Doing recipe analysis for the renal diet is a far more complicated endeavor than I realized when I started out in renal nutrition. The renal diet is a complex system and each “food group category” has a maximum allowable amount for potassium, sodium, and phosphorus and a minimum amount of protein. You can’t ignore carbohydrates, fibre or fat either since many kidney patients also have to deal with diabetes and cardiac disease.
So every once in a while a recipe comes along that looks great and has a lot of renal-friendly ingredients but when I do the analysis the potassium, sodium or phosphorus is just too high. Recently I was asked to look at a recipe for a honey-mustard sauce. Both honey and mustard are usually okay for kidney patients but the amount of prepared mustard was just too much to have a low sodium recipe. Sometimes even the amount of spices can push a recipe over the edge! I have learned that cinnamon is a pretty decent source of fibre (not a surprise when you consider it is the bark of a tree!). I have also learned that a “serving size” to a chef is at least 4 times bigger than a “serving size” is to a dietitian!
Which brings me to portion size. I spend a lot of time talking about portion size especially when it comes to potassium but it is important for all aspects of your nutrition. Whether you are trying to lose weight, gain weight, restrict sodium, potassium, phosphorus, fat or increase your fibre – portions matter. It is extremely easy to eat on the go without paying attention to your portions. Eating while cooking (or testing the meal as I like to call it) can add up when you really calculate it out. We call this “mindless eating”.
The key to getting your portions right is to pay attention! Every once in a while, measure out your portions or check how much your soup bowl really holds. Or keep a food record for a few days (sometimes that is an eye-opening experience). Try not to eat while you’re doing something else (reading, watching TV, driving). Eat the food you serve yourself on your plate, take your time and enjoy it.
Use the online nutrition information at restaurants before you eat out. Thinking of the Superbowl weekend, a patient of mine asked just how bad a pound of wings could really be. The answer: really bad. At that particular chain restaurant he went to – 1300kcal and 1300mg of sodium!
Sometimes it’s nice to find a recipe that takes care of the portions for you! Try this easy stuffed pepper recipe that my neighbour makes:
4 red, green or yellow bell peppers
1 cup cooked white rice or couscous
2 cup cooked ground beef (or try using leftover chopped roast beef, roast pork or chicken)
1 teaspoon dried basil
1 tablespoon fresh chopped parsley (or 1 tsp dried)
1/2 cup no salt added chicken stock
1/2 small red onion, chopped
(If you don’t require a potassium restriction, add a peeled, diced tomato to the mix).
Fresh ground pepper
1 tbsp parmesan cheese
Slice off tops of bell peppers, remove seeds and discard. Chop up the bell pepper tops and place into a large bowl. Add rice or couscous, chopped meat, dried basil, parsley, chicken stock and red onions. Toss to combine and season with fresh pepper. Stuff each pepper with filling, sprinkle with parmesan and place in a square baking dish. Bake at 325 degrees for 45 minutes or until tender.