Dining out can be a challenge while on dialysis, but there are steps you can take to do it with confidence:
– Plan ahead
– High protein
– Watch salt (sodium), potassium, fluid, and phosphorus
– Smaller portion sizes
– Talk with your dietitian before you go out for more advice
Plan ahead
Follow your diet extra closely before and after dining out. This may include following an extra low salt, potassium, and phosphorus and less fluid intake. Choose a restaurant where you can ask for your food to be made without added salt and where they have freshly cooked options.
High protein
Both animal proteins and plant-based proteins are helpful to maintain muscle mass. It also helps fight infections and maintains healthy protein levels (albumin) in your blood. You need albumin in your blood to lower your chances of holding on to extra fluid.
Here are some ways to increase protein when dining out:
– Prefer to have boiled, non-fried, non-spicy preparations of lean meat (like Chicken, fish, egg.
– Include plant-based protein options like soya products and freshly-made paneer preparations, variety of dals (ask if any preservatives have been added, as these may increase the phosphorus and sodium content).
Watch salt (sodium), potassium, phosphorus, and fluid intake
Ask for preparation with low salt, no preservatives
Avoid accompaniments like pickles, Papads, Podi and chutneys.
Salt
Salt can raise your blood pressure and also make you thirsty. Most restaurants add a lot of salt to their foods, especially fast-food ones. Here are some tips to help cut back on salt:
– Ask for your food to be made without added salt
– When possible, choose freshly prepared foods
– Avoid salty items like soy sauce, French fries (also high in potassium), and macaroni and cheese. Instead, order vegetables like carrots, green beans, or corn.
Phosphorus
Phosphorus is a mineral found in foods like proteins, milk, cheese, fast foods, and packaged foods. Limiting phosphorus can help to protect your bones and keep them strong. Here’s how:
– Choose freshly cooked foods whenever possible and skip the cheese.
– Remember to take your phosphorus binders with you and take them during your meal.
Potassium
Potassium is a mineral found in many foods, and it helps your heartbeat regular and your muscles work right. If the kidneys aren’t healthy, you may need to limit foods that can increase blood potassium levels to unsafe levels. Try:
– Avoiding tomato sauces and tomato juice, tropical fruits including bananas, melons, and orange juice, potatoes (white and sweet)
– Instruct to avoid sesame seeds, poppy seeds, coconut, groundnut and cashew in gravies. And no garnishing with coriander and mint leaves.
Fluids
It’s important to limit what you drink if your dialysis team has told you to follow fluid restrictions. Consider the amount of fluid you already had during the day and how much you will want to have after your meal. Choose for vanilla milkshake, cold coffee, strawberry smoothie or apple milkshake/smoothie. One glass of liquid should be okay, but remember to also count the following as part of your daily fluid intake:
– Soup
– Ice-cream
– Gelatin
Smaller portion sizes
Many portion sizes are too large. To avoid overeating, you can:
– Avoid the trap of “super-sized” portions, and order only what you need to enjoy your meal
– Ask for a to-go box when your food arrives and put half of your main dish in the box before you even start to eat. This may help control potassium, phosphorus, salt, and calories, depending on the types of food ordered
Talk with your dietitian
Every patient has different nutritional needs, so speak with your dialysis dietitian. They will help you plan and stick to your diet.
Written by
Shruti Sharma
Executive Dietician