By Heather Shenk
Many holiday celebrations focus on a meal, but none more so than Thanksgiving. For those whose health conditions require them to closely monitor their diet, the holiday can be stressful. This sentiment is especially true for dialysis patients. Although some patients may want to use Thanksgiving as an excuse to take a break from their diet, the reality is that any time certain foods are eaten in large enough quantities (holiday or not), they could be jeopardizing his or her health.
There are ways to alter a Thanksgiving feast so that those on dialysis can partake in the festivities. Whether you are a dialysis patient or have a dialysis patient attending your holiday meal, you might find the information below can help make the day more enjoyable for all.
Crash Course in the Kidney Diet
First, let’s talk about the kidney diet. The kidneys filter the blood to remove waste and toxins, and ensure that there are appropriate levels of minerals in the body. They also remove excess fluid. When the kidneys do not function, patients must rely on dialysis treatments to remove these elements and fluid. People on dialysis must not ingest any more than what can be safely removed at the next treatment. The big three things to consider in a kidney diet are sodium, potassium, and phosphorus. All must be limited to ensure patients remain healthy in between dialysis sessions. An overload of potassium can be very dangerous. With this background information in mind, the kidney diet is essentially a close monitoring of those three elements, as well as a restriction of fluid intake.
Simple Swaps to Change up Your Thanksgiving Meal
There are simple things that can be done to alter traditional dishes made on Thanksgiving to provide better options for dialysis patients. The list below outlines a few of these things:
- Use unsalted butter instead of salted butter. The savings: 90 mg of sodium per tablespoon!
- Avoid salt and salt substitutes. Salt substitutes use potassium chloride instead of sodium chloride and therefore contain very high amounts of potassium in even small quantities. Iodized salt will add some potassium as well, as the iodide comes in the form of potassium iodide. Kosher salt does not contain iodide but is still high in sodium.
- Make your own chicken stock. A few days ahead, place some chicken in a stock pot or a crock pot with water, some onion, some white wine vinegar and spices (thyme, bay leaf, parsley, rosemary, sage – or any others preferred). Cooking the chicken for a very long time makes for a broth that is dark and flavorful. Note: make sure the chicken doesn’t have any added sodium in it (or worse yet, sodium phosphate, which equals phosphorus) or the stock will as well. The stock can be used to make stuffing, gravy, etc. By making your own stock, you will be saving lots of sodium and possibly potassium and phosphorus, depending on what additives are in the prepared broth that is typically used.
- Choose fresh turkey over frozen. Frozen turkey has significantly more sodium than fresh. Depending on other additives used during the brine before the turkey is frozen, there may be sources of unnecessary potassium and phosphorus. If you make your gravy from pan drippings, the gravy will have less sodium as well.
- Watch the sodium content of the bread you choose to make stuffing. If making bread from scratch without salt is not possible, choose a variety of white bread that has about 100 mg of sodium per slice. If you choose to make the bread from scratch, reduce or omit the salt and add spices you’d typically use in the stuffing to add flavor.
- Use egg whites in stuffing instead of whole eggs. Egg yolks have quite a bit of phosphorus in them, so using the egg whites adds the necessary binding to the stuffing for a good texture, but keeps the phosphorus lower.
- Serve green beans. Try steaming them and adding a tablespoon of cider vinegar or dill to the water for extra flavor. Green beans are relatively low in potassium and very low in phosphorus. By themselves, they are a very good choice for dialysis patients. Other traditional holiday vegetables (such as lima beans, winter squash, and corn) are not as good of a choice for dialysis patients.
- Consider serving a rice or pasta dish, like risotto, instead of, or along with mashed potatoes. Potatoes and sweet potatoes are very high in potassium and should only be eaten by dialysis patients in very small quantities. Potatoes can be leeched (sliced in very thin pieces, boiled in water for 10 minutes, then drained and boiled in fresh water for another 10 minutes) to remove some potassium, but doing so changes the taste and texture. Mashed potatoes also have cream, milk, or some type of dairy product in them, which is a source of phosphorus. Simmer risotto in homemade chicken stock, unsalted butter, and desired spices (include a bit of lemon juice, for a nice kick) for a tasty alternative that dialysis patients – and the rest of the guests – can enjoy.
For more kidney friendly recipes visit NKF’s My Food Coach!
Heather Shenk’s significant other is a dialysis patient who chooses to adhere to a very strict kidney diet. She has learned to alter how she cooks so that he can maintain the best health and quality of life possible. These are some tips she has picked up along the way.