How do you all get your calories on a low p... - Kidney Disease

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How do you all get your calories on a low protein diet?

Bananas2007 profile image
35 Replies

My husband is trying to eat as low protein as possible while still eating healthy and getting 2000 calories per day. He's only 142 pounds so he cannot afford to lose weight. We found on Kidney.org that is says to add syrup from canned fruit or to eat candy. We think that that is terrible advice. Anyone have any tips?

Thanks in advance!

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Bananas2007 profile image
Bananas2007
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35 Replies
jodaer profile image
jodaer

Have you thought about some of those liquid protein drinks that are for diabetics or elder or ill people. Like Boost or Glucerna? I don't know what is in them, if they are good for CKD but might be worth a try.

Bananas2007 profile image
Bananas2007 in reply to jodaer

Unfortunately those are too high in protein. We are looking for more natural, whole food options. Preferably non dairy.

Chimama profile image
Chimama in reply to Bananas2007

Some of them are high in potassium too I think

CKDnomore3953 profile image
CKDnomore3953

Hi Bananas 2007,I am also on a low protein whole foods plant based diet. I am Stage 3a CKD with eGFR of 50. I eat a lot of steamed vegetables - Broccoli, cauliflower, cabbage, carrots,onions, celery, sweet potatoes, snow peas, green beans, spinach, water chestnuts. I either eat the vegetables plain or cook them into a low sodium soup or vegetable stew. In the summer when it’s warm I make salads. In order to get a reasonable amount of daily protein I eat nuts, steamed quinoa or buckwheat and 1-2 egg whites each week. My potassium is always in the normal range on my blood tests so I can eat the vegetables that are higher in potassium than the low potassium vegetables.

I eat three servings of fresh fruit every day - berries, apples, pears, pineapple, peaches, cherries or occasionally a half banana, When I first started this diet I lost 15 pounds in the first three months, now my weight has stabilized and has been the same for for the last 6 months. I was worried that I would get too thin when I first started losing weight - but my body adjusted to the amount of calories I was eating. I use the Cronometer App to help make sure that I am getting adequate nutrients in the foods I eat.

I am lactose intolerant and gluten intolerant so I can’t eat dairy products or most grains. I did meet with several Registered Dietitans who helped me find a diet that would work with my specific health issues as well as reading many books on the best diets to slow down the progression of kidney disease.

Raw unsalted nuts are a high calorie source that are also high in nutrients and health benefits. The following nuts all have less than 200 mg potassium per one ounce serving: cashews, walnuts, pecans, hazelnuts, and macadamia nuts.

Your husband is blessed to have such a caring wife to help him on his health journey. I wish you both the best in finding what works for him to preserve his kidney function.

Bananas2007 profile image
Bananas2007 in reply to CKDnomore3953

Thanks for your reply. Mt question is, since you are eating so many vegetables, how are you able to eat that much volume? That would be an absolute ton of vegetables since they are so low in calories. I'm worried he will waste away. And I'm right there with him, on this new diet plan as well to show support.

CKDnomore3953 profile image
CKDnomore3953 in reply to Bananas2007

Hi Bananas,I usually eat 3-4 vegetables with quinoa at each meal with 1/4 of an avocado. In my first response I listed the various vegetables that I can eat. There are many vegetables that I can’t eat due to digestive intolerance - i.e. soy, solanans, beans, rice, and corn. My daily calorie count is around 1500, which is enough to maintain my current weight. I usually include a tablespoon of chia seeds or ground flax seeds on my bowl of cut up fruit, and I eat a serving of nuts at least once a day to bring my calorie total up to 1500.

Bassetmommer profile image
BassetmommerNKF Ambassador

Hi Bananas,Adding protein can be a challenge with plant based or low protein diets. I add flax seed to my oatmeal and sometimes other foods. Broccoli and some other veggies do have protein in them. Adding sugar to anyone's diet is a bad idea and the syrup and candy is a terrible source of fat and protein, empty calories and just garbage. Since his weight is not an issue, real peanut butter is a great addition. Not the processed stuff, but the kind where they actually take peanuts, or any nut for that fact and crush it into a butter. Add that to fruit and other things like oatmeal. Avocados are also a good fat source, if you like them. Oatmeal has some protein and is a great filler-up. Add fruit and other things, like a nut butter for flavor. Add olive oil and seasoning to veggies for some good fats. The higher the quality of the oil, the better. Eat fruit in its original wrappers, instead of processed fruit like canned fruit. Make a great crumble with apples, cinnamon, nut meg and oatmeal and some real butter. Do not use margarine. If you are not going plant based, adding cheese adds calories, protein, but watch the salt. A good go to is cream cheese. Eggs are a good source of a tolerated low protein food. An egg white omelet with some cheese and lots of veggies is a good meal. If salt it an issue, skip the cheese and add nutritional yeast. Adds cheese flavor, but high in potassium so use sparingly. Nutrional yeast is also good in soups and on veggies. I love the stuff but had to watch the potassium. Hope these ideas help.

