By Maria Karalis, MBA, RD, LD

If you are planning on some road trips this summer, quick-service restaurants can provide you with a quick, easy, inexpensive bite to eat. A lot of fast food chains are now offering lower-fat options and if chosen wisely, fast foods can be healthy and fit into your renal diet. When ordering, keep these tips in mind:

Balance fast food items with other food choices. As you order, consider the other foods you have eaten or will eat during the day.

Choose broiled, steamed or grilled items over deep fat fried foods. To trim the fat from fried items, order the regular variety instead of the “extra crispy” and remove the skin before eating. Removing the skin also lowers the sodium content since most batters and coatings usually include seasonings rich in sodium.

Burgers and sandwiches are high in sodium because they are pre-salted. This may be difficult for the quick-service restaurant to omit the salt. Be sure to ask before you order.

Remember that fries and baked potatoes are rich in potassium. But if you cannot imagine a burger without the fries, order a small serving and ask for unsalted, if possible.

Keep in mind that ketchup, mustard and pickles are all high in sodium. Keep condiments, special sauces and dressings to a minimum.

Request these toppings served on the side so you can control the amount. 

Beverage sizes typically are large or “super-size” and can contribute to fluid overload if the entire beverage is consumed. Order the smallest beverage, and be sure to count it as part of your fluid allowance.

Sensible Salad Bar Choices

The huge variety of vegetables and fruits can provide you with vitamins A and C, folic acid and fiber. Be careful though, a trip to the salad bar can provide you with more fat and calories than a burger and fries! There are many salad bar items that can easily fit into your renal diet. The following chart includes a list of items to assist you in choosing sensibly from any salad bar.

“Renal Friendly” Salad Bar Choices

Choose

• Alfalfa sprouts       

• Beets          

• Cauliflower

• Celery sticks          

• Chinese noodles  

• Cole slaw   

• Cucumbers

• Eggs, chopped      

• Gelatin salads       

• Green beans          

• Green peas

• Green peppers      

• Italian, low calorie dressing        

• Lettuce, escarole, endive

• Macaroni salad     

• Mushrooms

• Oil & vinegar dressing     

• Okra

• Onions        

• Parmesan cheese

• Radishes    

• Tuna in spring water        

• Vinaigrette or low fat dressing    

• Zucchini     

 Limit

• Avocado     

• Bacon bits  

• Chickpeas  

• Chow mein noodles         

• Fried bread croutons        

• Kidney beans        

• Nuts

• Olives         

• Pickles        

• Potato salad          

• Raisins       

• Relishes     

• Sunflower seeds   

• Shredded cheddar cheese          

• Thick salad dressings      

• Three-bean salads

• Tomatoes          

Do you know what you are eating?

Get a breakdown of fat, calories and other nutrition information (potassium, phosphorus or sodium) from the store manager. You can also check out the restaurant’s Web site for a complete nutritional analysis of all their menu items. Please note that obtaining information on potassium and phosphorus can be difficult since the U.S. Department of Agriculture does not require these on food labels. 

The following table provides you with the nutritional analysis of some fast food menu items to help you make educated choices. Note the serving size and work with your renal dietitian to safely add these menu items into your eating plan. Generally speaking, choose meals under 500 calories with less than 30 percent of the calories from fat. Many items are loaded with sodium so limit your sodium intake for the rest of the day. Watch your fluid intake because these foods will make you more thirsty than usual. Some items may require that you increase your dose of phosphate binders. Check with your nephrologist and/or renal dietitian on making phosphate binder adjustments.

My personal recommendations:

McDonald’s®: plain hamburger on a bun
Burger King®: plain hamburger on a bun or
BK Broiler™, plain
Taco Bell®: taco, limit the tomatoes
Wendy’s®: single hamburger or grilled chicken sandwich, plain

Brown Bag it

You cannot afford to eat every meal at a fast food restaurant so make sure to take food with you in a cooler to eat as you go. By taking nutritious meals and snacks with you, you do not have to rely on vending machines, convenience stores or fast food restaurants. 

Take all kinds of low potassium fruit and vegetables in sealable plastic bags; try frozen fresh grapes – fruit can be a good thirst quencher.

Carry along single portion beverages – 4 or 6-ounce juice boxes can be kept cool in an insulated container with a chill pack.

Take nonperishable foods with you such as: unsalted pretzels, plain popcorn, graham crackers, bagels, boxes or crackers.

Dietary Values 

References:

1. “Journal of Renal Nutrition,” Vol 6, No. 4 October 1996, Product Update section

2. The American Dietetic Association’s “Complete Food and Nutrition Guide,” by Roberta Larson Duyff, MS, RD, CFCS

3. “Exchanges for all Occasions,” by Marion J. Franz, MS, RD, CDE

4. “Bowes and Church Food Values of Portions,” Commonly Used Sixteenth Edition revised by Jean A. T. Pennington, PhD, RD

Maria Karalis, MBA, RD, LD is a Registered Dietitian who has worked in various positions in the nephrology field for 14 years. Maria is the Nutrition Consultant for iKidney.com and Assistant Editor of the Journal of Renal Nutrition. In 2001, she was the recipient of the National Kidney Foundation Council on Renal Nutrition Recognized Renal Dietitian Award.

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 July 2004 issue of aakpRENALIFE, Vol. 20, No. 1.

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