Nurse Teaching on Choice of Foods for Consideration on Dialysis Diet

Nurse educated the patient and caregiver on choice of foods for consideration while on dialysis diet as below:

  1. Rely on other seasonings and spices, such as, onions, garlic, ginger, nutmeg, cloves, cinnamon, black pepper, green chilies, saffron, coriander, fennel, turmeric, and lemon to add flavor to the food. This can help avoid eating too bland and reduce craving for the salt. Herbs such as, parsley, mint, basil, rosemary, thyme, bay leaves, cilantro, curry leaves, lemongrass, oregano, dried fenugreek leaves, and sage could also add flavor to the food and contribute to reducing craving for salt.
  2. While picking spreads and salad dressings, such as, butter, margarine, mayonnaise, and peanut butter, look for unsalted versions to help compliance with the low salt recommendation. You can also rely more on lemon juice, vinegar, or vinaigrette for dressing and flavoring, which can reduce the need for adding salt. While picking sauces for seasoning and dressings, select from the list of sauces low on salt content, such as, tomato sauce, BBQ sauce, chili sauce, and lemon caper sauce.
  3. Many sauces, breakfast cereals, and bakery products, bought ready to eat, contain extra added salt to enhance the flavor. Check on the labels before doing the purchase and choose low salt or no salt added versions of these food items, in order to be consistent with low sodium intake recommendation.
  4. Make healthier choices for low sodium content snacks, such as, some fresh fruit, roasted nuts without added salt, air-popped popcorn, a cup of yogurt, fresh raw carrots, celery sticks, and roasted chickpeas without added salt.
  5. Choose to have your vegetables, such as, peas, beans, lentils, legumes and all soups fresh, to avoid loading yourself with extra salt from canned foods. Even while choosing to pick canned vegetables from the aisle, pick the products with the label, reduced or low sodium.
  6. While picking broth and stocks, pick the products with the label, reduced or low sodium. While preparing them at home, by boiling bones or simmering meat, do not add any extra salt, to be compliant with low sodium intake recommendation.
  7. Bread and bakery products like pizza, sandwich buns, dinner rolls, biscuits, bagels, pancakes, waffles, pretzels, and tortillas are very rich in sodium content, due to the additives added in the baking process. Also, more salt is added to these products as topping. In addition to this, a lot of ingredients that go with pizzas & sandwiches, such as, cheese, sauces, pepperoni, and processed meat, are very rich in salt content and contribute further to increased salt intake. Choosing smaller portions of bread and bakery products and picking unsalted products can significantly contribute towards reduced sodium intake and compliance with low salt diet recommendation. Even while picking cereals, look for healthier choices of unsalted cereals.
  8. Prefer low sodium products, such as, regular or low-fat whole milk, skim milk, half & half milk for dairy requirements. While picking cheese, select from the list of cheese low on salt content, such as, cream cheese, mozzarella cheese, swiss cheese, parmesan cheese, Monterey jack cheese, and goat cheese. Also, look for cheese products with the label, reduced or low salt/sodium.
  9. While picking meat, choose to have your meat fresh versus canned/processed/cured/smoked/cold cut deli. Among fresh meat, prefer lean meats of chicken, beef, lamb, and fish, as they are low in salt content compared to fresh sodium rich meat from turkey, pork, and veal. Make sure no extra salt is added to your meat products.
  10. While picking nuts and seeds, pick the products with the label low salt or no salt added. Select from the products that are raw or roasted.
  11. While picking fruits, depend on sources low on potassium content, such as, apples, pineapple, pears, peaches, grapes, strawberries, raspberries, blueberries, and cranberries.
  12. On vegetables, include string beans, green beans, garbanzo beans, carrots, cucumbers, eggplant, green peas, asparagus, cabbage, cauliflower, lettuce, celery, corn, mushrooms, onions, and radish for their lower potassium content.
  13. Observe strict moderation with consumption of dairy products, such as, whole milk, reduced fat milk, almond milk, soymilk, and yogurt due to their rich potassium content. With cheese, you can choose to pick from pepper jack cheese, cheddar cheese, cream cheese, blue cheese, swiss cheese, which are considered healthier choices for patients on low potassium diet recommendation.