orangecity41 profile image
orangecity41NKF Ambassador

I follow a prescribed CKD diet and weight has leveled off. My diet does include fruit. I have high potassium so am limited on some fruits. Here is a link to several articles on fruit and kidneys. kidney.org/search-results?s...

I feel for you, this was so challenging for me too. I wouldn't say I was a healthy weight, but I did my best to balance it all and I can give you a few tips to incorporate and maybe it can help. I tried to cut out protein everywhere else so I could eat mostly lean meats for my proteins. So instead of dairy yogurt, I bought the brand So Delicious coconut milk yogurt, even though it's coconut milk it has less that 1g potassium and no protein. Switch to rice milk, it has low potassium and no protein. At first it was weird but I got used to it and actually like it better now with cereal (I still used milk in cooking). I tried to use either no cheese or sour cream or just very little. I ate whole grain breads, nature's bakery fig bars, that's it bars, salads, roasted vegetables, unsalted tortilla chips (make nachos), I would add rice to chili to bulk it up without too much meat, I like grain or pasta salads (tabouli, couscous, Italian pasta salad). I would generally eat the same as my family but concentrate on the starch ie grain as the main portion. So for fajitas, I would put mostly rice and veggies on my tortilla, and just a small amount of meat. Soups are also great, there is more broth, pasta and veggies and a little meat. I hope this helps!

Marvin8 profile image
Marvin8

I feel for ya. I'm the same weight as your husband and find calorie consumption quite the challenge, especially given that I need to be on low oxalate diet due to previous kidney stones AND I work out a lot, including with moderate weights. It's really tough getting enough calories and protein to compensate for working out.

Confuseddiabetic profile image
Confuseddiabetic

My dietitian recommended Suplena. It’s expensive but I found regular Ensure has the same nutritional amounts. Higher in calories but only 9g of protein.

Bananas2007 profile image
Bananas2007 in reply to Confuseddiabetic

Unfortunately those 9 grams of protein would put him over for the day. He's really aiming for Whole foods as much as possible and it's been very very difficult.

Bananas2007 profile image
Bananas2007 in reply to Confuseddiabetic

I think I responded to your comments too quickly. I just went and looked up Suplena and omg that is over 400 calories but only 9 grams of protein! My husband is definitely intrigued. It's marketed for stage 3 or 4 and he's only stage 2. He's going to ask his doctor and maybe just buy them outright if he continues to have trouble reaching his nutritional goals. Thank you! 😊

horsie63 profile image
horsie63 in reply to Bananas2007

I looked it up also and omg the price. I could find anywhere what the potassium and sodium amounts were and those I have to watch along with protein.

NilsB profile image
NilsB

Have you looked into eating healthy fats? 2000 calories should not be hard to hit and eating fats may be (may) healthier than eating carbs.

Bananas2007 profile image
Bananas2007 in reply to NilsB

What he's having trouble with is getting too much protein throughout the day. He hasn't been to a renal dietitian yet but he has persistent proteinuria and he's trying to lower it naturally before his Nephrologist appointment at the end of this month. I will list his meal plan for the day:

Breakfast-

2 English Muffins

1 Granny Smith Apple

Earth Balanace vegan butter

Lunch-

Whole wheat bread

Peanut butter

Snack-

Honey Nut Cheerios

Baby Carrots

28 Oz gatorade (to help him meet his calorie goal)

Dinner-

4 Oz grilled salmon

Steamed broccoli

Whole wheat penne pasta

Great Northern Beans

Earth Balance vegan butter

One of the issues is, he was raised with southern cooking and if he didn't like something, his mom would cook him something separate. He regrets that now as he has trouble liking many vegetables. He's trying to change his palette but it's hard for him.

We are both in the process of giving up dairy. We read it's hard on the kidneys and I have sinus/migraine issues so we both think it can be beneficial. We also completely gave up any red meat or pork products. That was a while ago and the proteinuria just won't let up. Hopefully the Nephrologist will have answers to what's going on with his kidneys. Oddly enough, we were both overweight back in 2018 and changed our diets to clean eating almost overnight. That's when his problems become apparent so he's questioning if we changed our diets too drastically and somehow caused kidney damage...

