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Wednesday, 2 January 2013

Eating with kidney disease at Christmas


Marsha N. Woolery, Healthy Eating & Diet

The Christmas feast is most feared by persons on a special diet, their family members, and members of the health-care team.
Hospital admission rate usually increases because persons with diseases that require them to make certain dietary changes either lack knowledge, have misleading information or just can't be bothered. They devour whatever is prepared and available; whether or not it is suited for their condition.
In Jamaica, kidney disease is on the rise and many such persons are not sure of what to eat. Persons with chronic or end-stage kidney disease are usually on a low-sodium, low-potassium diet with fluid restrictions in addition to modified protein (higher or lower than normal depending on the amount of kidney damage).
It is recommended that processed foods such as ham, smoked chicken or turkey, sausages, canned meats/fish or vegetables, ice cream, salted fish/ mackerel/ pig's tail/ beef, soy sauce and ketchup be avoided because sodium is used as a, preservative to process these foods.
Avoid papaya, coconut water
Staples such as brown rice, unrefined cornmeal, plantain, breadfruit, wholewheat flour and its products, cassava, yam, banana and potatoes are not recommended. Fruits to avoid include papaya, coconut water and jelly, sweetsop, soursop, custard apple, ripe banana, guava, pomegranate, dried fruits (raisins, prunes, currants, mixed peel, mixed fruit, cherries) because they are high in potassium.
Vegetables such as callaloo, pumpkin, spinach, mustard greens, mushroom, beetroot, and canned mixed vegetables should be avoided because of their high potassium content. All peas, beans and nuts such as peanuts, cashews, almonds, nut butters, gungo, rice/Christmas peas, red peas, broad beans, soy beans and soy products are high in potassium and should be avoided. Fatty foods such as ackee, avocado, ham fat, bacon (pork, turkey or meatless/vegetarian) and salted butter and salted margarine should be avoided because of their high potassium and/or sodium content.
Salt, powdered seasoning containing salt, soy sauce, ketchup are high in sodium and should also be avoided. Ginger, coconut milk (water and jelly) and salt substitutes should also be avoided because they are high in potassium.
So, in the festive season, what dishes should be avoided by or modified for persons with kidney disease? Ham, rice and gungo/any peas, soup, ackee and salted fish/mackerel, salt pork/beef, sorrel with ginger, soursop juice, egg nog, fruitcake/pudding/any cake at all, fried dumpling/festival, wine, alcoholic beverages, tofu and foods containing coconut milk.
Eat unprocessed meats
Instead, eat fresh unprocessed meats such as chicken, goat, fish, turkey, pork and lamb. Eat white rice with variations such as adding herbs, curry powder and prepare without coconut milk. Consume vegetables such as cucumber, raw cabbage, lettuce, pak choi, string beans, okra and sweet pepper.
Eat fruits such as tangerine and watermelon; drink cranberry juice, grape juice, and sorrel (without ginger); and eat staple foods such as white rice, white flour and its products (bread, crackers, macaroni), white sugar/honey, old fashioned/rolled oats, refined cornmeal and leached yam, green banana, breadfruit, Irish potatoes. Leaching is the soaking of ground provisions and tubers in large amounts of fresh water, which is poured off about four times over an eight-to-12-hour period. This process reduces the amount of potassium in these foods.
Use natural seasonings
Use natural seasonings such as onion, scallion, garlic, thyme, pimento, pepper, lime/lemon, and fresh vegetables instead of salt, powdered seasonings, soy sauce and ketchup. White/granulated sugar or honey should be used to sweeten instead of brown sugar, molasses and wet sugar.
Enjoy healthy eating with or without kidney disease this Christmas, and may you have a prosperous New Year!
Marsha N. Woolery is a registered dietitian/nutritionist in private practice and adjunct lecturer at Northern Caribbean University; email: yourhealth@gleanerjm.com.