By Carra Moroni, LDN, RD Hello Summer! It is time for some fun in the sun. The first things that come to mind when thinking of summer, besides hot weather, are baseball, swimming, and family gatherings. The second thing that comes to mind is all the great food that accompanies these summertime events. Every event that one attends this summer – the kids’ baseball game, a day at the lake, or the Independence Day family reunion – is going to present an array of food that may or may not be healthy for those with chronic kidney disease (CKD). CKD can make summertime eating difficult to enjoy. Like always, foods high in sodium (salt), potassium, and phosphorus have to be limited or avoided, and fluid needs to be restricted. Rest easy and eat easy this year by being prepared to choose the right foods. Welcome summer with excitement, and bring on the menus. At the Ballpark There are two major highlights when it comes to sporting events – the excitement of your favorite baseball star making the play of the game and the concession stand. Face it; sporting events and food go hand-in-hand. The problem is that foods usually found at the concession stand are loaded with salt or cheese (high in sodium, potassium, and phosphorus), or come with a bag of potato chips (high in potassium and sodium). Rather than being worried about eating the wrong thing and starving at the ballpark, use the tables provided for examples of foods to choose and those to avoid. CHOOSE these foods when ordering from the concession stand: | Food Item | Eat With | Do Not Eat With | | Chicken or Fish Sandwich* | Lettuce, Onions, Pepper, White Bun or Bread | Cheese, Mustard, Tomatoes, Ketchup, Pickles | | Hamburger* | Lettuce, Onions, Pepper, White Bun or Bread | Cheese, Mustard, Tomatoes, Ketchup, Pickles | | Popcorn | Butter, Sodium/ Potassium-Free Seasonings, Pepper | Salt, Cheese | | Root Beer, Fruit Punch, Tea, Kool-Aid®, Coffee Without Milk | In a Small Cup | Ice (it counts toward fluid allowance); added Milk |
AVOID these foods when ordering from the concession stand: | Food Item | Why it should be avoided | | Nachos With Cheese | Corn tortillas are high in sodium and phosphorus; cheese is high in sodium, potassium, and phosphorus | | Hot Dogs | Wieners are high in sodium; the bun is okay | | Sausage Sandwich | Sausage is high in sodium | | Potato Chips | High in sodium and potassium | | BBQ Sandwich | BBQ sauce is high in sodium | | Peanuts or Chocolate | Peanuts are high in sodium and potassium; chocolate is high in potassium and phosphorus | | Cola, Cherry Cola, Beer, Chocolate Drinks | These drinks are high in phosphorus |
The Family Gathering or a Day at the Swimming Hole The Fourth of July has arrived; the family is gathered and ready for the party. They brought their favorite dishes cooked to perfection. It is easy to choose and avoid single food items. Everyone knows that bananas are high in potassium, but what about that homemade banana bread? When a delicious-looking dish is on the table, it can be hard to remember it may contain foods that one would normally avoid. This may cause the Independence Day family barbecue or the picnic at the lake to be stressful for some people with CKD. One may have to worry about the grandkids popping fireworks, but not about which foods to choose and which foods to avoid. CHOOSE these foods at the family gathering: | Food Item | Eat With | Do Not Eat With | | Grilled Chicken, Steak, Ribs, Pork Chops | Pepper, Garlic, Lemon Juice, Grilled Onions, Bell Peppers, Sodium/Potassium-Free Seasoning | BBQ Sauce, Steak Sauce, Worcestershire Sauce, Ketchup, Salt | Pasta Salad or Garden Salad | Carrots, Broccoli, Summer Squash, Celery, Cauliflower, Cucumber | Bacon Bits, Olives, Tomatoes, Smothered in Salad Dressing | Hamburger or Chicken Sandwich | Lettuce, Onions, Peppers, White Bun or Bread | Cheese, Mustard, Pickles, Tomatoes, Ketchup, Whole Wheat Bun or Bread | | Fruit