NilsB profile image
NilsB in reply to Bananas2007

Thank you for the detail. Fat contains no protein and has a lot of calories. A keto diet can be high fat and low protein (though many incorrectly believe it is high protein by definition). You should consult with a specialist. Perhaps you can cut out the sugars and go more towards fat and fibre, using fat for energy and fibre to benefit the digestive system. Of course, if you are happy with the current diet and just want to increase calories, eating more fat is an option. There are several oils that are quite healthy.

Bananas2007 profile image
Bananas2007 in reply to NilsB

Thank you. We both are open to trying new things. He's already having trouble eating the apple in the morning because the 2 english Muffins fill him up. He's just trying to not lose weight while intaking low protein. I will look into my fatty foods. Do you have any recommendations?

NilsB profile image
NilsB in reply to Bananas2007

Well, you don't eat dairy, so cheese is out. Adding olive oil to salads might be a good idea. Butter might also be out if you don't take dairy, but perhaps coconut butter. Coconut water is also healthy, as are cod-liver oil and many other oils. He could just do a straight shot of extra virgin olive oil every day as well. I think you have to be creative based on your preferences. After all, food should be nice to eat too. Just on the run. Will see if ai can give better advice later.

Bananas2007 profile image
Bananas2007 in reply to NilsB

Thank you. He's going to ask his doctor if he can have those oils. We have to be careful since heart disease runs in his family. He has familial hypercholesterolemia.

How are his blood pressures and blood sugars? Often for proteinuria, they will put you on blood pressure medication, even if you don't have high blood pressure! Very low dose, but that can often control proteinuria. How much protein is he limiting himself to? Too much isn't good, but too little isn't good either. Most doctors I've found do not recommend severely limiting protein. What stage is he at? Make sure you have a written list of questions for the nephrologist - including asking for a referral to a dietitian who specializes in kidney disease.

You are a blessing to your husband - joining him on his health journey! That kind of support is priceless!

Bananas2007 profile image
Bananas2007 in reply to GoodHealthIsAJourney

According to his bloodwork, he's stage 2. His first Nephrologist appointment is coming up on the 22nd. He's had persistent proteinuria since last year, ironically it started right after I got over covid so we aren't sure if he had it asymptomatic and it did something to his kidneys or not...

He hasn't has a 24 hour urine test, just urinalysis tests and blood and protein come back in each one. More recently he had Glucose as well but he's not diabetic. His blood pressure is very good naturally. He does have high cholesterol but he's been on a statin for 15 years and for the past 5 or 6 years it's pretty low, total 128. Triglycerides are low as well, 39.

He's limiting his daily protein intake to 12 to 15% of his daily calorie consumption. Its been averaging roughly 66 grams a day.

We are just trying to stop the proteinuria since that's an indicator of how quickly your kidneys will decline and start dialysis. He's only 39 so we are praying to halt any kidney decline for a long long time.

Renal scan came back perfect. He does have low copper in his blood and he did do a 24 hour urine copper test and he's got slightly over the normal level in his urine. He doesn't have Wilson's Disease so we are thinking it's a part of his kidney disease.

GoodHealthIsAJourney profile image
GoodHealthIsAJourney in reply to Bananas2007

I'm glad you're being so proactive! The nephrologist will probably order a 24hr urine, which will give you a more accurate picture of the amount of protein he is spilling, as opposed to random spot urine tests.

If it were me, I would ask my primary if he still needs to be on a statin. His numbers are very low and he may not need them anymore. Especially with his change in diet, they could get too low (we need cholesterol for cell membranes and structures). I don't know his dosage, but high dose statins can cause proteinuria. Don't discontinue anything without discussing with his doctor.

Great news about the renal scan, glucose and blood pressure! Those are all positive things! Sometimes nephrologists will start you on a low dose (like 5mg) of an ACE or ARB (lisinopril or losartan, as examples), even if you don't have high blood pressure. It can often stop the protein spillage.

Please keep us updated - I'll be praying for both of you!

Bananas2007 profile image
Bananas2007 in reply to GoodHealthIsAJourney

His cholesterol is genetic unfortunately. It was in the high 300's without a statin. He's on 40 mg of Crestor for his statin.

Bananas2007 profile image
Bananas2007 in reply to GoodHealthIsAJourney

So we both did research on his statin last night and 40 mg is considered high dose. Now we are wondering why his doctor never said anything, especially when he seen his test come back for his kidneys. Do you have any experience with statins causing kidney damage? If so, I wonder if the proteinuria would go away if he went off of his statin 🤔...

