By Sharon Goring, RD

The holiday season is upon us once again! Many kidney patients will be preparing to celebrate the holidays with family and friends, decorating their homes, shopping for gifts and, of course, shopping for food – the highlight of social gatherings.

The key to enjoying the festivities to the fullest is to plan ahead. It is necessary for dialysis patients to plan ahead in order to make the best food choices during the holidays. This is particularly important for those on hemodialysis where foods high in potassium and phosphorus have to be closely monitored. Those on peritoneal dialysis do not usually have to worry about high potassium foods, but the advice for phosphorus is the same as for those on hemodialysis.  

The following information will provide important tips on grocery shopping, planning for parties and special events and food safety. 

Grocery Shopping

• Plan ahead and use a grocery list to ensure appropriate food choices. Check with your dietitian to clarify any items of which you are unsure.

• In order to control the amount of added salt and sugar, try to prepare as many foods from scratch as possible. This allows you to substitute ingredients to make your dishes more “dialysis friendly,” as well as lowering the potassium and in some cases, phosphorus.

• Read food labels. Look for sodium, sugar, phosphorus and potassium content.

• Choose foods low in salt and sugar. This will help to reduce thirst, which in turn will prevent drinking too many liquids.

• Choose liquid non-dairy creamer instead of milk, cream cheese instead of cheddar cheese and sherbet or sorbet instead of ice cream. These dairy substitutions are lower in potassium and phosphorus.

• Choose fresh meat, fish and poultry over cured meats such as ham, bacon and sausage. Reduce the use of salt by seasoning with onions, peppers, garlic herbs and spices.

• Choose canned fruits for those delicious fruit pies and cobblers. Try non-dairy whipped topping instead office cream.

• Choose canned fruits for those delicious fruit pies and cobblers. Try non-dairy whipped topping instead of ice cream.

Use these guidelines to enjoy the holidays, while creating and maintaining a balance in food choices.

Tips for Successful Holiday Eating

• When planning to attend a holiday event, ask if you will be served a meal or just appetizers and what items are on the menu. Use the information to plan what you will eat. If appropriate, make suggestions of foods to include on the menu.  

• Have a snack before the event such as a low potassium vegetable salad (lettuce, cucumber, onions, bell pepper slices or coleslaw) or low potassium fruit (apple, pear) to control your appetite.

• Limit sodium, sugar and fluids on the day of event.

• Take chewing gum, hard candy (sugarless for diabetics) or breath spray with you to aid in controlling thirst.

• If appropriate, take a dish that you can eat, for example a potato dish using dialyzed potatoes such as sweet potato pie or potato salad, or a homemade stuffing.

• Mingle and hold conversations of interest and stay away from the food table, until time to eat, in order to avoid mindless eating.

• If you will be sampling several foods, serve smaller portions and eat slowly to savor the flavor. If there are any unfamiliar foods, ask about the ingredients or pass on that dish. If your doctor agreed that you could drink alcohol, choose a less potent drink, for example a wine spritzer and limit yourself to one drink of about four ounces.  

• Limit high potassium and high phosphorus foods, such as sweet potato pie, pumpkin pie, pecan pie, mincemeat pie, cream pies, eggnog, ice cream, chocolate desserts, milk and cheese dishes, bean dishes, candied and dried fruits, coconut, nuts and potato chips.

• Take phosphate binders with or directly after meals or snacks.

Food Safety

• At the grocery store separate raw meats (referring to meats, poultry and fish) from the other foods in the cart and make sure they are packed separately in their own grocery bags, preferably plastic.

• Do not pack the refrigerator to capacity, as airflow is     important in maintaining the temperature to keep foods safe. Place raw meats on the bottom shelf of the refrigerator so that juices will not be able to drip on to other foods. Use within two days, otherwise store in the freezer.

• Thaw all meats in the refrigerator on the bottom shelf, never on the kitchen counter. The microwave can be used if the meat will be cooked immediately upon thawing.

• All meats should be thoroughly cooked with no pink showing. Seafood should never be eaten raw.

• Refrigerate leftovers within two hours of cooking even if not cooled entirely.

• Wash hands often and thoroughly, especially after handling raw meats.

• Thoroughly clean counter tops and cutting boards with hot soapy water immediately after preparing meats. Dish sponges, rags and towels should be soaked and washed in bleach and hot water. Sponges can be washed in the dishwasher and should be replaced regularly to avoid bacterial growth.

Steps To Dialyze Vegetables

Follow these instructions to reduce the amount of potassium and sodium in potatoes (white and sweet) and other vegetables such as carrots, beets and squash.  

1. Peel vegetables and slice 1/8 inch thickness.

2. Place slices in cold water until all vegetables are peeled to avoid darkening.

3. Rinse in warm water for a few seconds.

4. Soak for a minimum of two hours in warm water. Use 10 times the amount of water to the amount of  vegetables.

5. Rinse again in warm water for a few seconds.

6. Cook for five minutes. Use five times the amount of water to the amount of vegetables.

Dialyzed potatoes can be used in dishes such as mashed potatoes, potato salad, scalloped potatoes or french fries.

Both recipes are from Kidney Cooking, The Georgia Council on Renal Nutrition, National Kidney Foundation of Georgia, Inc. Steps to Dialyze Vegetables are from American Journal of Clinical Nutrition. Thanks to Mary Etta James, MEd, RD, LD and Lillie Akpele, MS, RD, CSR, LD for their assistance in providing tips for this article.  

Sharon Goring, RD, LD has been a renal dietitian for over five years. She is currently the chairperson for The Georgia Council of Renal Nutrition (GCRN).

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 November 2003 issue of aakpRENALIFE, Vol. 19, No. 3.

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