Recipe Adjustments for Low- and High-Protein Kidney Diets

Kidney diets vary in protein content depending on your stage of chronic kidney disease (CKD) or if you’re on dialysis (it also depends on the dialysis type). You may come across a recipe that is either too high or too low in protein for your individualized diet, yet wonder how to include it. DaVita^® dietitians have put together some tips to help you adjust kidney-friendly recipes to your protein requirements.

How to adjust portions

Changing portion size is the easiest recipe adjustment to make. If you have a meal plan, use the guide for protein or meat allowance to determine your total for the day. Many meal plans are flexible, allowing you to decide how to divide this daily goal. For example, instead of 2 ounces of protein or meat at lunch and 2 ounces at dinner, you could have 1-ounce at lunch and 3 ounces at dinner.

For instance, the Citrus Salmon recipe on DaVita.com suggests a 3-ounce portion that provides 23 grams of protein. You can decrease the portion to 1-1/2 to 2 ounces for less protein, or increase it to 4 to 6 ounces for more protein. Also be aware that these changes will decrease or increase the amount of potassium and phosphorus in the recipe.

Once you get the hang of it you will find many recipes that can be adjusted to fit your high- or low-protein diet. Consult your dietitian if you do not already have a meal plan.

How to adjust ingredients

Ingredient changes are another way to adjust protein in a recipe. First, identify the protein-containing ingredients. Obvious sources include meat, poultry, fish, eggs, cheeses, milk, tofu and meat analogs. Protein sources that are not as obvious include broth, egg or milk added as a “hidden” ingredient. Egg noodles or pasta, cereals, grains, bread or crackers, beans and vegetables also add protein to a recipe. Once you identify the protein ingredients, make adjustments in the amount or replace with a lower or higher protein ingredient.

For example, Slow Cooker Creamy Chicken recipe ingredients include:

• 1-1/2 pounds of boneless chicken thighs
• 1 onion
• 2 cups carrots
• 1 cup green peas
• 4 celery stalks
• One 14-ounce can of low-sodium chicken broth
• 1/2 cup cream cheese

The recipe makes six portions, each with 28 grams of protein. You could decrease the chicken to 1-pound instead of 1-1/2 pounds, replace half the broth with water or fruit juice, and replace the cream cheese with sour cream. These changes will decrease the protein down to 17 grams per serving. Replacing the green peas (8 grams of protein) with green beans (2 grams of protein) or decreasing the amounts of other vegetables would also give you a little less protein. For more protein, increasing the chicken thighs to 2 pounds and using 2 cups of green peas would give you 37 grams of protein for each portion. It would also increase the potassium and phosphorus content of the recipe.

When adjusting ingredients, remember a few rules of the kitchen:

• Alter the recipe seasonings so that the flavors are not too strong or weak.
• When reducing the amount of cheese, use sharp or extra sharp cheese for more intense flavor.
• If replacing part of the broth in a recipe, add an equal amount of water. Boost flavor with additional herbs and spices, a dash of reduced-sodium Worcestershire sauce or balsamic vinegar.
• Replace milk or yogurt with lower protein nondairy substitutes such as rice milk or sour cream. For more protein, use a milk substitute with higher protein content, such as soy milk, and replace sour cream with Greek yogurt.
• Some ingredient adjustments, particularly for baked goods, will change the way your recipe turns out. Bread, cakes, cookies, muffins and items such as cooked puddings, may require some reworking to get the recipe right.
• When decreasing meat or whole eggs in a recipe, add extra, healthy fats (olive oil or canola oil) to replace calories and add flavor.
• Smaller portions of protein may call for adding extra starches or fruits in addition to added fats for adequate calories.
• Larger portions of protein may call for limiting fats and portion size if weight gain and cholesterol are a concern.

The next time you find a recipe outside your protein target, reconsider skipping it. Use these adjustment guidelines and kitchen tips to make many recipes fit your individual kidney diet. Sign up for myDaVita.com for an easy way to save recipes that match your protein needs.