  14. In general, low fiber bakery products are considered low in potassium. While picking bakery products, you can choose among products made from white flour. Limit to consumption of products low in potassium content, such as, noodles, cereals, pasta, and bread made of white flour. You can also count more on white rice for low potassium content and discourage consumption of brown rice and wild rice due to their rich potassium content.
  15. All sources of meat and seafood, such as, beef, pork, lamb, chicken, turkey, salmon, halibut, cod, tuna, and trout are good sources of potassium. These food sources are also rich in protein, which is an essential element needed for growth, maintenance, and repair of body tissues and so, cannot be completely avoided. So, observe moderation with intake and exercise careful watch on your intake portions, just to make sure you do not overdo on your daily potassium allowance. Vegetarians and vegans have the choice of completely avoiding meat products and rely on beans, pulses, lentils, and nuts for their protein content.
  16. Limit to consumption of fruit juices and beverages low in potassium, such as, fruit juices and punches made of apples, pineapple, strawberry, and grapes. Among alcoholic beverages, you can count more on drinks such as, white wine, vodka, rum, gin, and whisky to help compliance with low potassium intake. Strictly avoid consumption of beer, red wine, and soft drinks to help compliance with dialysis diet recommendations.
  17. For desserts, limit intake of products containing dark chocolate and milk products, such as, ice cream, for their rich potassium content. Rely more on pies and cookies, without adding any chocolate, dry fruits and nuts.
  18. Use nondairy creamers and milk substitutes, such as, almond milk, some forms of soymilk, and whipped toppings, instead of milk to make coffee and tea, for compliance with low phosphorus diet. You can count on moderate amounts of cream cheese and parmesan cheese, as low phosphorus cheese varieties.
  19. Among meat and seafood, chicken, turkey, pork, lamb, salmon, tuna, sardines, crabmeat, can be on the higher end for phosphorus content and so, must be carefully consumed. Also, fresh meat from beef, oysters, and shrimp can be a safer bet for a low phosphorus diet. On poultry products, you can also choose to consume the egg white and discard the yellow, as the yellow of egg is rich in phosphorus content.
  20. While picking bakery products, you can choose among products made from white flour, such as, tortillas, white bread, and dinner rolls. Limit to consumption of products low in phosphorus content, such as, noodles, cereals, and pasta made of white flour. You can also count more on white rice and couscous for low phosphorus content.
  21. Fresh apple, pineapple, and berries help better for compliance with low phosphorus diet. Limit consumption of fruits high in phosphorus, such as, bananas, oranges, peaches, and prunes.
  22. On vegetables, include more string beans, green beans, carrots, cucumbers, green peas, cabbage, cauliflower, lettuce, celery, onions, peppers, and spinach on your diet for their lower phosphorus content.
  23. On beverages, ginger ale, lemon soda, clear sodas, and sparkling water can be good choices for low phosphorus drinks. Among alcoholic beverages, you can count more on white wine, vodka, rum, gin, and whiskey to help compliance with low phosphorus intake recommendation.
  24. Observe moderation with intake of protein rich foods, such as, beef, pork, lamb, turkey, chicken, organ meats such as, liver, brain, & kidney, and processed meats like sausage, bacon, ham, jerky, and salami. Sea food, such as, tuna, cod, halibut, sardines, tilapia, salmon, anchovy, dried fish, & crab and animal & dairy products such as, eggs, milk, cheese, cottage cheese, and yogurt are also rich sources of protein, whose intake should be carefully watched on dialysis diet.
  25. Rich vegetable/vegan sources for protein include beans, such as, baked beans, kidney beans, lima beans, pinto beans, fava beans, and garbanzo beans. Various pulses, lentils, nuts, and seeds such as, green peas, chickpeas, beans, walnuts, cashew, brazil nuts, peanuts, pecans, almonds, macadamia nuts, pistachios, sunflower seeds, sesame seeds, pumpkin seeds, flax seeds, and chia seeds are good vegetable sources for protein. Observe moderation with intake of these rich protein sources, to exercise compliance with daily allowance of protein intake on dialysis diet.