Salad, Fresh Fruit, Fruit Desserts | Apples, Blueberries, Strawberries, Grapes, Lemons, Pineapple, Limes, Cranberries, Raspberries, Bananas, Cantaloupe, Apricots, Grapefruit, Orange, Kiwi, Nectarine, Papaya, Melons, Dried Fruit Coleslaw | Cabbage, Mayonnaise, Carrots, Pepper Added Salt, Olives | | Fresh Vegetables or Vegetable Casseroles | Cauliflower, Carrots, Garlic, Summer Squash, Collard Greens, Corn, Eggplant, Lettuce, Cabbage, Onions, Radishes, Turnips, Hominy | Potatoes, Sweet Potatoes, Tomatoes, Tomatoes Sauces, Beans, Cooked Spinach, Mushrooms, Winter Squash, Olives, Salad Dressing Dips | | Cake | Angel Food, Yellow or White, Butter, Pound, Spice Cakes, Strawberry, Lemon | Chocolate, Nuts, Banana, Peanut Butter | | Cookies | Shortbread, Sugar, Vanilla Wafers | Chocolate, Nuts, Peanut Butter, Dried Fruit | | Pies | Apple, Berry, Cherry, Lemon, Peach | Chocolate, Nuts, Peanut Butter, Dried Fruit, Cream Pies, Custard, Ice Cream, Pudding | | Tea, Coffee, Fruit Punch, Lemonade, Cranberry Juice, Sunny Delight®, Tang®, Root Beer, Sprite®, Ginger Ale, Orange Soda | In a Small Cup | Ice (it counts toward fluid allowance); added Milk |
AVOID these foods at the family gathering: | Food Item | Why it should be avoided | | BBQ Meats/Dishes, Teriyaki Sauce, Soy Sauce | These sauces are high in sodium; flavor meats with low sodium sauces or salt-free seasonings (i.e. lemon juice, garlic powder, onion powder, herbs) | | Cheeseburgers | Cheese is high in sodium, phosphorus and potassium | | Hot Dogs or Sausage Sandwiches | Wieners and sausages are high in sodium; the buns are okay | | Potato Salad, Baked Potatoes, Mashed Potatoes | Potatoes are high in potassium; dialyze potatoes first if this dish is a favorite | | Baked Beans, Pork ‘n Beans, Red Beans, Dried Peas, Lentils, Bean Dip | Beans, dried peas, and lentils are high in phosphorus; canned beans are also high in sodium | | Pretzels or Crackers | High in sodium; buy unsalted versions | | Potato or Tortilla Chips | High in sodium; potato chips are high in potassium | | Nuts or Dishes With Nuts | High in sodium, potassium and phosphorus | | Beef Jerky | High in sodium and phosphorus | | Peanut Butter Sandwiches, Peanut Butter Pie, Peanut Butter Cookies | Peanut butter is high in phosphorus | | Ice Cream, Yogurt, Ice Milk, Pudding, Custard, Cheese | These products contain milk; milk is high in phosphorus and potassium | | Banana-Nut Bread or Banana Pudding | Bananas are high in potassium; nuts are high in sodium, potassium and phosphorus | | Chocolate Pie, Chocolate Cookies, Chocolate Cake | Chocolate is high in phosphorus and potassium | | Colas, Cherry Cola, Beer, Chocolate Drinks | High in phosphorus |
It can be hard to avoid high sodium, phosphorus and potassium foods all of the time. Pay attention when the dietitian discusses lab values. If the dietitian says that this month’s potassium is low or normal, it should be okay to have a small taste of cantaloupe. If the dietitian says that this month’s phosphorus level is high, then pass on the colas and other high-phosphorus foods. Use the tables as a guide or starting point, and remember that many dishes contain foods that should be avoided (i.e. custard pie contains milk). Moderation is crucial. One small taste of a normally avoided food is okay, but do not let those “small tastes” add up. This summer, eat well and enjoy the fireworks! Carra Moroni is a clinical/outpatient dietitian at Touro Infirmary in New Orleans. The information contained herein is intended for educational purposes only. It is not intended and should not be construed as the delivery of medical care. Persons requiring diagnosis or treatment, or those with specific questions, are urged to contact their local healthcare provider for appropriate care. This article originally appeared in the June/July 2005 issue of Kidney Beginnings: The Magazine, Vol. 4, No. 2.
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