By Wyat Leung, Nutrition Student, and Dani Renouf, RD, MSc, CDE
Managing diabetes and kidney health may feel overwhelming at first, especially after learning about all the food restrictions. If you are living with diabetes and kidney disease, it is important to have support in meal planning. Consult with a dietitian early-on to find the balance that serves you best. Along with support from your care team, here are some tips* to help keep your blood sugars in a healthy range, and support your kidneys’ health:
- Limit Processed Foods Where Possible.
Processed foods have a higher glycemic index (a measure of how much a food raises blood glucose level) in comparison to whole foods, and often contain phosphorus as a preservative. Eating processed foods, which are usually filled with preservatives and salt, makes it harder to regulate blood sugar levels and adds pressure on the kidneys.
- Eat Low-Glycemic Index Carbohydrates
Eating low-glycemic index carbohydrates, such as high fibre whole grains, fruits, vegetables, beans and legumes, helps manage hunger without causing large spikes in your blood sugar level. Remember that phosphorus in foods that are not processed is not going to raise your phosphate levels as much as phosphate additives in processed food.
- Substitute Salt with Spices and Limit High Sodium Foods
The recommended sodium intake is 2300mg per day. Nowadays, it’s very easy to exceed this limit with all the sauces, seasonings, and convenience foods on the market. Read labels and aim for sodium content of less than 10% per serving, or use dilution with water to reduce salt in your soup bases, sauces and dressings. At restaurants, try asking for your sauces on the side and replace salt with spices that you enjoy such as oregano, turmeric, curry powder, cinnamon, and cayenne pepper to name a few. Remember that salt substitutes like “No Salt” or “Half Salt” are high in potassium, so avoid their use as a salt replacement.
- Regulate the Type and Amount of Protein That You Eat
Try choosing oily fish, like salmon or mackerel, legumes, nuts and seeds over red meats to reduce saturated fats and increase your intake of unsaturated fats. By including plant-based unprocessed proteins in your diet, you can help to lower your risk for heart disease. Consult your renal dietitian about the type and amount of protein that you should consume.
- Remember to Look at Nutrition Labels
Nutrition labels provide important information on the potassium, phosphorus, sodium, and fat content of a food product. Try making it a habit to look at the specific serving size to help balance out your portions when planning meals. If you are spending much of your time on reading labels, try simplifying your grocery shopping experience by using the perimeter of the store more often, and choosing seasonal fruits, vegetables, starches made from whole grains, unprocessed animal meats, lower-fat dairy, and eggs.
- Try Switching to a Plant-Based Diet
Plant-based diets, such as the Mediterranean and DASH diets, have been proven to keep blood sugar levels in check and slow kidney disease progression. Plants contain phytates that bind to phosphorus, decreasing the amount that you absorb and reducing the potassium filtration load on your kidneys. Remember that processed plant-based products like meat and dairy alternatives may contain sodium, phosphate, and other additives, so make sure to read labels carefully. Choosing canned beans and other legumes or pulses are favorable options if you want to include more plant-based proteins, as they are lower in additives, and higher in fibre, protein, and other nutrients.
As always, when making major adjustments to your diet as a diabetic, CKD patient or both, you should consult your renal dietitian first, as you have individual and unique needs that require a tailored dietary approach. In the meantime, if you are trying to reduce processed foods in your diet, preparing a meal at home can help. This Fish Taco recipe from the Kidney Community Kitchen is an excellent summer recipe that is both nutritious and delicious.
*References: Diabetes Canada and the National Kidney Foundation