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Friday, January 16, 2009

Low Potassium Diets for People with Kidney Disease

Having to go on a low potassium diet definitely has its challenges. That is because potassium is a mineral that is found in many of the foods that we eat. In fact, many of the foods that were recommended when you were diagnosed with diabetes, like fruits and vegetables, nuts, lean meats, milk and whole grains are high in potassium. Now, you are being told to limit these foods. Why?

First, let’s explain how potassium works. All of the different minerals in our bodies have different functions that they perform to keep your body running smoothly. Potassium helps maintain normal blood pressure and also helps muscles, including the heart muscle, to contract properly. It is the job of your kidneys to keep the right balance of potassium in your body. When your kidneys are not functioning properly, potassium can build up in your blood, and this can lead to dangerous side effects, such as confusion, irregular heartbeat and even a heart attack. If your kidneys are not functioning properly, your doctor may recommend that you limit potassium in your diet to keep your potassium levels in your blood in a safe range.

This article offers some general guidelines for a low potassium diet, and describes a sample meal plan. It is highly recommended that you see a dietitian who specializes in kidney disease, to help you with more specific meal planning.

General Tips:

  • Eat refined grains the majority of the time, because they contain less potassium than whole grains. Bran and bran products are high in potassium.

  • Use refined grains as the base of your diet, because they tend to be lower in potassium than many of the other food categories. Try to have at least 6 to 10 servings a day, spread out over 3 meals plus snacks. Of the 6 to 10 grain servings, up to 2 can be whole grains.

  • Make sure to get enough fat in your diet to keep your calories consistent. Olive oil, butter and margarine tend to be low in potassium. Choose olive oil most of the time in cooking, since it is a healthy fat and contains no potassium.

  • Incorporate 2 – 3 ounces of medium-fat cheese (less than 5 grams of fat per ounce) into your diet daily as it a good source of protein and lower in potassium than most meats and fish.

  • Egg whites are a low potassium food and are a good source of protein.

  • Some foods are so high in potassium that they are best avoided most of the time:

    • Fruits you should avoid include apricots, avocados, bananas, cantaloupe, grapefruit, honeydew melon, kiwi, orange juice, oranges, nectarines, papaya, plantains, prune juice, prunes, raisins, tangelos, watermelon.

    • Vegetables you should avoid include artichokes, butter beans, beets, brussel sprouts, collards and other dark green leafy vegetables, mushrooms, potatoes, rutabagas, sweet potatoes, tomatoes, winter squash, yams, and zucchini.

    • Milk should be limited to one 8-ounce serving per day. This would include buttermilk, yogurt and ice cream.

    • Meats and fish should be limited to three 4-ounce servings or the size of a small deck of cards, up to 2 times a day.

    • Beans and legumes should be avoided or used in very small quantities, infrequently.

    • Nuts are high in potassium, but if you limit them to 1 ounce per day or less, they offer a healthy source of fat and are a good source of protein.

    • Other foods to limit are bran, chocolate, molasses and sardines.

  • You can remove some of the potassium from your favorite high-potassium vegetables using a soaking process called ‘leaching’. Though you will still need to limit how often you eat them, this soaking will allow you to eat these vegetables occasionally.

    To leach vegetables, peel and slice them into small pieces. Rinse under warm running water and then soak them in a large amount of warm water (10 times the amount of vegetables) for several hours. Drain and rinse the vegetables under warm running water and then cook them in about 5 times the amount of water as the amount of vegetables.

  • There are still many fruits and vegetables that you can eat. It is recommended to limit to 4 servings of fruit or vegetables a day. The serving size is ½ cup or 1 small fruit.

  • Avoid salt substitutes because they usually contain potassium.

  • Use only salt and seasoning mixes that do not contain potassium.

  • Limit most dried fruits and juices because they are more concentrated. If you really want to drink juice, choose a lower potassium fruit juice such as cranberry juice, peach or pear nectars, and limit to 4 oz. once a day.

  • For other beverages, water is best, but you can also drink one or two 8-ounce sugar-free lemonade or diet sodas, which tend to be low in potassium. Limit coffee to one cup per day.

As you can see, a low potassium diet may be tricky to follow because so many foods contain potassium. I bet you are thinking, so what can I eat? And that is a good question. I recommend working with a renal dietitian to help you get the right balance of foods in your diet.

In the meantime, here is a sample meal plan for a low potassium, low sodium diet. A diet is considered low potassium when it totals between 1500 - 2400 mg of potassium per day. The samples below fall between approximately 1800 – 2200 mg of potassium, depending on which serving size and food items you choose.

* I used the nutrition counting guide listed as a reference at the bottom of this article to determine the potassium content of this meal plan.

1 cup coffee or tea
1 – 1½ cup cornflakes with up to 1 cup of milk or soymilk
½ cup blueberries
OR –
1 cup of coffee or tea
1 – 1½ cups of cream of wheat
½ cup strawberries and 1 Tbsp chopped nuts
OR -
1 cup of coffee or tea
1 English muffin or equivalent bread product
1 - 2 eggs
1 slice ham
½ cup applesauce

1 slice of bread with 1 Tbsp peanut butter

1 sandwich on white, oatmeal or wheat bread with 2 oz. of turkey, chicken or roast beef, 1 slice of cheese, mustard and mayo, a few slices of cucumbers.
1 small apple or peach
2 vanilla wafers or 10 pretzels
Sugar free lemonade or water

4-5 crackers and 1 - 2 oz. of low fat cheese

3- 4 oz. of chicken, beef or fish
1 cup of green beans or
1 cup of white rice or pasta
1 slice of rye bread

3 - 4 cups popcorn

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