I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Diet and Recipes => Topic started by: kickingandscreaming on December 26, 2015, 12:08:42 PM
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I am a former vegetarian, now pushing animal protein to keep my albumin up. But my phosphorous is running high and I really can't afford enough phosph binders to cover the amount I take in. I know there are assistance programs, but I don't qualify for most and I am now in Medicare's donut hole so the copays are pretty high. I can't do Tums anymore as my calcium also runs high.
I'm looking for ways to get enough protein (preferably with some pleasure value remaining) without incurring a huge phosphorus load. For breakfast I have a 3-egg omelet with only one egg yolk, but lunch involves a turkey sandwich or similar and dinner is a hunk of meat and a salad or other vegetable. i have one fruit/day (I'm a diet-controlled diabetic and hope to stay that way with a low-carb diet). But the protein/phosphorus business is driving me nuts.
Any good suggestions?n Thanks.
'
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The only advise I can is to be carefull about the meats you buy. Target sells great steaks but they put phosphorus in them as a preservative. Read the labels on every thing, there is a good web site called food facts.com check every thing.sorry about donut hole it sucks.check web site goodrx.com it may be possible to buy other mend almost as cheaply and save your Medicare drugs for renvella and Sensipar.
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I only eat organic or pastured meat and wild fish and organic local eggs. The turkey breast I get for sandwiches is just turkey from a real bird that was cooked at Whole Foods without anything added, not even salt. I am very careful about NOT eating foods that are a product of our industrialized profit-driven food system. I no longer trust that anyone is looking out for our well-being. Call me cynical, but I am being proven right as time goes by. Most of my budget goes for good food. I don't have a lot of money, but that's one of the ways I spend it. Don't buy clothes, don't eat out, don't go to movies, but I don't skimp on quality food. Unfortunately, even good, high quality food is laden with substances that are now off limits.
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The nephrologist told me that fish is a healthy source of protein and that kidney patients can eat unlimited amount.
Other source of protein such pork and beef are too harsh on our kidney. Chicken is a little mild he said.
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Although fish and poultry are more renal friendly than red meats , you still have to eat fish in moderation I'm afraid.
:angel;
Luck and love, Cas
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Red meats get a bad rap. I don't know that they are any less "renal friendly" than any other meat. I do think it's important to get red meat that isn't a product of our industrialized farming system where the animals are fed crap and are treated inhumanely (which contributes to their stress and toxin level). Same goes for chickens who are treated just as badly or even worse in terms of poor farming practices Same is true for farmed fish. The source of the meat is pretty much everything.
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I had asked my Nitritionist not long ago almost this very question. What food, plant based could I add to replace some of the meat protein in my diet.
Quinoa. I looked and finally found it at Wal-Mart. But it costs. A little foil bag, flavored is $2.49 and equals two servings. It was also available in a larger size for $8 something, plain.
The 'Garden Vegetable' mixture didn't taste bad, but I thought it would be better added to 'other' dishes. Sort of a filler if added to a real vegetable soup. The grain is quite small even after soaking, cooking and absorbing all the water for the measured amount.
Since I don't have teeth, I wasn't able to crush the cooked grain so I can't say whether it has a different internal taste or not.
As a side dish I wouldn't eat it too often. Added into other dishes it would be any problem to eat many times each week. If I were to cook a quantity and kept it in the refrigerator, I could add a tablespoon to a lot of things. From sprinkled over a salad, stirred into a bowl of most any cereal, soup or stew. Even added into many vegetables. All would help you get more protein into your diet.
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If I'm eating eggs, I try to double up my protein by adding a little meat in to the dish as well. Omelets, scrambled egg burritos, poached eggs on top of leftover protein.... I'm trying to figure a good quiche recipe that is easier on the dairy...
My nurses also gave me a bottle of this (nasty tasting) goo that is high in protein. Once I get home, I'll edit the name in here... Don't remember offhand.
Edit: Liquicel. it's gross tasting, but it does the trick. We also are given Bodyquest 'Icecream" which is much better tasting but slightly higher in the sugar and other stuff.
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Hi kicking and screaming what is your daily protein goals
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I don't actually have a protein goal except to score well on my albumin test. So far I have. Since I have started PD and stopped going to the dialysis center, I have stopped eating lunch. I have my mainly egg white omelette (3 whites and 1 yolk and a bit of cream cheese) and I have dinner that includes 4 or 5 oz. of some meat or fish.
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My albumin levels improved with less protein intake also since I switched from in-center to home hemo with nxstage. It does not sound like you are consuming too much phosphorus loaded meals. If it is still high I had seen studies indicating niacin as a phosphorus binder. Here is one of them. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459519/
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http://www.llorenspharm.com/proteinex/proteinex_chewable_tablets.html (http://www.llorenspharm.com/proteinex/proteinex_chewable_tablets.html)
Proteinex Chewable Tablets provide healthy protein and a full compliment of vitamins.
These work Maggie's been taking them for 9 years. Albumin runs 4.6 steady taking 6 per day was 9 to rise the albumin. Back when she took 9 they did not have vitamins added.
