From Pot To Potassium

As a child of the 60s, I encountered pot (marijiuana) everywhere I went.  I was a college student and went wherever college students went.  The difference between my peers and me is that I was so naive, I didn’t recognize what I was smelling.  My folks were far more savvy on this topic than I was since my mother routinely checked my eyes whenever I came home from socializing.  I didn’t know what she was looking for, but she did.

Then, as we all did, I grew up.  I finished college, started teaching, got married,  had children, bought a house, got divorced and developed Chronic Kidney Disease.  That’s where the potassium  comes in.  You know we (as Chronic Kidney Disease sufferers) have to limit the amount of potassium we ingest. Medline delivered this incredibly informative article to my inbox this week.  It is written so well and in such a manner that even the most stunned of the newly diagnosed can understand it that I’ve reproduced most of it here.

AuthorsGeorge L Bakris, MDBarbara Olendzki, RD, MPH, LDN Section EditorGary C Curhan, MD, ScD

INTRODUCTION

Potassium is a mineral that is found in many foods. It keeps the heart beating regularly, helps to maintain fluid balance, and allows the nerves and muscles to work properly.

The kidneys maintain the correct level of potassium in the blood. People who take certain medicines or who have chronic kidney disease must limit the amount of potassium in their diet to keep their potassium level close to normal.

WHY SHOULD I REDUCE POTASSIUM IN MY DIET?

Normally, the level of potassium in your body is balanced by eating foods that contain potassium and getting rid of excess potassium in the urine. However, some people with chronic kidney disease cannot get rid of enough potassium in their urine because the kidneys do not work well.

In these people, the level of potassium in the blood can become higher than normal, causing a condition known as hyperkalemia (hyper=high, kal=potassium, emia=in the blood). Eating a low potassium diet can lower the risk of developing hyperkalemia.

The potassium level is measured by taking a small sample of blood from a vein. A typical normal range for potassium is 3.5 to 5 meq/L. A level greater than 6 meq/L is considered dangerous. A low level can be dangerous as well.

Hyperkalemia does not usually cause noticeable symptoms until the potassium level is very high. At this level, dangerous complications can develop, including an irregular heart rhythm or severe muscle weakness or paralysis.

HOW MUCH POTASSIUM DO I NEED?

In general, experts recommend eating a diet that contains at least 4700 mg of potassium per day. However, most people with chronic kidney disease should eat less than 1500 to 2700 mg of potassium per day.

A registered dietitian or nutritionist [the government pays for you to see the nutritionist attached to your nephrologist’s practice] can help to create a low potassium meal plan. An example of one such plan includes:

  • Fruit — One to three servings of low-potassium fruit per day
  • Vegetables — Two to three servings of low-potassium vegetables per day
  • Dairy and calcium rich foods — One to two servings of low-potassium choices per day
  • Meat and meat alternatives — Three to seven servings of low-potassium choices per day (approximately 15 percent of calories)
  • Grains — Four to seven servings of low-potassium grains per day

[me again: Does this remind you of your CKD diet? It should.]

HOW DO I CUT DOWN ON POTASSIUM?

  • Almost all foods contain some potassium, so the key is to choose foods with a low potassium level, when possible.
  • Notice the serving size when calculating the amount of potassium in a food; a large serving of a low potassium food may have more potassium than a small serving of a food with a high level of potassium. [here I am again: I hadn’t realized that and had to read it on some website or other. It would be interesting to hear from you about whether or not your nutritionist covered that.]
  • Drain canned vegetables, fruits, and meats before serving.

A process of “leaching” can reduce the amount of potassium in some vegetables.

You can eat low potassium foods regularly, but watch your portion size since potassium can quickly add up if you eat a large portion.

Reducing potassium levels in vegetables — It is possible to remove some of the potassium in certain vegetables with high potassium levels. Leaching is a process of soaking raw or frozen vegetables in water for at least two hours before cooking to “pull” some of the potassium out of the food and into the water. You should not eat these vegetables frequently because there is still a lot of potassium in the food after leaching.

  • Wash and then cut the raw vegetable into thin slices. Vegetables with a skin (eg, potatoes, carrots, beets, rutabagas) should be peeled before slicing.
  • Rinse the cut vegetables in warm water.
  • Soak the vegetables for at least two hours or overnight. Use a large amount of unsalted warm water (approximately 10 parts water to 1 part vegetables). If possible, change the water every four hours. Drain the soaking water.
  • Rinse the vegetables again with warm water.
  • Cook vegetables as desired, using a large amount of unsalted water (approximately 5 parts water to 1 part vegetables). Drain the cooking water.

References

Nutrition and Your Health: Dietary Guidelines for Americans. Available online at http://www.health.gov/dietaryguidelines/dga2005/report/HTML/D7_Fluid.htm.

Sample low potassium diet

   Food    Calories    Sodium content, mg    Potassium content, mg
   Breakfast
   English muffin, white 129 242 62
   Low calorie margarine, 2 teaspoons 58 65 4
   Puffed corn cereal (non-sweetened), 1.5 cup 135 247 45
   Eggs, 2 medium fresh 126 123 118
   Coffee, 1.25 cups 3 6 145
   Artificial sweetener (Splenda, any amount) 0 0 0
   Non-dairy fat-free coffee creamer, 1 ounce 20 3 0
   Snack
   Cheddar cheese (reduced fat), 1 ounce 49 270 19
   Apple, 1 medium 72 1 148
   Lunch
   White bread, 2 slices 108 234 44
   Turkey breast, 3 ounces 119 189 236
   Mayonnaise, low fat, 1 tablespoon 25 140 2
   Lettuce, 1 leaf 4 7 47
   Cheddar cheese (reduced fat), 1 ounce 49 270 19
   Egg, hard boiled 78 62 63
   Lettuce (iceberg), 1.5 cups 12 8 116
   Cucumber, peeled, 1/2 medium 12 2 137
   Water chestnuts, canned & drained, 5 pieces 17 5 54
   Carrot (raw), 1 medium 25 42 195
   Salad dressing (Italian, low fat), 1 tablespoon 27 192 4
   Snack
   Clementine, 1 35 1 131
   Dinner
   Chicken breast (skin removed, baked with breadcrumb coating and no fat), 4 ounces 221 87 287
   Green beans, cooked, no salt added, 1 cup 60 46 184
   Margarine, low fat, 1 teaspoon 29 33 2
   Rice, white, cooked in unsalted water, 1 cup after cooking 234 3 89
   Olive oil, 1 teaspoon 40 0 0
   Snack
   Oatmeal cookies (reduced fat), 2 small 56 58 22
 
