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By DaVita® Dietitian Donna Trigg, RD, and Yolanda Rodriguez, DaVita Dietetic Intern
For many people on dialysis, fatigue and low energy is a common symptom. This sluggishness may be due to many factors, including the foods in a person’s diet. What and when we eat can impact energy balance and performance throughout the day. Other dietary reasons for fatigue can include too much alcohol, a lack of certain vitamins, iron deficiency anemia or inadequate food intake. Certain diseases, medications, stress or inadequate sleep can contribute to fatigue as well. The good news is that people can optimize their body’s potential by consuming a well-balanced kidney diet that boosts energy from sun up to sun down and helps improve quality of life.
Our bodies get energy from the foods we eat and drink. Foods containing carbohydrates, proteins and fats provide calories which are used by our bodies to produce energy. The amount of calories we need depends on our age, size, gender, physical activity level and nutritional status. Thus, eating the right amount of calories spread throughout the day can help people have energy just when they need it. Renal dietitians help dialysis patients determine the amount of calories and protein they need each day to optimize their energy level.
In order to get enough energy from kidney-friendly foods, dialysis patients must include foods rich in carbohydrates, proteins and fats.
Carbohydrates are the body’s preferred energy source. Therefore, the best way to maximize our body’s potential is to eat carbohydrate-rich foods. Complex carbs such as rice, pasta and starchy vegetables are high in carbohydrates and some of these provide fiber. They also provide a steady source of glucose for energy and blood glucose regulation. If a person on dialysis also has diabetes, spreading out carbohydrates throughout the day will help control blood sugar and contribute to feeling energized. The key for optimal energy is having a consistent amount of carbohydrates at each meal. The timing of meals is highly related to a person’s energy levels. Skipping meals or eating meals too far apart may take a toll on energy balance.
But some carbohydrate-rich foods, such as legumes and milk, are high in phosphorus and potassium, so people with kidney disease who need to control those nutrients may need to limit certain foods. Prescribed phosphate binders taken with each meal plus working with a dietitian to learn the best food choices can help balance phosphorus and potassium in a person’s dialysis diet.
Foods rich in protein also help optimize the use of energy in our bodies. Eating the right amount of protein is especially important for patients on dialysis. During the dialysis treatment, some protein is lost; becoming deficient in protein can compromise the immune system so that infections cannot be fought effectively, cause damaged tissues to not heal well and result in hormonal imbalances. Replenishing your protein stores by having the right amount of protein and calories will help you feel your best. The amount of protein a person needs depends on many factors, such as body size, activity, lab values and type of dialysis treatments. Renal dietitians counsel patients on how much protein they need. Good sources of protein are lean meats, including eye of round beef, lean ground beef, pork tenderloin, poultry, fish, eggs and egg substitutes. Since many protein-rich foods are also high in phosphorus, taking phosphate binders before or with your meals will help keep phosphorus in range. Consider adopting the habit of eating two ounces of high protein food or taking a protein supplement that contains approximately 14 grams of protein before and after each dialysis treatment. This will help replace protein lost during treatment.
Fats are a concentrated source of energy, and even though they have a bad reputation, people need fat in their diet to stay healthy and function at an optimal level. In addition to giving us energy, fats keep us warm and help us use certain vitamins. Too much of the wrong fats can lead to weight gain and heart disease. There are two types of fats: saturated and unsaturated. The saturated fats, also known as bad fats, come from animal foods, are solid at room temperature, can raise cholesterol levels and increase risk of heart disease. Some examples include lard, butter, hydrogenated cooking oils and processed meats such as bacon, hot dogs, sausages and pepperoni. Limiting these high fat foods in a kidney diet and choosing more unsaturated fats, also known as good fats, is a healthy way to eat. Unsaturated fats include non-hydrogenated vegetable oils such as canola, olive or corn oil and soft, trans-fat free margarine. Unsaturated fats help reduce cholesterol and provide extra energy, but moderation is the key because too much of the good stuff can lead to unwanted weight gain and other health problems.
If a person with kidney disease feels sluggish despite eating a good balance of calories, carbohydrates, proteins and fats, visiting their doctor is in order to examine symptoms and recommend treatments. Dialysis patients who strive to consume the best balance of foods will feel more energetic from making healthy kidney-friendly food choices throughout the day.
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