Kidney Disease Low Phosphorus Diet

We are all provided with two equal fist sized organs, found in our lower back on either side of the spine just above the waist called Kidneys. Renal physiology is the study of kidney function, while nephrology is a medical specialty that focuses on kidney disease.

In brief, the kidneys perform multiple functions to sustain the life of the body, cleanse the body by removing waste and excess fluid through urine, provide a balance of water, salt, potassium, phosphorus and produce an active form of Vitamin D.  Multiple hormones and enzymes are produced in the kidneys and released into the body affecting the function of other organs, signaling red blood cell production, regulating blood pressure (Renin) and calcium metabolism.

The degradation of the kidneys can be influenced by a variety of factors. Having regular check-ups is key to kidney health. Do not miss doctor appointments if you have diabetes, high blood pressure, chronic urinary tract infection, bladder issues, chronic lower back pain. Any of all of these factors should be monitored an communicated in a timely manner.

   When kidneys begin to function improperly an individual may have any, or all of the following symptoms: nausea, vomiting, loss of appetite, fatigue and weakness, loss of energy, sleep problems, any change in output or color of urine, decreased mental awareness, muscle twitches or cramps, hiccups, swelling of feet or ankles, persistent itching, chest pains, shortness of breath, high blood pressure. Symptoms should be discussed with your Doctor. Early detection of kidney disease can be addressed, so that the health of the kidneys can be sustained.

A diet low in phosphorus, sodium and balanced protein is critical when addressing kidney disease. Listed below are foods allowed for patients facing kidney issues taken from DaVita who specializes in Renal Disease.  Four important points should be reviewed with your Doctor or Dietitian.

  • Foods Low in Phosphorus (less than 110 mg per serving)
  • Consume 800-1000 mg of phosphorous per day.
  • Portion Size is critical to staying in range of low phosphorus.
  • (A normal phosphorus blood level is 3.5 to 5.5 mg/dL)
Additional information on the kidneys can be reviewed at The National Kidney Foundation. Learn more about Renal Health, disease and locate professionals that can answer your questions.
By: Kimberly Crocker-Scardicchio
References
The National Kidney Foundation http://www.kidney.org/index.cfm
DaVita http://www.davita.com/
Webmd http://www.webmd.com/a-to-z-guides/understanding-kidney-disease-basic-information
Mayo Clinic http://www.mayoclinic.com/health/kidney-failure/DS00682

LOW PHOSPHORUS FOOD SERVINGS & mg/100g

Low-phosphorus meat and poultry choices
Fresh or frozen red meats without additives or enhancements are better choices (be sure to check ingredient labels; even fresh chicken and pork may be injected with phosphates and sodium) for a kidney diet.

** Choose meats without breading, marinades or sauce. On average, fresh meat contains 65 mg of phosphorus per ounce and 7 grams of protein per ounce. Check with your Doctor or Dietitian on serving size per meat. While most will say that 3 ounces is fine the following serving size has been modified to a 2 ounce serving size.

Phosphorus content for a 2-ounce portion, cooked:

Beef, pot roast: 104 mg Beef, sirloin steak: 126 mg
Chicken breast, skinless: 126  mg Chicken thigh, skinless: 100 mg
Hamburger patty 90% lean ground beef: 114 mg Lamb chop: 122 mg
Pork roast: 126 mg
Turkey breast meat, skinless: 122 mg Turkey thigh meat, skinless: 114 mg

 Low-phosphorus fish choices 

Fish is a high-quality protein that contains omega-3 fatty acids. Fatty saltwater fish such as salmon and tuna are highest in omega-3, reducing inflammation and protecting against heart disease and cancer.

Phosphorus content for a 2-ounce portion, cooked:

Mahi Mahi: 104 mg
Tuna, canned: 88 mg

 

Low-phosphorus seafood choices

Seafood is an excellent source of very low-fat, high-quality protein. However, there are differences in varieties of the same species. For example, Pacific oysters contain 50 mg more phosphorus in a 3-ounce serving compared to Eastern oysters.

Phosphorus content for a 3-ounce portion, cooked:

Shrimp: 120 mg
Oysters, Eastern: 120 mg
Snow crab: 120 mg

 Low-phosphorus breads

Bread is a good source of carbohydrates and calories needed by your body fo renergy production. While whole grain bread is a healthy source of fiber, it also has more phosphorus and potassium than white flour bread.

