What's in That Lunchbox? Back-to-School Basics for Your Child with Kidney Disease and or Diabetes

August 12, 2014, 10:06am EDT

Most children tend to consume excess salt in their diets, since busy parents often rely on processed foods. According to the National Kidney Foundation, a daily limit of 2000-2500 mg of sodium, or one teaspoon is appropriate for most children with kidney disease or diabetes. High levels can make them more susceptible to high blood pressure, heart disease, strokes and possibly kidney disease later in life. This is especially true for those already living with chronic disease. Eating foods that contain potassium helps to balance the effect of salt in the body. However, when facing a potassium restriction which is the case for those with kidney failure, it is important to be knowledgeable of food content.

In surveys on children's packed lunches, it was found that 8 in 10 packed lunches included potato chips and other salty snacks. Sweets such as chocolate cookies or candy bars, cake or cereal bars represent 25%-35% of those surveyed. Habits and food choices begin in childhood and what children eat can make a big difference in their long-term health. This is especially important when preparing lunches for children with diabetes and kidney disease. Being familiar with your child's individual diet prescription and keeping in touch with your Registered Dietitian is important so you know which foods to avoid and which ones to limit to smaller portions.

A healthy lunch should do the following:

  • Help keep your child's attention span and learning on-track while serving to promote good behavior during afternoon hours.
  • Provide 1/3 of your child's daily requirements of nutrients.
  • Provide protein source to stay alert, complex carbohydrates for slow release energy, protein and calcium for growth, healthy fats for staying power and fresh fruits and vegetables as a source of vitamins and minerals.

The National Kidney Foundation offers the following Mix 'n Match Lunch Box choices:

Sandwiches Fruits & Vegetables Treats
Peanut Butter and Jelly Apple Homemade Trail Mix
Nut Butter and Banana Carrot sticks Low-fat Yogurt
Low-fat Cheese and Mustard Celery Sticks Homemade Cookies (1-2)
Low-fat Deli turkey and Tomato Clementine or Tangerine Air-Popped Popcorn
Tuna fish with Low-Fat Mayo Plum or Nectarine Homemade Whole Grain Muffin
Egg salad with Low-Fat Mayo Grapes Homemade brownie
Chicken Salad with Low-fat Mayo *Banana Lite pudding
Part-skim mozzarella cheese & whole grain crackers *Orange slices Whole grain cereal bar
*Designates foods high in potassium and some foods mentioned may be high in phosphorus as well. Please consult with your Registered Dietitian if you child has been given a special diet prescription.

Small additions to make life more interesting include:

  • string cheese, miniature cheese
  • twin cartons of cream cheese with miniature breadsticks
  • probiotic mini yogurt drinks
  • mini packs of dried fruit, nuts or raisins,
  • vegetable chips made from carrot, sweet potato, and beets.


Follow your carbohydrate-counting diabetic regimen if your child is diabetic. The three most common types of diabetic meal plans are constant carbohydrate, carbohydrate counting and the exchange meal plan.

Special thanks to Karen Dunker, RD for her contributions to this article.