Embrace your humanity.
Perfection doesn’t exist, and expecting perfection paves the way for a big letdown. So if you’ve stumbled, use this as an opportunity to accept and welcome the fact that you’re human.1 Be your own best health advocate. Don’t be afraid to ask questions—lots of them. The more you know, the more control you’ll have over your health. The choices you make are the best predictors of your health outcomes, so make informed ones.
2 Choose wisely. Right, wrong, or indifferent, your outcomes are dependent on the choices you make. Planning is key to avoiding impulsive decisions, so integrate planning into every facet of your diet for best success. Plan meals ahead, keep healthy on-the-go snacks at arm’s reach, and don’t go food shopping hungry.
3 Practice meal planning. To streamline the process, follow the weekly grocery lists, especially at first. As you become comfortable with this diet, you’ll be able to customize your own meal schedule that balances your preferences with the nutrients you need.
4 Fresh is best. Processed foods contain unwanted sodium and phosphorus. Cook from fresh, unprocessed whole ingredients to make renal-friendly meals.
5 No one is perfect. Don’t be too hard on yourself. We all have good and bad days, and diet slipups may happen. A thought worth repeating: It’s not about perfection but what you do most of the time that matters.
WORKSHEET : Make Your Own Weekly Menu
Use this blank chart to prepare your own weekly menus:
| BREAKFAST | LUNCH | SNACK | DINNER | |
| MONDAY | ||||
| TUESDAY | ||||
| WEDNESDAY | ||||
| THURSDAY | ||||
| FRIDAY | ||||
| SATURDAY | ||||
| SUNDAY |
Going out to eat is fun—and yes, you still can do it! When you have kidney disease, you can dine out without worry if you make smart food choices. Unfortunately, many restaurants add a lot of sodium to their foods, making some dishes unhealthy for just about anyone. With kidney disease, you should be a little more cautious, and watch out for foods that have hidden contents of protein, sodium, potassium, and phosphorus. Along with the tips listed here, use the chart “Strategies for Dining Out” to help you make healthier restaurant food choices.
Preview the menu. Many restaurants post menus on their websites—check them out before you go.
Choose the venue. Pick a restaurant where it will be easiest to select foods best suited for your diet, such as one where food is made to order.
Seek answers. Ask your server for more detail about items you don’t understand.
Split a meal. Consider sharing a main dish with your dining companion.
Sauce on the side. Ask for salad dressings, gravies, or sauces to be served on the side.
Pass the salt. For any grilled, sautéed, or baked entrées, ask that no salt be added. For Asian foods, ask for no MSG (monosodium glutamate).
Simplify sandwiches. Order sandwiches or burgers without cheese, and ask for mustard or ketchup on the side.
Cut the meat. To scale back on protein, you may want to request half portions of main dishes that contain meat, poultry, fish, or even cheese.
Take it home. Bring part of your main dish home in a takeout box.
Watch for culprits. Keep in mind, protein is found in cheese and cream sauces; food prepared with milk, nuts, and eggs; and vegetarian dishes containing dried beans or lentils.
Social events, such as birthdays, weddings, graduations, picnics, and barbecues, are wonderful opportunities to get together and celebrate with family and friends. Let’s talk about how to avoid overindulging and instead how to make healthier choices about what to eat and drink that won’t leave you feeling deprived. Here are some tips:
Don’t go hungry. Try not to leave the house on an empty stomach. Going to any event hungry will set you up for disaster and most likely lead to impulsive overeating. Grab a high-protein snack beforehand, such as a boiled egg with crackers, to help you feel a little full and avoid desperate decisions at the buffet.
Avoid high-sodium foods. Salty foods will make you thirsty, which will make you want to drink more than is recommended. Instead of hot dogs or sausages, seek out lower-sodium foods, such as chicken and hamburgers. Enjoy the barbecue sauce and salad dressing on the side to better control portion sizes, because they are very high in salt. If possible, ask for vegetables to be grilled.
Practice food safety. Kidney disease puts you at higher risk for food-borne illnesses. If you’re hosting or assisting with the event, cook food to safe temperatures, wash produce well, and use separate cutting boards for raw and cooked meats.
Plan ahead. Feel free to ask your host about the menu in advance. This way you can decide exactly what you want to eat. If it’s not to your liking or doesn’t fit with your diet, bring your own dish to share.
Avoid smoking. Smoking can affect medicines used to treat high blood pressure, which is the leading cause of kidney disease. Smoking also slows the blood flow to your kidneys and can even worsen your kidney disease.
Limit alcohol. Alcohol can also affect certain high-blood-pressure medications. Check with your doctor to make sure it is safe for you to drink alcohol.
Focus on folks. Move away from the buffet, and make loved ones the center of your attention.