Phosphorus content for a 1-ounce portion, (usually one piece of bread):

Bagel, cinnamon raisin, blueberry, plain, onion, 1 ounce: 53-70 mg Corn tortilla, 6-inch: 75 mg
English muffin, 1 ounce: 52-76 mg Flat bread: 48 mg
Flour tortillas, made without baking powder: 20-37 mg French bread or rolls: 28 mg
Italian bread or rolls: 29 mg Light wheat bread: 38 mg
Pita bread, white: 58 mg Sourdough bread: 30 mg
White bread: 25 mg

 Low-phosphorus pasta and rice

Pasta, rice and other grains are a great source of carbohydrates, calories and B vitamins, plus zinc, copper and iron. For a kidney diet, whole grains like brown rice, oat bran and wild rice ARE LIMITED due to the higher phosphorus content. A half cup of brown rice has 75-81 mg of phosphorus which can add up if you eat a larger portion.

Phosphorus content for a 1/2 cup portion, cooked:

Couscous: 20 mg Egg noodles: 50-60 mg
Macaroni: 40 mg Pearled barley: 43 mg
Plain white rice, short, medium or long grain: 35 mg Rice noodles: 14-28 mg
Spaghetti: 42 mg

 Low-phosphorus dairy, dairy substitutes and egg whites

Milk and milk products are high in calcium and phosphorus, so finding an acceptable lower phosphorus substitute is a must. A half cup of milk (4 ounces) contains 111-138 mg of phosphorus. Some liquid dairy substitutes can be used in cooking to replace milk, but not all products are interchangeable. Read ingredient lists to look for phosphate additives in nondairy products. Some products are fortified with calcium-phosphate. Beware of the ones that promote “high in calcium” as these are also high in phosphorus. Eggs are a great protein source but also contain 95 mg phosphorus in a large egg. Remove the yolk and phosphorus is only 5 mg for each egg white.

Phosphorus content for a 1/2 cup portion, unless stated otherwise:

Almond milk, Almond Breeze®, original: 50 mg Nondairy creamer without phosphate additives: 40-53 mg
Nondairy whipped topping, 2 tablespoons: 0-10 mg Sherbet: 38 mg
Sour cream, 2 tablespoons: 20-40 mg Soy milk varies by brand: 50-125 mg
Unenriched rice milk without calcium-phosphate additives: 29 mg Egg whites, pasteurized 15 mg

 Low-phosphorus snacks

Crackers, cookies, candy, fruits or vegetables — all are appealing snack foods.There are many low-phosphorus choices for your kidney diet.

Apple, 1 medium: 10 mg Applesauce, 1/2 cup: 6 mg
Baby carrots, 9 pieces: 25 mg Biscotti, without chocolate or nuts, 1 ounce: 35-50 mg
Blueberries, 1/2 cup: 9 mg Celery, 1 stalk: 10 mg
Cherries, 1/2 cup: 15 mg Fig bars, 2 bars: 10-25 mg
Fruit candies, hard candy, chews or gummy: 0 mg Fruit cocktail, 1/2 cup: 17 mg
Gelatin, without phosphate additives: 20-30 mg Low sodium crackers, 1 ounce: 20-35 mg
Peach, 1 medium: 10 mg Lemon Juice, 3 fluid ounces: 3.6 mg
Pineapple, fresh, 1/2 cup: 6 mg Radishes, 10: 9 mg
Shortbread cookies, 4 cookies: 17-35 mg Sorbet, 1/2 cup: 2-6 mg
Strawberries, fresh, 1/2 cup: 18 mg Unsalted popcorn, 1 cup: 8 mg
Unsalted pretzels, 1 ounce: 20-40 mg Vanilla wafers, 1 ounce = 5-8 cookies: 12-20 mg

 Lower phosphorus cheese choices

All cheese contains phosphorus with most having 120-250 mg per ounce; some contain more than 300 mg per ounce. The suggested portion for a dialysis diet is usually one ounce of cheese 1-2 times a week if phosphorus is controlled. Check with your dietitian for individual recommendations. Cream cheese-based spreads are much lower in phosphorus than cheese-based spreads. Portion control is key when it comes to cheese!

Low-phosphorus cheese choices:

Blue cheese, 1 ounce: 110 mg Cottage cheese, 1/4 cup: 92 mg
Cream cheese, 2 tablespoons: 20-40 mg Feta cheese, 1 ounce: 96 mg
Neufchatel cheese, 1 ounce: 39 mg Parmesan cheese, grated, 2 tablespoons: 72 mg

 Managing a low-phosphorus diet

Avoid dried fruits which are higher in phosphorus levels including: raisins, prunes, peaches, pears, dates, currants, bananas. Legumes should be reviewed with your dietitian, some are higher in phosphorus and may not be allowed.

