Understanding the kidney diet

Initially, making changes in any way whether by cutting back on portions consumed, limiting concentrated sweets, greasy foods, and salty snacks, or complying with the prescribed diet and medications from your medical doctor may be challenging at times .

Amidst of the difficulties one may probably experience, physicians, dietitians/nutritionists, and other public health educators working collaboratively with patients, and community residents can make the difference .

Risk factors Studies show that risk factors such as overweight/obesity, uncontrolled blood pressure, high blood sugar and cholesterol levels, unhealthy diet, tobacco consumption, physical inactivity and alcohol abuse have a negative impact on overall health contributing to the chronic non-communicable diseases .

Just taking a brief look at overweight and obesity, the World Health Organization (2016) documented that in 2014 among adults 18 years and older 1.9 billion were overweight, of which 600 billion were noted to be obese. While within the given period, 41 million children under age five were noted to be overweight or obese .

These people lived in countries where overweight and obesity may probably tend to greatly affect health much more than underweight .

Overweight and obesity can result due to overconsumption of calories from energy-dense foods rich in fat and sugar, and sugary beverages, along with too little energy expenditure (physical inactivity). This simply means that when people eat a poor diet over period of time, and also do not engage regularly in physical activity such as walking, running, aerobics, gardening, volleyball, football and so on, it becomes easy to add pounds to your body weight .

You should also note that obesity is a major health problem contributing to other chronic diseases and conditions, which include but may not be limited to hypertension, stroke, heart disease and diabetes mellitus, just to list a few. Research shows that the associated complications of high blood pressure and uncontrolled blood glucose (blood sugar) levels are potential risk factors for kidney disease. Hence, engaging regularly in physical activity to manage your body weight, and making wise food choices can more than likely help you to lower your risk for disease. Note: prior to participating in physical activity, first check with your medical doctor .

Evaluating body weight The body mass index (BMI) is used for the classification of body weight (underweight, healthy weight, overweight and obesity in adults and children; it is calculated by dividing weight in kilograms by height in centimetres square. For example, the adult classification – overweight is classified by BMI ≥ 25 kg/m2, obesity the BMI ≥ 30 kg/m2, healthy weight 18.5 – 24.9 kg/m2, underweight ≤ 18.5 kg/m2 .

Children BMI classification: underweight ≤ 5th percentile, healthy weight fifth to the 85th percentile, overweight 85th to the 95th percentile, and obesity ≥ 95th percentile (U.S. Department of Health and Human Services, 2010) .

Nutrition management Being able to manage and comply with your prescribed diet is a plus for some individuals. In the case of the kidney patient or those who are at potential risk for kidney disease, “good nutrition will aid in providing energy to perform daily tasks, maintain healthy weight, prevent infection and loss of muscle mass, and slowing the progression of kidney disease (National Kidney Foundation).” The aim here is to ensure that you understand which foods to choose based on the nutrient content, plan balanced meals, select healthy snacks, and how to manage any complications that might occur. Therefore, the kidney (renal) diet should be comprised of the right amount of these nutrients: protein, carbohydrate, fat, vitamins and minerals (sodium, potassium, phosphorus, and calcium) .

From this you may conclude that there is need to work with the diet, and the registered dietitian will provide the appropriate nutrition education and nutrition counselling customised to meet the needs of the client .

Moreover, having knowledge of basic nutrition information pertaining to the kidney diet is helpful. You and/or the meal managers, chefs or caterers should know which foods are sources of the aforementioned nutrients; this also includes which foods are high in potassium, low in potassium, high in sodium, low in sodium, high in phosphorus, and low in phosphorus. For example, foods which contain large quantities of potassium include: avocado, banana, orange juice, prune juice, plantain, mango, cantaloupe, honey dew melon, beetroot, spinach, dasheen leaves, sweet potatoes, tomato, lentils, carrot, pumpkin and so on .

Lower potassium foods are corn, melongene (eggplant), cabbage, peppers (green, red, and yellow), cucumber, cauliflower, lettuce, etc.; foods containing large amounts of phosphorus – dried peas and beans, nuts, peanut butter, cheese, milk, yogurt, pudding, ice cream, chocolate flavoured beverages, cola beverages, macaroni and cheese, bologna, hot dog, bran bread, bran cereals, etc.; low phosphorus foods – fish, eggs, chicken, rice, crackers, popcorn, sherbet, apple/apple juice, grapes, cucumber, graham crackers, green beans, among others .

Take home nutrition message: manage your weight wisely, follow the diet and medical prescription provided by your medical doctor, make the necessary changes in lifestyle practices – select nutritious foods and participate in physical activity .

Claudette Mitchell, PhD, RD is an Assistant Professor, University of the Southern Caribbean, School of Science, Technology, and Allied Health