Strategies for Dining Out
| TYPE OF FOOD | AVOID/LIMIT | BETTER CHOICES |
| BUFFET | Soups (generally high in sodium and potassium); chips, potato wedges, roasted or baked potatoes; raw spinach; olives; pickles; bacon bits; tomatoes; mushrooms; broccoli; kidney beans; seeds or nuts; croutons; potato salad; three-bean salad; olive salads; relishes; pickles; dried fruit; fresh fruit salad; kiwifruit; melons; bananas; oranges | Salad bar (limit serving size to that of a bread and butter plate or a small bowl): lettuce, carrots, radishes, cauliflower, green peppers, celery, onions, cucumbers, green peas, beets, alfalfa sprouts, Chinese noodles, grated cheese (in moderation), coleslaw, macaroni salad, gelatin salads, cottage cheese, canned peaches or pears, canned fruit cocktail, fresh grapes, fresh or canned pineapple, small fresh peach |
| Grilled, pan-fried, or marinated meats; chicken; fish; seafood | ||
| ASIAN | Nuts; green leafy vegetables such as bok choy, Chinese spinach, and Chinese cabbage; fried rice; soy sauce; teriyaki sauce | Egg rolls, dim sum, pot stickers Steamed veggies, rice, plain noodles (lower-fat choices) |
| Request that your food be prepared without soy sauce, fish sauce, or monosodium glutamate (MSG), all of which contain a lot of salt | ||
| FAST FOOD | French fries (high in potassium), fried fish, fried chicken, ketchup, mustard, milkshakes, dark sodas | Unsalted onion rings (as a substitute for French fries) |
| Salads, when available | ||
| Ask that condiments be left on the side | ||
| Burger King: plain hamburger | ||
| McDonalds: plain hamburger | ||
| Taco Bell: taco with few or no tomatoes | ||
| Wendy’s: plain single hamburger or grilled-chicken sandwich | ||
| MEXICAN | Beans, guacamole, cheese, tomatoes | Plain rice, tacos, burritos, fajitas, and enchiladas filled with minced meat, beef, or chicken |
| Best to order from the à la carte menu | ||
| ITALIAN | Red sauces (usually high in potassium), white sauces (usually high in phosphorus) | Plain or meat-filled pasta (e.g., spaghetti, fettuccine, penne, tortellini, ravioli) |
| Wine sauces like in chicken marsala | ||
| Order sauce on the side | ||
| Small portion (3 ounces) of clam and mussel sauces that are not tomato- or cream-based (better choices than red or white sauces) | ||
| Salad, bread, very plain pasta, such as garlic and butter pasta | ||
| One tablespoon of grated Parmesan cheese may be used for added flavor | ||
| MEDITERRANEAN | Spinach-filled phyllo pastries, sausage rolls and chiko rolls (very high in sodium), tabouleh, falafel, scalloped potatoes | Cream or white-wine sauces; grilled, pan-fried, or marinated meats, chicken, fish, or seafood; dishes served with rice; couscous; kebabs and skewered lean meats; risotto |
| BARBECUE | Barbecue sauce, steak sauce, mustard, ketchup, horseradish, sausage, hot dogs, corn bread | Lean meat, chicken, fish, or seafood; French bread or garlic bread; grilled vegetables |
| Marinades with wine, lemon juice, oil, vinegar, garlic, honey, herbs, and spices | ||
| ENTRÉES | Casseroles; sauces; gravies; heavily fried items; breaded or battered foods; cured or salted meats; omelets with cheese, ham, sausage, or bacon | Broiled or grilled lean meats and fish, omelets with vegetables, sandwiches with meat filling |
| SIDES | Kale, spinach, potatoes or potato salad, tomatoes, mushrooms, winter squash, baked or fried beans, sauerkraut, vegetables in heavy creams or sauces | Peas, sweet peas, green beans, corn, cabbage, zucchini, eggplant, cauliflower, lentils; plain rice, jasmine rice, pastas, noodles |
| DESSERT | Chocolate; nuts; coconut; cheesecake; custard; puddings; dried fruit, star fruit, cantaloupe, oranges; pies such as cream, minced, pumpkin, rhubarb, and pecan; ice cream | Low-potassium fresh fruit or canned fruit, sugar cookies, angel food cake, gelatin |
Adjusting to a new diet and lifestyle can be difficult—after all, you’re creating new habits. Slipups happen, and you will actually have more success if you don’t beat yourself up when you veer off track. I want to share some self-compassion strategies that will help you work through your slipups with grace. These tactics can also help you understand and process some of the emotions that you may be experiencing.
Embrace your humanity.
Perfection doesn’t exist, and expecting perfection paves the way for a big letdown. So if you’ve stumbled, use this as an opportunity to accept and welcome the fact that you’re human.
Give thanks to your failures.
Learn from your experience, instead of feeling guilty. You’ll gain valuable wisdom and perspective from the experience of disappointment and the resolve of trying to do better.
Commit to grow.
Accept that this letdown was the stimulus you needed to cement your commitment to healthier habits and wean away from bad ones. Take this opportunity to reflect, and commit to whatever action it takes to grow from your slipup.
Be kind to yourself.
It’s okay if you turned to junk food. It’s done—graciously accept that reality, give yourself a hug, and move on.
Some days we all feel a little overwhelmed. With a new chronic-kidney-disease diagnosis, you may be dealing with high stress levels. It’s important to both your physical and your emotional health to maintain healthy stress levels, so you’ll want to find ways to maintain a sense of calm, and with a few lifestyle adjustments, you can arm yourself with what you need for your mind and body to function at their best. Rest and relaxation are enjoyable pursuits, but they’re also rituals that your body needs in order to recharge and regroup for busy days and healthy living. Additionally, physical activity is more important than ever when you have kidney disease. For starters, statistics reveal the number one cause of death in patients with kidney disease is related to heart disease. But 30 minutes of exercise a day may help curb those cardiovascular predispositions. In fact, physical activity of any kind can help with blood circulation, reducing stress, boosting energy levels, building strong muscles, sleeping better, and weight management. So carve out time to walk, swim, meditate—whatever works best for you.