Ask the Doctor
Questions about kidney disease? Risk factors? Signs and symptoms? Are you concerned about yourself, a friend or family member? Ask Dr. Spry.
Dining out can be enjoyable even when you must follow a special diet. You simply need to choose your foods more carefully. Before eating out, it is important to understand your diet. If you have any questions, discuss them with your dietitian.
Always try to follow your diet as closely as possible. Plan ahead. Ask your dietitian for advice before you attend a special social function where food will be served.
When dining out, choosing the restaurant is critical. You may want to phone ahead to ask some questions about the menu. Restaurants that serve a wide variety of foods make eating out easier.
When you arrive, study the menu while waiting to be seated. Before ordering, ask your waitress/waiter questions to get more specific information about menu items. In this health and nutrition conscious age, restaurant personnel are accustomed to special requests for food items or preparation.
If you find yourself at a restaurant where few food choices are available, order as carefully as possible. The following guidelines will help you with your decisions.
The key to successful dining out in an American restaurant is watching portion size and limiting your selection of certain items. See sections on "Protein Control When Dining Out" and "A Menu Guide. "
Mexican foods frequently contain low quality protein and are high in sodium, potassium and phosphorus. It might be helpful to order from the a la carte menu. A good food choice would be a taco with meat and lettuce and plain rice.
Typically, Italian sauces should be used in small quantities because they can be high in sodium, phosphorus and potassium. Order the sauce on the side, if possible, but be advised that many Italian restaurants already have their sauce and pastas mixed. A good choice would be salad, bread and a very plain pasta, such as garlic and butter. Pizza is usually salty and high in potassium and phosphorus. If you eat pizza, eat one slice and supplement with a small salad. A pizza with hamburger, green pepper and/or onions would be preferable to a pizza with pepperoni, sausage, olives, anchovies and/or extra cheese.
Asian dishes usually consist of meat, fish or poultry combined with fresh vegetables. This can make them high in potassium. Ask for your food to be cooked to order so that it may be prepared without soy sauce, fish sauce or monosodium glutamate (MSG), all of which contain a lot of sodium. Order plain rice; it is lower in sodium than fried rice. Do not add soy sauce to prepared Chinese or Japanese food.
Eating at fast-food restaurants is not totally out of the question. It does, however, take some thought. While many fast-food items are presalted, you can ask that yours have the salt and/or extra condiments left off. This may take a few extra minutes of waiting time. French fries are high in potassium. You must know how much potassium you are allowed if you choose this item. Unsalted onion rings would be a better choice. Choose a small noncola soda rather than a milk shake or large soda. Many fast-food restaurants now have salad bars as an alternative. See section on Salads/Salad Bars.
Protein control is a key factor when trying to stay within dietary protein limits. Become familiar with different meat portions by practicing weighing them at home. You may want to request half portions of meat dishes, share a part of your large portion with a dining companion, order a child's portion or ask for a 'doggie bag. " Watch starch and vegetable portions - they have some protein too!
Another good way to control protein is by ordering a la carte. You may choose to make your meal from several appetizers instead of the typical "complete" dinner menu offerings.
Avoid "hidden" proteins such as cheese or cream sauces, au gratin dishes, dishes prepared with milk, nuts, dried beans or eggs.
Breakfast may be one of the easiest meals to eat out. Most restaurants offer a la carte style breakfast items.
Cocktails and Beverages
When dining away from home, it is important to limit fluids. Many beverages you choose when eating out may have high potassium and/or phosphorus content. This is especially important since the meal itself probably has a higher content of these minerals than the meals you have at home. Request lemon wedges or crushed ice if you remain thirsty and ask the waiter not to refill your water glass. After the meal, chew gum or suck on hard candies to avoid drinking too much fluid. Have the waiter remove your water glass to avoid the temptation.
It is probably best to skip this course unless you are going to use it as a substitute for an entree item. Evaluate the protein content of the remainder of the meal before you select high-protein appetizers like cottage cheese or seafood cocktail.
Eating salads and selecting from salad bars IS possible once you understand your diet. In fact, salads can be an excellent way to obtain sources of vitamins and fiber as well as adding color and variety to your meal. Small tossed salads are generally a good choice. Ask for the dressing on the side and use it sparingly. Remember you can bring your own low-sodium dressing. You may want to mix your own dressing at the restaurant by combining vinegar and oil (usual ratio 3:1) or mix lemon with black pepper.
Most entrees are prepared with salt. Ask that yours be prepared without salt or other salted seasonings. Ask that sauces and gravies be served on the side instead of over foods so that you can use them sparingly. Remove skin or crust from breaded items to reduce sodium intake.
The kind of side dish you order depends on the amount of potassium you should eat each day. Fried, baked and hash-browned potatoes are higher in potassium than mashed or boiled potatoes. You might also consider asking for a lower potassium substitute like rice or noodles. If the cooked vegetable is not a good choice for you, order a salad or ask for a substitute vegetable.
Since many of you are probably being advised to add calories to your diet, the dessert course is a good time to treat yourself to something special. Remember, some desserts, such as fruit ice, gelatin and sherbet must be counted as fluids. If you have diabetes, check with your dietitians about which desserts you should choose.
Eating out is a great way to take a break from cooking. It should not be used as an excuse for skipping your phosphate binders, however. To achieve good control of your phosphorus level, which is so important for maintaining healthy bones, you need to take your phosphate binder each time you eat. With a little planning, this doesn't have to be a problem.
Plan to take your medication with you. For women carrying a large purse, this may be as easy as dropping the bottle into your purse. However, more than likely, you will prefer to take along a small container with just the pills you need. A variety of pill boxes are available that slip easily into a pocket or small purse. If you are taking a liquid phosphate binder that might be difficult to carry, ask your doctor about prescribing a 'pill' form to take with you when going out to eat.
When you are away from home or are not following your usual routine, it is easier to forget to take your phosphate binder even if you bring it with you. This problem can also be overcome with a little planning. It may be helpful to make a habit of putting your pills at your place when you sit down for a meal. You may also want to ask a companion to help you remember. A pill box with an alarm is another solution. Simply set the alarm for the time you plan to eat. Place your medication in your wallet - you will see it when you pay for your meal.
If you would like more information, please contact us.
©2014 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.