To Eat It Or Not To Eat It

Merry Christmas… and for tomorrow, Happy Kwaanza. Oh, all right, let’s throw in Happy Chanukah although that’s already passed this year. What all these celebrations – yes, and New Year’s Eve, too – have in common is food. And food has potassium and phosphorous in it. Those are two of the electrolytes that Chronic Kidney Disease patients have to curtail.

Let’s backtrack a little bit and find out what these are. Each was included in the glossary of What Is It and How Did I Get It? Early Stage Chronic Kidney Disease:

“Phosphorus: One of the electrolytes, works with calcium for bone formation, but too much can cause calcification where you don’t want it: joints, eyes, skin, and heart.

Potassium: One of the electrolytes, important because it counteracts sodium’s effect on blood pressure.”

Now, let’s see if we can get a bit more information about the ill effects of having too much of either one.

This is from SlowItDownCKD 2011:

“Be aware that kidney disease can cause excessive phosphorus. And what does that mean for Early Stage CKD patients? Not much if the phosphorous levels are kept low. Later, at Stages 4 and 5, bone problems including pain and breakage may be endured since excess phosphorous means the body tries to maintain balance by using the calcium that should be going to the bones.”

And potassium? SlowItDownCKD 2012 has the answer:

“Too much potassium can cause irregular heart beat and even heart attack. This can be the most immediate danger of not limiting your potassium.”

We all have limitations on these (as well as sodium and protein) based upon our latest blood and urine lab results. Since my lab results registered normal for both electrolytes, I have pretty generous daily limitations: potassium: 3000 mg; phosphorous: 800 mg. If you’re like me, the numbers didn’t mean much.

Let’s try this another way. My husband’s traditional family Christmas dinner consists of standing rib roast, sweet potatoes baked in orange juice with marshmallow topping, string bean casserole, dinner rolls, tea or coke, and apple pie. (I added salad so there would be something I could eat.)

We’ll need a list of high potassium and high phosphorous foods before we can to analyze the meal. Luckily, there is one for phosphorus in SlowItDownCKD 2015:

HIGH PHOSPHORUS FOOD TO LIMIT OR AVOID

Beverages:
ale                                                    beer
chocolate drinks                           cocoa
drinks made with milk                dark colas
canned iced teas

Dairy Products:
cheese                                              cottage cheese

custard                                            ice cream

milk                                                 pudding

cream soups                                  yogurt

Protein:
carp                                                crayfish
beef liver                                       chicken liver
fish roe                                          organ meats
oysters                                           sardines

Vegetables:
dried beans and peas                  baked beans
black beans                                   chick peas
garbanzo beans                            kidney beans
lentils lima                                    northern beans
pork’n beans                                 split peas
soy beans

Other foods:
bran cereals                                brewer’s yeast
caramels                                      nuts
seeds                                            wheat germ
whole grain products

Now we need a list of high potassium foods. The National Kidney Foundation at https://www.kidney.org/atoz/content/potassium was helpful here. They also have a list for “Other Foods.”:

Fruits and Vegetables:
Apricot, raw (2 medium) dried (5 halves)    Acorn Squash
Avocado (¼ whole)                                           Artichoke
Banana (½ whole)                                             Bamboo Shoots
Cantaloupe                                                          Baked Beans
Dates (5 whole)                                                  Butternut Squash
Dried fruits                                                          Refried Beans
Figs, dried                                                            Beets, fresh

then boiled
Grapefruit Juice                                                  Black Beans
Honeydew                                                            Broccoli, cooked
Kiwi (1 medium)                                                 Brussels Sprouts
Mango(1 medium)                                             Chinese Cabbage
Nectarine(1 medium)                                        Carrots, raw
Orange(1 medium)                                             Dried Beans and Peas
Orange Juice                                                       Greens, except Kale
Papaya (½ whole)                                              Hubbard Squash
Pomegranate (1 whole)                                      Kohlrabi
Pomegranate Juice                                             Lentils
Prunes                                                                    Legumes
Prune Juice                                                           White Mushrooms,

cooked (½ cup)
Raisins                                                                    Okra
Parsnips

Potatoes, white and sweet
Pumpkin  

Rutabagas
Spinach, cooked
Tomatoes/Tomato products
Vegetable Juices

(Looks like my formatting is on vacation. Sorry about that, folks.)

Okay, here comes the hard part. Let’s scan the lists to see which of the foods in the dinner my husband craved are on this list. I see canned iced teas, dark colas, orange juice, and sweet potatoes. The potassium and phosphorous in one serving (?) of each is as follows:

food                                  potassium                                    phosphorous
canned iced tea                    18 mg.                                            32 mg.
dark cola                               44 mg.                                            62 mg.
orange juice                       235 mg.                                            40 mg.
sweet potatoes                   542 mg.                                            81 mg.
totals                                   839 mg.                                          215 mg.

Doesn’t look bad at all, does it? But it’s all guesswork. Is your liquid serving an ounce? Eight ounces? What about the juice in the sweet potato dish? Surely it’s not just one ounce. And maybe not eight depending upon how much of the juice is in the size portion of the sweet potato dish you had. Maybe you had seconds. Same for the sweet potatoes.

Since this is not at all a precise science, you’re better off practicing more limiting rather than less. I’m not a doctor as I keep mentioning, but I don’t see anything wrong with a just a taste or a small serving of each.

Of course, I’m not a fan of soda or any canned drink, so I get a pass on that. If you’re not sure how much of what you can eat on a daily basis, make an appointment with your renal dietician after the holidays and just enjoy today’s Christmas meal.

Hey, that doesn’t give you free reign to eat all those things expressly not on your renal diet. I know if I decide to eat some of the standing rib roast, I’m still limited to five ounces of protein a day… including the hardboiled egg I had for breakfast.

Lay.off.the.salt.shaker.too. Sodium is not your friend if you have CKD. Ask your hostess if he or she has Mrs. Dash’s seasoning or garlic powder (NOT SALT) should you be asked if you’d like the salt. Oh, was the green bean casserole made with canned, creamy soup? That’s going to up the salt content. Just another thing to be aware of when salivating at the sight of the scrumptious meal in front of you today.

I’d go really light on the hot chocolate, too, if you were planning on having some. The message here is to enjoy, but limit, those high phosphorous and potassium holiday foods you really crave.

Until next week (and next year),
Keep living your life!

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