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Combining Renal & Diabetic Diets

Combining Renal & Diabetic Diets. Emily Cannon RD , CDE. What is the Need?. According to NIDDK, 44% of kidney failure is caused by DM National Kidney Foundation states that 1/3 of people with diabetes will get chronic kidney disease Who do you know that teaches both diets together well?.

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Combining Renal & Diabetic Diets

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  1. Combining Renal & Diabetic Diets Emily Cannon RD, CDE

  2. What is the Need? • According to NIDDK, 44% of kidney failure is caused by DM • National Kidney Foundation states that 1/3 of people with diabetes will get chronic kidney disease • Who do you know that teaches both diets together well?

  3. My Goals for Today • Help all disciplines understand the basic dietary restrictions involved in Renal and Diabetic diets • Help RDs learn to teach the combination diet more simply and effectively to their patients

  4. Whose Job is it? • A. The dialysis RD • B. The CDE • C. The RN • D. The patient • E. Any RD that sees the patient

  5. Medical Nutrition Therapy • Medical Nutrition Therapy is defined as: nutritional diagnostic, therapy, and counseling services for the purpose of disease management which are furnished by a registered dietitian or licensed nutrition professional

  6. Why is it So Hard? • Specialty practitioners focus only on specialty • Restrictions seems to conflict • Complicated recommendations • Limited good resources • Limited time • Less educated or motivated patients

  7. RenalDietary Recommendations • Restrict Protein • Limit Sodium • Limit Potassium • Limit Phosphorus • Fluid Restriction • Extra Fat and Sugar for calories

  8. Translated into Foods • Restrict Protein • Limit Sodium • Limit Potassium • Limit Phosphorus • Fluid Restriction • Extra Fat and Sugar for calories Less meat/cheese/fish/eggs No salty snacks Less boxed/canned foods Limited fruits/veggie choices No whole grains-only white Limited milk/yogurt No cola drinks or beans Limited beverages Extra butter, oil, dressings sugar, candy, desserts

  9. Diabetes Dietary Recs • Smaller, consistent meals • Controlled carbohydrate amounts • Limited simple sugars • Low fat choices • More produce and whole grains

  10. Translating into Food • Smaller, consistent meals • Controlled carbohydrate amounts • Limited simple sugars • Low fat choices • More produce and whole grains Limited amounts of Starch/Fruit/Milk at meals Only small desserts/candy Avoid drinks with sugar Choose lean beef, poultry, fish, Low fat milk, yogurt and cheese Limited oils/dressings/butter More whole fruits/vegetables Whole grain bread/crackers Choose beans/starchy vegetables

  11. Compare the Recommendations RENAL Less meat/cheese/fish/eggs No salty snacks, boxed, or canned food Limited fruits/veggie choices No whole grains-only white Only 1 milk or yogurt per day No cola drinks or beans Limited beverages Extra butter, oil, dressings sugar, candy, desserts DIABETES Choose lean beef, poultry, fish, More whole fruits/vegetables Whole grain bread/crackers Limited amounts of starch/fruit/milk at meals Low fat milk, yogurt and cheese Choose beans/starchy vegetables Limited extra oils/dressings/butter Only small desserts/candy Avoid drinks with sugar

  12. Sample Menu Lunch 1 hamburger bun 2 oz hamburger patty 1/2 C mushrooms ½ C potato salad 1 whole tomato 1 dill pickle ketchup and mustard Dinner 3 oz pork chop 1 sweet potato 1 dinner roll 1/2 C unsweet. applesauce 1 C cooked spinach 2 TBSP low fat margarine Breakfast 1 scrambled egg 2 sl. whole wheat toast 1/2 banana 1 C skim milk

  13. Sample Menu Lunch 1 hamburger bun 2 oz hamburger patty 1/2 C mushrooms ½ C potato salad 1 whole tomato 1 dill pickle ketchup and mustard Dinner 3 oz pork chop 1 sweet potato 1 dinner roll 1/2 C unsweet. applesauce 1 C cooked spinach 2 TBSP lowfat margarine Breakfast 1 scrambled egg 2 sl. whole wheattoast 1/2 banana 1 C skimmilk

  14. Sample Menu Lunch 1 hamburger bun 2 oz hamburger patty 1/2 C mushrooms 1/3 C pasta salad 1 cucumber with vinegar mayo and mustard Dinner 3 oz pork chop 2/3 C rice 1 dinner roll 1/2 C unsweet. applesauce 1 C cooked green beans 2 TBSP margarine Breakfast 1 scrambled egg 2 sl. whitetoast 1 C berries 1 C 2%milk

  15. How to Simplify • Combine lists for them • Use only 1 method of meal planning • Exchanges, plate method, pick from simple lists, etc. • Focus on those foods with lowest sources of offending nutrients

  16. How to Simplify • Make sure you aren’t over-restricting for patient needs • Focus on foods patient eats and enjoys • Focus on what they can eat, rather than what they can’t eat

  17. Special Issues • Food Group Inconsistency • Uncontrolled Blood Glucoses (thirsty) • Starfruit • Malnourished patients • Salt Substitutes (K) • Obesity

  18. Other Resources • www.AAKP.org “How Can I Follow My Diabetic and Renal Diet Restrictions?” article • www.foodfitnessfirst.com “Renal Diabetic Diet Plan” (has picture versions of the lists for less literate) • American Dietetic Association (Nutrition Care Manual) for CKD Nutrition Therapy • www.kidneyschool.org (patient learning modules)

  19. Questions?

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