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very restrictive meal ideas needed

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bw2082 Aug 17, 2009 11:30 AM

My dad has been having kidney problems and the doctor has put him on a low potassium/sodium/protein diet and I'm having a hard time figuring out what to cook him 3 meals a day every day of the week while at the same time maintaining his calorie count.

We've been doing a lot of rice and low gluten pastas.... Some vegetables like zucchini, squash, eggplant, cauliflower which are low in potassium... at dinner he can have 4 oz of a lean protein so I've been grilling pounded thin chicken breasts to make it look like more.

I've been using lemon juice and olive oil and lots of herbs and curry to offset the need for sodium but I am running out of ideas! He also has to watch his fluid intakes which takes soups out of the equation.

any help would be greatly appreciated

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  1. g
    gordeaux RE: bw2082 Aug 17, 2009 11:47 AM

    IMO, olive oil + unsalted butter+ white wine+lemon juice+ a small amt of balsamic vinegar was my favorite "sauce" for veggies/pasta while I was on my dr recommended sodium cutback. I think the fats added a mouthfeel to the acids and mellowed them out quite a bit when mixed together and heated up.

    1. Uncle Bob RE: bw2082 Aug 17, 2009 11:55 AM

      IMO you need professional help/advice...Contact your dad's Physician, and have him recommend a registered dietitian or nutritionist to help you with meal plans. Also the National Kidney Foundation should be an excellent resource for materials. HTH

      Best Wishes.......

      1. n
        nemo RE: bw2082 Aug 17, 2009 12:29 PM

        Looks like cooked cabbage is on the low potassium list. Use rice and chopped vegetables that he can have to make stuffed cabbage rolls. Cook in unsalted chicken broth and use the leftover broth for something other family members can eat. Same idea, but with stuffed peppers or zucchini.

        Stretch the 4 oz of chicken by making chicken meatballs and mix with shredded zucchini.
        I've used a small portion scoop to make the meatballs, then did the math to figure out how many meatballs equals 4 oz. It has often come out to 5 or 6 meatballs which looks like a lot.

        Can he have flour? If so, you can make the no-knead bread without salt and use that for slicing and bread crumbs (like for the meatballs above).

        I was late to the party with smoked paprika. It's my new best friend. I swear it tastes like bacon. Use it lavishly on vegetables or anything that you might use ham or bacon with.
        Can he have legumes? I love smoked paprika with lentils. Any type of beans? Make garlic bean spread for cucumber rounds or lettuce leaves. If you cook your own beans from dried, you can prepare them without any salt.

        Make "dry" soup. Like minestrone without the stock. Saute carrots, onions, celery if allowed, zucchini in olive oil, add just enough water to steam them. A few canellini or black beans, cooked small pasta. Serve like hash.

        Whatever fruits he is allowed should help with the calories. Low protein is a tough one.
        Can he have any dairy or eggs as an exchange for the protein allotment? If so, you could make your own low fat yoghurt cheese. That might help with some of the curry dishes.

        Good daughter. Lucky dad that he has a personal chef.

        2 Replies
        1. re: nemo
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          bw2082 RE: nemo Aug 17, 2009 12:41 PM

          thanks for the suggestions. Beans are out though as they are high in protein. Dried beans that is. Green beans are ok. He needs to be below 35g protein per day. The dietitian was not very helpful with the meal planning aspect or with recipes.

          1. re: bw2082
            n
            nemo RE: bw2082 Aug 17, 2009 01:00 PM

            bw2082: I was meaning to suggest beans instead of any meat on a particular day. It seems to me 1 cup of cooked beans, lentils, or chickpeas can run from 15 to 17 grams of protein, and a cup of legumes can be very filling. 1-1/2 cups would keep him well below his 35g max.

            I figured you had already met with a professional. Best of luck. You'll figure it out.

        2. amyzan RE: bw2082 Aug 17, 2009 01:13 PM

          Since the dietitian was little to no help, consider calling a reference librarian if you have a well staffed library system. They should be able to pull up books or periodicals on living with kidney disease, perhaps even specific to daily menus from which you can pull ideas. Good luck!