Of course he will never be able to completely go off it unless they come up with a new drug. He has familial hypercholesterolemia.

GoodHealthIsAJourney profile image
GoodHealthIsAJourney in reply to Bananas2007

I don't have personal experience, so can't tell you if it will return to normal if he reduces his dosage or discontinues it. But I would have a frank discussion with my doctor as to why he has me on such a high dosage when my cholesterol is 128 - well below normal! Too low is just as bad as too high. If you're not happy with his answer, I would look around for another doctor.

While I have to believe that most doctors are well meaning, they can't possibly keep up with all the research and new studies, and they often don't tell us about issues when we would have time to fix them. If you've been around this forum for a bit, you've probably seen story after story of people upset that their doctor never told them when their eGFR was declining until they were at stage 3 or below!

Bananas2007 profile image
Bananas2007 in reply to GoodHealthIsAJourney

Thank you so much for your kind reply. I can't tell you how much it means to us that there are people out there in similar situations and who care. My husband sent his GP a note on his MyChart with two links to studies on Crestor and Proteinuria. We are waiting for a reply. Me and my husband have talked about it and if his Nephrologist orders a biopsy, my husband will push the neph to look into taking him off of his statin to see what happens first. (That's if his GP doesn't do it first.)

We may have to get a heart doctor or a genetic counselor involved too. See my husband has familial hypercholesterolemia but has never had a dna test to prove it. We know because his father had it but it was a more severe form. We are thinking his father had the genes from each parent. He also has two cousins who've been on a statin since they were 14 years old. My husband's cholesterol was in the high 300's with his first ever lipid panel when we was in his early 20's. Back then, he was only 125 pounds so the doctor put him on Zocor. Well that stopped working about 5 or 6 years later.

Looking back, that's when my husband and I both started gaining weight. His doctor told him that it cannot be controlled by losing weight. Well, with the new prescription of Crestor, it was in the 160's and 150's until 2018 when he lost 36 pounds. That is when his cholesterol started dropping.

So we did some research and apparently there's 5 types of familial hypercholesterolemia and now we are both wanting to know exactly which type he has so we can possibly explore different treatment options other than a statin. Apparently, his cholesterol does go down with weight loss and eating less meat as we've got proof in the lab work.

Thanks again! 😊

GoodHealthIsAJourney profile image
GoodHealthIsAJourney in reply to Bananas2007

I'm so happy you're being so proactive in his care! It sounds like you both have a great plan. One last word ... even if everything returns to normal and he does not have CKD (that's what I'm praying for!), consider this a very early warning to make small lifestyle changes now that will prevent problems in the future. So many of us think, "if I had only known!". Now you do! 😉

horsie63 profile image
horsie63 in reply to Bananas2007

I too have familial high cholesterol. I can not take statins as they cause excruciating daily migraines so my neph put me on Zetia which seems to be working for me. I'm small at 4'9" and 93 lbs and I'm having issues with gaining enough weight/stopping losing any on a mostly plant based diet. It's a struggle every day to get in enough calories. I've ordered some of the unsalted organic walnuts and macadamia nuts to see if that helps. Watching sodium, potassium, eating lower protein (not cutting it all out) with my picky eating is challenging. The dietician I saw was less than useful. So I pick and chose those foods I like that fall into the "good" category.

RoxanneKidney profile image
RoxanneKidney

Carbs. Rice. Beans.

chicablue profile image
chicablue

Just one comment after reading other replies: My Neph told me never to eat any nuts because of the acid content.

Confuseddiabetic profile image
Confuseddiabetic

Ensure or other generic supplements also only have 9g of protein but less calories. Good luck, you got some great suggestions from others.

whats profile image
whats

Nuts, whatever he likes, or more nut butters. They are high calorie, not very high in protein and seem to be a longevity food, as the healthiest people (research says) eat some every day. Research also says plant based protein is less harmful to kidney function than animal protein. More bread? Tofu is the most "complete" plant protein, if he doesn't hate it. You are kind to be so involved.

Bananas2007 profile image
Bananas2007 in reply to whats

Thanks! We will look into different types of nut butters.

whats profile image
whats

I also changed my diet overnight when I found out I had kidney problems. My eGFR has mostly gone up, which means kidneys are less stressed. I doubt he'll find much support for the theory that suddenly changing to a healthy diet is bad for kidneys and plenty of support for the opposite.

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