TOTALS 1743 2336 2173
This sample diet would be adequate for a person who is sedentary and not overweight; a person who was active and/or overweight would need additional calories. This diet contains less than 7 percent of calories from saturated fat, and less than 30 percent of calories from total fat, making it ideal for people with coronary artery disease.

Foods with high levels of potassium

Grains Whole-grain breads, wheat bran, granola and granola bars
Beverages Sports drinks (Gatorade, etc.), instant breakfast mix, soy milk
Snack foods/sweets Peanut butter (2 tablespoons), nuts or seeds (1 ounce), fig cookies, chocolate (1.5 to 2 ounces), molasses (1 tablespoon)
Fruits Apricots, avocado (¼ whole), bananas (½ whole), coconut, melon (cantaloupe and honeydew), kiwi, mango, nectarines, oranges, orange juice, papaya, pears (fresh), plantains, pomegranate (and juice), dried fruits (apricots (5 halves), dates (5), figs, prunes, raisins), prune juice, yams
Vegetables Bamboo shoots, baked or refried beans, beets, broccoli (cooked), Brussels sprouts, cabbage (raw), carrots (raw), chard, greens (except kale), kohlrabi, olives, mushrooms (canned), potatoes (white and sweet), parsnips, pickles, pumpkin, rutabaga, sauerkraut, spinach (cooked), squash (acorn, butternut, hubbard), tomato, tomato sauce, tomato juice, and vegetable juice cocktail
Dairy products Milk and milk products, buttermilk, yogurt
Proteins (3-ounce serving) Clams, sardines, scallops, lobster, whitefish, salmon (and most other fish), ground beef, sirloin steak (and most other beef products), pinto beans, kidney beans, black beans, navy beans (and most other peas and beans, serving size is ½ cup)
Soups Salt-free soups and low-sodium bouillon cubes, unsalted broth
Condiments Imitation bacon bits, lite salt or salt substitutes (avoid completely)
Unless noted, one serving is ½ cup (4 ounces). These foods have greater than 250 mg of potassium per serving and should be avoided or eaten in very small portions if you have been told to eat a low-potassium diet.

Foods with low levels of potassium

Grains Foods prepared with white flour (eg, pasta, bread), white rice
Beverages Non-dairy creamer, fruit punch, drink mixes (eg, Kool-Aid), tea (<2 cups or 16 ounces per day), coffee (<1 cup or 8 ounces per day)
Sweets Angel or yellow cake, pies without chocolate or high-potassium fruit, cookies without nuts or chocolate
Fruits Apples (1), apple juice, applesauce, apricots (canned), blackberries, blueberries, cherries, cranberries, fruit cocktail (drained), grapes, grape juice, grapefruit (½), mandarin oranges, peaches (½ fresh or ½ cup canned), pears (1 small fresh or ½ cup canned), pineapple and juice, plums (1 whole), raspberries, strawberries, tangerine (1 whole), watermelon (1 cup)
Vegetables Alfalfa sprouts, asparagus (6 spears), green or wax beans, cabbage (cooked), carrots (cooked), cauliflower, celery (1 stalk), corn (½ fresh ear or ½ cup), cucumber, eggplant, kale, lettuce, mushrooms (fresh), okra, onions, parsley, green peas, green peppers, radish, rhubarb, water chestnuts (canned, drained), watercress, spinach (raw, 1 cup), squash (yellow), zucchini
Proteins Chicken, turkey (3 ounces), tuna, eggs, baloney, shrimp, sunflower or pumpkin seeds (1 ounce), raw walnuts, almonds, cashews, or peanuts (all 1 ounce), flax seeds (2 tablespoons ground), unsalted peanut butter (1 tablespoon)
Dairy products Cheddar or swiss cheese (1 ounce), cottage cheese (½ cup)
Unless noted, one serving is ½ cup (4 ounces). These foods have a low level of potassium (less than 250 mg potassium per serving on average). You can eat these low potassium foods, but be sure to watch your portion size since potassium can quickly add up if you eat a large portion.
 
Official reprint from UpToDate® www.uptodate.com
Unfortunately, there is no news on the book front.  My poor little notebook became overwhelmed by all I was asking it to do and I ended up buying a new computer.  I would urge you to avoid Best Buy since it took ten people with misinformation, five store visits and who knows how many phone calls before I decided to just return what they suggested.  Even the return presented  problems. On the upside, maybe it was just the particular store  I tried to do business with that conducts their repairs and sales this way.  That took over a week and now – with the help of my loving Bear – I’m getting up and running again.
 
Until next week,
Keep living your life!
 
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Published in: on October 24, 2011 at 12:03 pm  Comments (4)  
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4 CommentsLeave a comment

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    • That is already available. The address is http://gailrae.wordpress.com/feed/. Thank you for asking and for your compliment. I never get tired of those.

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