          1. nomadchowwoman RE: bw2082 Aug 17, 2009 01:16 PM

            I sympathize. My brother spent several months on dialysis, and the diet was horribly restrictive. I ordered a cookbook online--"Cooking for David"--which he found extremely helpful. If you go to this website of the National Kidney Foundation, you'll find it and a number of other selections. (I've heard from others that The Renal Patient's Guide to Good Eating is excellent; maybe you can find a used one on-line.)
            http://www.kidney.org/professionals/C...

            1. 4
              4Snisl RE: bw2082 Aug 17, 2009 01:34 PM

              This is just a random assortment of ideas- renal diets can be challenging, but you're ahead of the game in that you seem to know your way around the kitchen- that's a big start! For a lot of renal patients I saw, one of the toughest things was moving off of super-high-sodium packaged foods.....anyway, here goes, and forgive me if I slip with a high potassium or phosphorous ingredient (is he on a low-phos diet, or is it just fluids, sodium, protein and potassium he's watching?):

              Spaghetti squash tossed with herbs and olive oil

              Try coating the chicken in mustard (watch for sodium levels), then roll in panko, spray with nonstick spray and bake.

              Asian dumplings, light on soy sauce, heavy on flavoring from sesame oil, ginger, garlic and scallions. Filling can be filled with vegetables like cabbage and zucchini but light on meat.

              "Fried rice" variation could also work, or lettuce cups- again, relying less on soy sauce for flavoring. Both are also good ways to stretch out protein.

              As a change from pasta and rice, maybe try polenta?

              Perhaps he'd try out a baba ganoush type dip (light on tahini, heavy on lemon juice, garlic, maybe even a few roasted red pepper strips?) Serve with pita or crudites of low-potassium vegetables and maybe some tangy rice-filled dolmas (if using brined grape leaves, will want to soak to get rid of excess sodium)..

              Fish tacos, served in corn tortillas with a zesty cabbage slaw of shredded red and green cabbage, lime juice, jalapenos, toasted cumin and cilantro. ETA: It looks like a tomatillo-based sasla verde could fill in the role of pico de gallo or tomato-based salsa,

              Kim O'Donnel, formerly of the Washington Post, published a fantastic recipe for "mock" crab cakes made with shredded zucchini. May want to take it easy with the Old Bay, but otherwise, it's a terrific recipe.

              http://blog.washingtonpost.com/mighty...

              I'm sorry your dietitian isn't too helpful- if you have the means, you might be able to find a better one through the ADA website: http://www.eatright.org/cps/rde/xchg/...
              Having someone with the "big picture" in terms of any complications and coinciding health goals is definitely important- but so is enjoying food! I hope this thread will give you some inspiration, even if all the ideas won't work for your situation.

              Also, you may find this booklet from the Virginia Commonwealth University Hospital system helpful (I'm not affiliated, and you may already have something similar, but I like that there's more focus on things that are OK to eat instead of the restrictions):
              http://www.vcuhealth.org/transplant/p...

              1 Reply
              1. re: 4Snisl
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                Val RE: 4Snisl Aug 17, 2009 01:44 PM

                Westbrae makes a no-sodium mustard...Boar's Head Deli Mustard is the lowest sodium "regular" mustard out there, well, in my area of SWFL.

                Vinegars are good salt substitutes HOWEVER I think I've read that Apple Cider Vinegar is higher in potassium than most other vinegars. Balsamic vinegar is a lovely flavor enhancer.

              2. b
                bw2082 RE: bw2082 Aug 17, 2009 05:43 PM

                Thanks for all the replies. They have been very helpful and inspiring! One thing though is that he's chinese and I am finding it very tough to cook anything asian without soy sauce or oyster sayuce or anything like that since they are high in sodium. Even "low" sodium soy is high

                3 Replies
                1. re: bw2082
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                  Val RE: bw2082 Aug 17, 2009 06:01 PM

                  bw2082, have you looked into the Bragg's Liquid Aminos? Comes in a spray bottle ... 1/2 teaspoon=160 mgs sodium. You'd have to decide if this is still too much...but a little spritz on veggies is very flavorful! Tastes very similar to soy sauce, too.

                  1. re: Val
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                    bw2082 RE: Val Aug 18, 2009 08:30 AM

                    I was looking around here about soy substitutes and read about Bragg's but the protein content is really high.

                    edit: I thought it said 310 grams per half teaspoon instead of milligrams lol

                    ok will give it a try. Thanks!

