Switching to Plant-Based Diet

In the first part of our plant-based diet blog series, we established that following a low-fat diet which consists of fruits, vegetables, and whole grains can help preserve the kidney function of non-dialysis kidney disease patients. Several studies also show that following a plant-based diet helps lower blood pressure and blood sugar levels, both of which are essential in ensuring your kidneys stay in top shape.

Now the next step is to put what you’ve learned into practice! It’s one thing to be convinced of the renal health benefits of going plant-based, and another to incorporate it to your lifestyle. But with willpower, consistent effort, and careful planning, kidney-friendly dieting can become your second nature.

In this article, we lay out the basics of making plant-based dieting a lifestyle. We also share helpful tips on how you can transition to healthy eating habits.

(IMPORTANT NOTE: Before making any dietary changes, please consult with your nephrologist and renal dietitian first to determine if a plant-based diet is advisable for your condition.)

Grocery Shopping Tips

Below are important reminders when doing your groceries:

  • Plan your meals. Decide on what you want to eat for a particular time. Plan the meals and snacks you will eat for each day of the week. To save time, devote a certain day each week to sit down and carefully plan your meals before hitting the grocery store.

    List down meals that are simple and easy to prepare in case you need a healthy grub when you’re in a hurry (as always, consult with your dietitian when creating your meal plans).
  • Create a grocery list each time. Whether it’s on a small notepad or saved on your phone, having a grocery list ensures that you don’t miss out on any food and ingredients you need. It becomes easier to fill up your grocery list once you have all your meals and snacks planned out ahead. 

    See all the ingredients you need for all your meals and snacks for the week, then check the items you already have in your fridge/pantry. Write down those that you don’t have and will need to purchase.

  • Practice reading labels. Pay attention to the serving size. If you consume a lesser or greater amount of the product, you’ll also be consuming a lesser or greater amount of every nutrient stated in the label.

    Also, check the amounts of sodium, phosphorus, potassium, and protein. Note that phosphorus and potassium are not always indicated in nutritional labels. It’s best to ask your dietitian which foods are safe for you to eat. Know whether you need more or less protein based on your CKD stage.

Food Preparation and Kidney-Friendly Cooking Tips

One of the greatest challenges with kidney-friendly cooking is maintaining the flavor of a dish. Removing one or two ingredients might reduce the flavor of your food. However, there are certain cooking techniques that help get the essence of remaining ingredients while still making them easy on your kidneys.

Here are a few culinary techniques from RenalTracker’s resident CKD chef, Duane Sunwold:

  1. Replace animal protein with plant protein. Grains, tofu, seitan (a kind of wheat protein), beans, and couscous all make a delicious alternative to beef. 

  1. Roast veggies to increase flavor. When cooking soups and sauces, roast the vegetables first to extract their flavor. You can also dry-rub a mixture of natural herbs on tofu and other plant-based proteins to flavor them up.

  1. Use plant-based sauces for dry dishes. Add more moisture and flavor to grilled tofu or seitan. Replace traditional sauces with rice milk or roasted vegetable stock.

    You can also use homemade vegetable stock as a substitute for salad oils/dressings. The stock helps maintain flavor in your salads while doing away with animal fat.
  1. Mix dried herbs together over heat. Replace salt with natural, homemade seasoning mixtures to lower your sodium. Chef Duane recommends combining whole herbs and seeds and roasting them in a pan until they release aroma.

    This is a great way to bring out their flavor without adding salt. Afterwards, allow the mixture to cool down then grind it in a coffee grinder. 
  2. Eat fruit for snacks and dessert. Cut back on your sugar consumption by eating fresh fruit for when you crave cakes and pastries. Examples of kidney-friendly fruits are apples, blueberries, and strawberries.

Tips for Dining Out 

You can still enjoy dining out at a restaurant or at a party if you have kidney disease. However, you need to stay mindful of your food choices and how much you eat. Here are some tips:

  • If you plan to eat out or order takeaway food, consider the foods and drinks you’re allowed to eat as well as the serving size.
  • Limit your consumption of salty food items like crackers and soup.
  • Before ordering, ask the restaurant staff about the ingredients of the dish you wish to have.
  • Ask to leave out ingredients that are high in potassium from your dish.
  • Avoid or limit your use of condiments like ketchups, soy sauce, and dips.
  • Sauces tend to be high in sodium, so it’s best to leave them out of your food.
  • Ask for your order to be cooked/served without salt.
  • If possible, ask for dressings or sauces to be served in a separate container. This way, you can control how much you can have.
  • Avoid heavily-seasoned dishes.

Getting Started with Food Journaling

Keeping a food journal/food diary helps you stay on top of your diet. It’s an effective way to track your progress as well. 

If you prefer a physical journal, choose a notebook that will fit in your purse, pocket, or bag so you can take it with you at all times. You can also download free journaling apps on your phone. Any platform is fine. What’s important is you develop the habit of listing down every food and drink you consume daily.

