

By DaVita® Dietitian Stacy Coolbaugh, RD, LDN

No matter what kind of diet you’re on, fast food is usually not included on the list of healthy things to eat. But, fast food doesn’t necessarily have to be unhealthy. Many restaurants are adding healthier choices to their menus. For people on dialysis, fat and calories are not the only nutrients that need to be considered when eating out. It is very difficult to know the sodium, potassium and phosphorus content of the foods you select at a restaurant. Careful choices need to be made at any dining out experience. However, with fast food there are usually more limitations due to fewer food choices.

Drive-thru convenience, tasty treats and meals-in-a-minute are sometimes hard to resist. To enjoy fast food and not go over your dialysis diet limits here, are some things to remember when ordering from your car or at the counter.

These tips are recommended for those on in-center hemodialysis. If you are on peritoneal dialysis (PD) or home hemodialysis (HHD), you generally do not need to avoid potassium-containing foods. However, fast foods rich in sodium and phosphorus can be a problem for all dialysis patients. Talk with your renal dietitian to find out what is best for your specific renal diet.

Breakfast choices for the dialysis diet

If you’re feeling rushed one morning and want to grab breakfast on the road, you can make a good breakfast selection at the local hamburger spot. Most hamburger chains offer a morning menu featuring scrambled eggs that can be sandwiched between a croissant, English muffin, bagel or sourdough bread. To limit the potassium, sodium and phosphorus, remember to ask for no cheese, bacon or sausage and avoid the biscuit. Limit your morning meal to only one sandwich and skip the hash browns.

Lunch and dinner choices for the dialysis diet

If you find yourself occasionally craving a fast food hamburger, it’s fine to have one every now and then. Remember to order your hamburger with no salt, pickles or grill seasoning, so you can limit sodium and potassium. Also, cheese is limited for those on the dialysis diet. However, there are several condiments you can add to your renal-friendly hamburger, including: lettuce, onion, one slice of tomato, mayonnaise, mustard and pepper. To stay within the recommended guideline, only have one quarter pound hamburger or order a child size meal.

A fried fish sandwich from a fast food restaurant can be enjoyed by those on dialysis with a few modifications. Request that there is no cheese or pickles on the sandwich. If the fish sandwich comes with tartar sauce, you can substitute the tartar sauce for kidney-friendly mayonnaise instead, or ask for tartar sauce on the side and use only a small amount. Other condiments that are recommended on the renal diet include: lettuce, onion, one slice of tomato, mustard and pepper. One sandwich is the recommended serving.

Variety on the dialysis diet

While hamburgers are usually the first food to come to mind when you think about fast food, there are now many other choices. Roasted and charbroiled chicken offers an alternative to burgers and fish. It is recommended that the portion be limited to one breast or two legs. By removing the skin you may also reduce the amount of sodium you consume. When choosing your side dish, keep in mind the vegetables that are low in potassium such as green beans. You may also want to try a side salad, pasta salad or coleslaw.

Want to spice up your day with Mexican food? You can enjoy a beef or chicken soft taco on a flour tortilla. Remember, corn tortillas are high in phosphorus, so flour tortillas are a better choice for people on the hemodialysis diet. Say no to the cheese or limit the amount, but feel free to add lettuce, onion, cilantro, hot sauce and a small amount of tomato. Two tacos are the recommended portion for lunch or dinner. A beef or chicken gordita is another choice instead of tacos. While traditional gorditas are made with corn, the gorditas at your nearby Taco Bell® are made with a pita-type shell. Avoid the cheese topping, but pile on the lettuce, onion, cilantro, hot sauce and a small amount of tomato. One gordita is the recommended serving size.

Another choice for lunch or dinner is a deli sandwich. Request the six-inch white roll with a meat selection of either roast beef, turkey or chicken breast. Say yes to toppings including: lettuce, onion, green pepper, cucumber, mayonnaise, mustard, oil and vinegar, pepper and one slice of tomato. Pass on the high potassium and high sodium condiments including: cheese, olives, avocados, pickles and salt.

Side dishes and beverages on the dialysis diet

Kidney-friendly side dishes include a small salad with only one tomato, and ask for the dressing on the side. Coleslaw or macaroni salad are additional side order choices that keeps the dialysis diet on track. For a sweeter treat with your fast food, choose an all natural apple or cinnamon twists at places that offer them.

Because fluid control is such an important part of the dialysis diet, it is recommended that you order a child-size beverage. Most fast food restaurants offer a variety of fountain drinks, including those recommended on the renal diet, such as root beer, Sprite®, 7UP® and iced tea.

Phosphate binder reminder

Remember to carry your phosphate binders with you when you go out to eat and remember to take them before, during or immediately after your meal, as prescribed by your doctor. Taking your binder when you eat helps control the amount of phosphorus from food that gets into your bloodstream. Because you can never be completely sure of the amount of phosphorus in the foods when dining out, it is important to also take your binders each time you dine away from home.

Everyone should be able to enjoy fast food on occasion. Using these renal diet tips for eating fast food should help those on dialysis make the healthiest possible choices.

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