                    1. re: bw2082
                      v
                      Val RE: bw2082 Aug 18, 2009 09:48 AM

                      I was hesitant to also suggest Mrs. Dash because I wasn't sure about how much potassium is in their herbal seasonings but their website does give low-postassium recipes and some have very good user reviews...Asian Meatballs for one. My son was on a low protein and low sodium diet early in 2008 ... potassium was not restricted so I used lots of Mrs. Dash ideas. Of course, only you will know the amount of potassium your dad can have but this might be another option for you to look at some recipes from that website.

                2. t
                  toveggiegirl RE: bw2082 Aug 19, 2009 07:43 AM

                  Here is a complete free online 110 page cookbook (in PDF form) from the National Kidney Foundation. http://www.kidney.org/atoz/pdf/dialys...

                  This website has a great list of kidney disease/dialysis recipes including some Asian-style dishes: http://www.davita.com/recipes/

                  A directory of websites for renal recipes:
                  http://www.nafwa.org/lma/directory/Sp...

                  I hope your dad's health improves soon.

                  1. k
                    kchapman RE: bw2082 Oct 24, 2009 10:29 PM

                    Hello,

                    I just happened across your post and wanted to offer that I have found there is a cookbook entitled "Chinese Renal Kitchen, Cookbook for People Living With a Special Diet for Kidneys" available by calling St. Paul's Hospital in Vancouver, British Columbia at (604) 806-8141. My dad is in the same situation and I am doing some research for my mom (we are of Indian descent, but I feel the Chinese recipes will be more flavorful than some of the others we have come across). I haven't placed my own order yet so I can't say whether the book is any good, but just thought I would let you know what I had found.

                    I wish you and your father all the best.

                    1. l
                      lgss RE: bw2082 Oct 25, 2009 05:25 AM

                      Here's a similar topic. http://chowhound.chow.com/topics/659458

                      1. mcf RE: bw2082 Oct 25, 2009 12:12 PM

                        The worst part of this dietary advice is that it hastens decline in kidney function by being so glycemic and depriving the body of the protein it needs to maintain lean body mass and to build new tissue.

                        It's possible to prevent and even reverse even advanced kidney damage with a low glycemic/low carb diet, which I did even after a decade of documented kidney damage.It's elevated glucose that damages kidneys.

                        A case study from Scandinavia, demonstrated that even end stage renal failure could be improved with a low carb diet. It's possible to do this with very moderate protein by raising the fats, especially from olives, fish, avocadoes, nuts.

                        http://www.ncbi.nlm.nih.gov/pmc/artic...

                        I've maintained my restored kidney and nerve health and normal blood sugar levels for over a decade with diet, no meds. It's never too late to be healthier and slow down progression of disease.

                        3 Replies
                        1. re: mcf
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                          Val RE: mcf Oct 25, 2009 02:33 PM

                          MCF...and the protein can be non-meat, right? Just wondering...this is all very fascinating...I've also read that any renal sicknesses (kidney) related involve glucose and the glucose MUST be reduced. For the protein, I've read that even healthy individuals should have *some* protein with each meal (does not have to come from meat or fish)...thanks for your post! Glad you are doing better WITHOUT meds, yay!

                          1. re: Val
                            mcf RE: Val Oct 25, 2009 03:17 PM

                            Yes, it can be non meat, but that can make it somewhat less bioavailable. I don't have a citation, but recall reading that elderly folks added and maintained stronger bones and more muscle with animal proteins. Thanks, I'm not only better, I have no protein or even microalbumin in my urine, and no more nerve pains or numbness in my hands, feet and legs. I was an undiagnosed diabetic for many years because fasting glucose fails to diagnose most diabetes but that's what the ADA keeps recommending. That and scary high post meal glucose numbers. BTW, I was slim, not obese and numerous studies have found just as much benefit for low carbing in diabetics and non diabetics without weight loss.

                            It makes me nuts that glucose causes kidney damage, and that the recommended guidelines have dietitions feeding diabetics in the hospital juice, waffles, pudding, toast, cereal...

                            Good luck with your dad's care.

                            1. re: mcf
                              v
                              Val RE: mcf Oct 25, 2009 03:23 PM

                              Well! I recently read that fasting is NOT necessary for blood work anymore...I guess it depends on what bloodwork is being requested...but I know I read that somewhere this year! Will try to find the link...thanks again!

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