FRUITS

Most fruits can be factored at 10 mg phosphorus per serving. Some fruits do not have any phosphorus. Fresh fruits with higher levels of phosphorus can be eaten in moderation. Weigh your food carefully to configure the amount of mg/100g.

GREAT CHOICE, No present phosphorous in fruit; Raspberries, Cherries, Grapefruit, Lychee, Apricots, Pineapple, Plum, Pumpkin

Banana 27 mg; Blackberries 27 mg; Kiwi 71 mg; strawberries 27mg; Tomato 63 mg; Watermelon 26 mg; Mango 23 mg; Orange 18 mg

VEGETABLES

GREAT CHOICE, No present phosphorus in vegetables: Brussel Sprouts, Chicory, Cucumber, Pickles, Leeks, Olives, Radish, Red Paprika,

Asparagus 49 mg: Artichoke 103 mg; Avocado 82 mg; Broccoli 46 mg; Baked Beans 132 mg; Cabbage 36 mg; Carrots 23 mg; Cauliflower 20 mg; Corn 79 mg; Green Beans 26 mg;  Green Peppers 14 mg; Mushrooms 36 mg; Onion 23 mg; Peas 187 mg; Potato 78 mg; Spinach 15 mg; Zucchini 7 mg; Lima Beans 178 mg;

If baking at home, explore substitutes in baking found at DeVita.com. Bakers Active Dry Yeast provides a good solution when baking.  Another TIP to adding levitation is to follow the recipe backwards, eliminate baking powder and salt. Beat the egg whites in a separate bowl until foamy, add a few grains of cream of tarter, beat another 10 seconds. Lastly, fold egg whites into the other ingredients.

Read Your Palm, Determine Your Diet

Open hand, read your palm to know your serving size of meat.

Read your own palm and know your personal dietary needs. An open flat palm (don’t include the fingers) shows the size of meat, poultry or fish that YOU should consume. The thickness and the length of the palm perfectly identifies your personal protein needs. While an individual’s fist size (closed hand) can give you your own serving size for fruit and vegetables.

Your fist size determines your own single serving.

Clear the confusion over serving size, don’t let it upset your apple cart and ruin your diet! By better understanding what a serving size may look like, consider these unique tips to trigger your memory the next time your prepare a meal, or go out to eat a restaurant. Ones body can tell an individual how they must eat to meet their own individual needs. Remember, in order to not over eat, drink (245 ml) 1 glass of water before your meal and another during the meal.

Serving Sizes: Use the list below to measure foods and serving sizes. A serving size means the size of food after it is cooked or prepared.

  • 1 teaspoon (tsp) is about the size of the tip of your little finger (from the last crease)
  • 1 tablespoon (Tbsp) is about the size of the tip of your thumb (from the last crease).
  • 2 tablespoons (Tbsp) is about the size of a large walnut.
  • One ounce of hard cheese is about a 1 inch cube.
  • 3 ounces of cooked meat, fish, or poultry is about the size of a deck of cards.
  • 1 ounce of cooked meat, fish, or poultry is about 1/4 cup (c).
  • 1/2 cup of fruit or vegetables is about half of a fist (A serving of cooked vegetables is 1/2 cup (1/2 handful) or 1 cup (1 handful) raw.)
  • 1 cup of food is the size of a fist, or 8 fluid ounces of liquid.
  • 1-1/2 cup (12 fluid ounces) of liquid is the size of 1 soda-pop can.
  • 1 pint or 2 cups (16 fluid ounces) of liquid is the size of 1-1/3 soda-pop cans.

The American Dietetic Association counsels that individuals maintain a healthy lifestyle by
including the following into their dietary intake:

  • 4 Serving Fruits
  • 5 Servings Vegetables
  • 2 Servings of Milk
  • 2 Servings of Protein
  • 2 Servings of Healthy Fat (2 Tbsp of Extra Virgin Olive or Canola Oil)
  • 6-11 Servings of Bread (Determined by body size; men eat more bread servings, while women eat less.)
Be smart and plan each meal! When choosing foods, aim for a daily total of 25-38 grams of fiber that will come from Vegetable, Fruit and Multi-Grains.
By: Kimberly Crocker- Scardicchio

References

Satisfying 1200 Calorie Diet

A 3 Step Plan to Achieving a 1200 Calorie Diet Can Work for You!  By loading the calories on the earlier part of the day, then gradually reducing intake, energy is used into the evening.  The suggested plan is for:

  • reducing dietary intake
  • promoting weight loss
  • for the individual who is not physically inclined to move as often.
  • slow metabolism (i.e. hypothyroidism)

Reducing and controlling the intake of energy by cautiously planning meals is easy to do by simply following 3 Steps.