A detailed food journal contains the following pieces of information (set different columns for each):

  • How much you eat - Record the amount of food and drink you consume every time. List the measure of your food and drinks in volume (e.g. 1 cup), weight (e.g. 2 ounces of water), or the number of items (e.g. 5 strawberries).

  • Nutrient content - Indicate the amount of sodium, phosphorus, potassium, protein, and other nutrients each food item contains.

  • The kid of food - You need to be as specific as possible when it comes to the type of food and drink you consume. That includes the extras, like the sauces, condiments, or toppings that come with your food. Also, list down the supplements you take.

  • Date and time - Log the specific date and time of day of your meals/snacks.

  • Place - If you eat at home, write down the room (e.g. dining room or kitchen). If you dine out, indicate the name of the restaurant.

  • Company - You also need to take note of the person or people whom you eat with (e.g. name of your spouse, brother, sister, son, daughter, or friend). If you live on your own, write “alone.”

  • Activity - Specify the activities you do as you eat your meals. This can be anything, like typing a document, watching TV, or conversing with someone.

  • Mood - Your mood can affect your diet and when you eat/drink. Pay attention to how you feel each time. Are you happy, sad, bored, or inspired? Write it down.

Your food journal should contain every last bit of food, drink, or vitamin supplement you feed your body. List down all the details as you go or right when you take them. 

During your regular checkups, share your journal with your nephrologist and your renal dietitian so they can review it. They will use the information as they plan for your further treatment.

How to Get Started with CKD-Friendly Plant-Based Diet

When switching to a new diet, every CKD patient has unique goals and individual pace. Some people can completely eliminate animal products from their diet. Others start with baby steps; they slowly introduce plant proteins one meal per day and build a momentum from there. Both actions are a step in the right direction!

How you proceed from here is entirely up to you. What’s important is you honor your pace with the help of your renal health team. The following are a few tips to get started with a kidney-friendly plant-based diet:

Start small. In the world of dieting, small, decisive, and consistent steps are better than an explosive one-off change. Begin with plant-based dishes that you love (just make sure these meals are approved by your dietitian) and rotate them throughout the week.

Consider the first few weeks as an adjustment period where you allow your tastebuds to get used to the taste of plant-based foods.

Minimize your intake of meat and processed food. Tweak the proportion of plant foods and animal foods on your plate. This way, you can give your mind and body the time to get accustomed to the new diet. 

Add a bowl of fresh fruit to every meal. When cooking your favorite meals, swap animal-sourced ingredients with plant-based substitutes (e.g. tofu/mushroom for meat, or quinoa/cauliflower for ground meat). 

Gradually introduce plant-based dishes to your meals. A few weeks into the diet, you can now take it up a notch. Commit to eating at least one plant-based meal per day. Start with breakfast. Then work your way up to your lunch, snacks, and dinner.

Be mindful of your protein intake. Every CKD patient has a different recommended daily protein intake. On average, non-dialysis CKD patients (stages 1-4 CKD) have a limit of 0.6-0.8 grams of protein per kilogram of body weight per day. But you need to consult your dietitian to know your exact protein limit. There are plenty of low-protein recipes you can try when on a plant-based diet.

Learn how to turn up your dishes. Don’t worry if you think you lack the crafty kitchen skills needed to make your meals more delicious and appetizing. Start with easier recipes. Then learn more ways to add more flavor to your recipes using the ingredients you’re allowed to eat. 

You can also explore more kidney-friendly recipes from food blogs. There are also support groups on social media where people with kidney disease band together to share new recipes, cooking tips, etc. 

Bottomline

Like any transitions in life, switching to a plant-based kidney friendly lifestyle takes time. It can take weeks, months, or years before you get fully adjusted to it. 

As you weather the changes, there will be days where you’ll slip or lack the motivation to go on. And that’s normal. Many well-meaning CKD patients experience the same. 

When such challenges come, stay kind and compassionate to yourself. Soldier on and try again the next day. Always stay true to your own pace and celebrate little wins along the way.

(Note: This article is inspired from RenalTracker’s 12-week course on chronic kidney disease dieting.

Sources:

Kidney Disease Friendly Cooking

https://www.kidney.org/patients/kidneykitchen/FriendlyCooking 


Grocery Shopping Guide: Information for Patients with Kidney Disease and Their Families

http://www.stmichaelshospital.com/pdf/programs/hemodialysis/grocery-shopping-guide.pdf

 

Everyday Eating: Tasty Recipes and Helpful Hints for Kidney Patients by Kidney Patients

https://www.guysandstthomas.nhs.uk/resources/patient-information/kidney/everyday-eating-recipe-book-for-kidney-patients.pdf


Nutrition: Keeping a Food Diary

https://familydoctor.org/nutrition-keeping-a-food-diary/