Step 1: Move the higher caloric dinner-time to a lunch menu, allowing energy to be expended over the day instead of packing the calories at night when they can turn to fat quicker, because of less movement and exercise on an individual’s part.

Step 2:  Promote effective digestion by adding: the juice of  a 1/2 lemon freshly squeezed to 1 glass of water and drink the special “lemonade” twice throughout the day.  After meals chew on 6-12 fennel seeds to add: fiber, reduce gas, natural phyto-estrogens and freshens breath.

Step 3: Plan Each Meal, pick and choose your food, aiming for the total suggested calories per snack or meal.

BREAKFAST is important to fueling your day with energy and focus throughout the morning.  Begin your day by drinking 2 glasses of water then choose your menu, aim for 300 calories for breakfast, try to include 1 fruit.

  • 1 egg  (211 calories)
  • Yogurt 1% milk fat 8 ounces (218 calories)
  • Slice multi grain bread (69 calories)
  • 1 tsp Jelly (40 calories)
  • 1 tsp honey (49 calories)
  • Slow cook unflavored oatmeal made with water (14 calories)
  • Glass 1 % Milk 8 ounces (110 calories)
  • Orange Juice 6 ounce (71 calories)
  • 1 Cup coffee (5 calories)
  • 1 fruit (70 calories)
A.M. SNACK time is a way to pick up and recharge allow for 100 calories
  • 1 fruit  is one serving size (tennis ball size), on average varies in 70-85 calories
  • 1/2 ounce of nuts (80 calories)
  • 1/2 ounce sunflower seeds (82 calories)
  • 1 glass water
LUNCH anytime between Noon and 2:00 pm provides a boost to get throughout the day. A larger lunch provides a feeling of satiety that will last to light dinner.  Begin with 1 glass of water then opt for: 1 protein, 1 bread, 2 vegetables, 1 fruit. Aim for 500 Calories.
3 ounces of any protein:
  • Fish (138 calories)
  • Chicken (245 calories)
  • Red Meat (213 calories)
  • Pork (207 calories)
  • 1 cup beans (215 calories)
  • 1 cup lentils (226 calories)
Bread
  • White Rice 1/2 cup cooked (85 calories)
  • Long Grain Brown Rice 1/2 cup cooked (108 calories)
  • Pasta cooked (140 calories)
Vegetables
  • Green Salad (60 calories)
  • 1/4 cup: sliced Carrots or snow peas or beans (25 calories each)
  • 1 tsp olive oil / vinegar dressing (45 calories)
Fruits
  • 1 fruit (70-80 calories)
  • 1/4 cup berries (16 calories)
  • 4 prunes (80 calories)
P.M. SNACK for  a total of 70 Calories
  • 1 fruit (70 calories)
  • 1 glass of water
DINNER time keeps it light. Best time for dinner is when hunger hits. Begin with a glass of water and have dinner between 6:00-8:00 pm allowing for digestion and a full nights sleep. Suggestion: Soup and salad or 2 vegetable and a fruit serving.  Goal is 230 calories, include 1 glass of water before or with dinner.
  • sweet potato baked (115 calorie)
  • 1 cup salad (60 calories)
  • 1 cup vegetable soup (110 calories)
  • roasted pepper and mushrooms with minced garlic and 1/2 tsp olive oil (80 calories)
  • 1 sliced whole red, green, yellow peppers  (37 calories)
  • 1 cup sliced zucchini (20 calories) saute` with 1/2 Tbsp olive oil (80 calories) and minced garlic
  • Saute` or grilled portobello mushroom (80 calories)
  • 1 glass milk (110 calories)

Before bedtime have a glass of water. Allow eight hours of rest to promote additional calorie loss and waking up refreshed and ready to begin a new day!

By: Kimberly Crocker-Scardicchio

  • Lemon Juice:  http://eatknowhow.com/2008/01/28/gas-pains-drink-lemon-water
  • Fennel Seeds: http://eatknowhow.com/2011/12/05/fennel-seeds-to-restore-health

Stuffed Sirloin Steak

Stuffed Thin Sirloin Steak

Thin Sirloin Steak filled with vegetable of choice! May be grilled or prepared in skillet. Serves 4

  • Choose 2-3 vegetables: peppers, beans, carrots, mushrooms, asparagus, *arugula, *tomatoes (*use fresh)
  • 1/4 cup Olive Oil
  • Garlic Clove (minced)
  • 1/4 tsp salt

Thinly slice vegetables of choice

Directions for Vegetables

In a skillet, over medium heat add oil and minced garlic clove.
Wash and thinly slice vegetables of choice. Add vegetables to skillet, cover and allow to saute` for 5 minutes. (*for Arugula and tomatoes use fresh and do not cook.) Remove vegetables from heat to cool.

Select thinly sliced Sirloin Tip

Ingredients for Meat

  • 1/2 tsp Salt
  • 1 garlic clove minced
  • 1/8 tsp Pepper to taste
  • 1/4 tsp Dried Mint Leaves
  • 1/4 tsp Dried Thyme
  • 1 Tbsp butter
  • 8 thin slices of sirloin steak
  • 8 Toothpicks OR Skewers

Combine in a bowl all salt, garlic, pepper, mint and thyme.

Season Meat

Place Sirloin on a plate, rub seasonings into meat slices on both sides. Set aside.

Place about 5 thinly sliced vegetables into center of meat and wrap meat around securing roll with large tooth picks or skewers.

Place skillet on medium-high heat. Add butter.
Add each roll to skillet (or place meat directly onto pre heated 500 F grill). Allow to sear in pan for 1 minute per side. Total of 3 minute cooking time for each roll.

Serve with side of Mustard, Horseradish or Greek Yogurt. Enjoy a side dish Fresh Vegetable Salad

Fennel Seeds to Restore Health

Fennel field typical in Mediterranean Countries

Across the fields of the Mediterranean country of Italy, yellow-flowered green feathery leaves gently move in the breeze. The “Florence Fennel” or Finocchio (feen o key oh) produces a vegetable and seed commonly used in promoting digestion at kitchen tables within Europe, India, Southeast Asia and North Africa.

Foeniculum Vulgare (genius) is listed under the species Apiaceae, or hollow stemmed plants, grouped with other family members including: anise, carrot, caraway, cilantro, cumin, dill, parsley and parsnip.The fennel seed is both green (soft and easy to chew) and yellowish in color (used in cooking) and full of nutrients.

Fennel seeds promote digestive healing. Limited to 1/2 tsp per day.

A dozen fennel seeds chewed on at a time will soothe and relieve various ailments in both men and women.

  • Breath freshener
  • Ease gum soreness
  • Assists in digestion
  • Combats acid reflux
  • Relieves flatulence, gas, stomach ache
  • Creates bile to promote bowel movement. Unclogs liver.
  • Due to their “expectorant properties”, fennel seeds ease coughs and treats bronchial congestion,  asthma
  • Reduces menstrual cramps, hot flashes, night sweats, water retention. Functions as a phytoestrogen and improves libido.
  • Curves stress eating!  ( 12 seeds 3x’s a day) Fennel Seeds or Flax Seeds are a natural “Appetite Suppressant” contributing to weight maintenance, or weight loss
  • Used to improve anxiety and depression
  • Lowers Blood Pressure
  • Fennel seeds can be purchased in the grocery isle that sells herbs and spices.
Eaten raw, steamed or boiled, fennel is encouraged to be part of ones nutritional intake. The texture of the smooth white fennel bulb when sliced releases a gentle aroma of lemon and licorice. The mouth feel of the vegetable is similar to celery. Full of fiber, it is an easy snack to pack, or consumed as an after dinner palate cleanser. Gently boil sliced fennel and green leaves for about 10 minutes. Pour water from pan into a mug and slowly drink water to promote intestinal healing.

Fennel can be eaten raw, steamed or boiled

FENNEL’S Nutrient Composition: “Fennel seeds contain antioxidants, dietary fibers, vitamins A, B and C. Minerals that promote healing are also present: copper, iron, calcium, potassium, manganese, selenium, zinc and magnesium. Its active components anethole, limonene, fenchone, anisic aldehyde, chavicol, myrcene, cineole and pinene are what make fennel seeds effective in their many restorative and curative functions in different body systems like the digestive system, respiratory system and the female reproductive system.”
WARNINGS: Fennel seeds oil is considered volatile. Those who experience plant allergies should approach fennel consumption with caution. Consult with your doctor before consuming fennel seeds if: pregnant, experience allergies or before giving to a child or baby.  Important to note that research has not proven fennel’s ability to calm colic in babies.
By: Kimberly Crocker-Scardicchio