No Phos
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Just the other day I ran across a pdf listing the amount of phosphorous in various foods. It is quite a list and I was surprised that Google found this on a Veterans Administration site. Sorry, I save it on my Desktop machine and not this laptop so I cannot attach it here but will repost later from that room.
I have to admit that I like pork, the 'other' white meat. Our local Kroger grocery often has pork loin at a very reasonable price, far less then lean hamberger. The other day they had pork shoulder roasts on sale. Way to big for just the two of us, but I got one anyway. One has to be careful roasting or baking large pieces of pork as the meat is lean enough it will dry out if not careful to seal it completely in heavy foil with just enough vegetable, like carrots, to keep it well moistened. I usually bake it far pat well ldone to further ensure even more fat has melted out and the meat be literally fallilng apart done. Once cooled it is solid enough I can slice it to desired thinnes for sandwiches.
Granted pork is listed as having an amount of phosphorous but you wouldn't know it by my labs.
I'll have to remember to repost that pdf in an hour or so when I get in there.
Take Care,
Charlie B53
EDIT: Capped off from my Cycler and ran in here least I forget. Now hope I figure out how to attach this as this is my first attachment.
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Quinoa. I looked and finally found it at Wal-Mart. But it costs. A little foil bag, flavored is $2.49 and equals two servings. It was also available in a larger size for $8 something, plain..
Quinoa is a more expensive grain, and like most grains its lowest cost when you by it plain without value added flavors. I'd also worry that flavored versions have stuff like sodium and phosphorus in it. You might find lower cost Quinoa at health food stores in bulk. Also we have bought it a Costco but it was mixed with rice.
At whole foods today quinoa in the bulk bins was $5.50/lb except some colored version was $6.50.
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My doctor just recommended protein bars which have 25 milligrams of protein. It's hard to eat enough meat to make up 25 mgs of protein. But she said to look for plant based bars, not whey or soy based bars. I know that Costco and Trader Joes have a huge assortment of protein bars. But I'm not sure what the phosphorus content is in the bars. Would be good to know. Hopefully less phosphorus in the plant based protein bars.
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I find it hard to eat a protein bar every day. The ones on the market from Costco, trader joes......all tend to be too sweet for my taste. Plant based ones that have nuts, seeds , grains will have phosphorus. How high depends on the ingredients, so you'll want to check the labels or call the manufacturer once you find a bar with ingredients that you think you'll like. A complete amino acid supplement wit zero phosphorus like the one Maggie and Jeff mention before is a great idea and easier to stick to on a daily basis. I did that when I was in predialysis and was completely vegan.
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http://www.llorenspharm.com/proteinex/proteinex_chewable_tablets.html
Proteinex Chewable Tablets provide healthy protein and a full compliment of vitamins.
These work Maggie's been taking them for 9 years. Albumin runs 4.6 steady taking 6 per day was 9 to rise the albumin. Back when she took 9 they did not have vitamins added.
No Phos
Proteinex sounds interesting, but I wish it didn't contain propyiene glycol (anti-freeze). Also, 1 gram of protein isn't much. Just 3 oz. of chicken contains a ton of protein. (and phosp) You don't have to eat much.
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I had seen studies indicating niacin as a phosphorus binder. Here is one of them. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459519/
This is fascinating. Thank you. I will read more of them. It figures that such studies would come from other countries. There is no money to be made on niacin, and the Big Pharma lobby would pretty much poo poo such a thing-- unless they could find a way to patent it and make a fortune. Very sad medical system we in the U.S. have.
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That really is an interesting report. I'll try to inform a Neph here (UK) and ask if they have tried it, or are willing to try.
Kickingandscreaming I'm afraid I haven't found a 'non sad' medical system yet. Well, for the patients that is.
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Kickingandscreaming I'm afraid I haven't found a 'non sad' medical system yet. Well, for the patients that is.
Well, that is very sad indeed. It would be interesting for someone to study the various ways in which the world's medical systems suck. I guess there's nowhere to run to, as the song says.
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http://www.llorenspharm.com/proteinex/proteinex_chewable_tablets.html
Proteinex Chewable Tablets provide healthy protein and a full compliment of vitamins.
These work Maggie's been taking them for 9 years. Albumin runs 4.6 steady taking 6 per day was 9 to rise the albumin. Back when she took 9 they did not have vitamins added.
No Phos
Proteinex sounds interesting, but I wish it didn't contain propylene glycol (anti-freeze). Also, 1 gram of protein isn't much. Just 3 oz. of chicken contains a ton of protein. (and phosp) You don't have to eat much.
The propylene glycol is not listed on the bottle I just looked. I see it on line though.
The 6 grams of protein may not seem like much but it is in a very absorbable.
They were better before they added the vitamins Maggie took 9 per day for a year or more. Now she takes 6 per day.
We could not find anything else that Maggie could stomach daily.
The lack of phos is a big plus.
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The VA Hosp Dr's have had me taking Niacin for years to help reduce my cholesterol. At first I was fine with it but as they increased the daily dosage I became 'sensitized' and began flushing. Like a whole body sunburn within minutes of taking a dose. I really do not remember what that dose level was, but ended up stopping for months then restarted at 250 twice a day, and I STILL flushed. Began taking one standard aspirin 325's alone with the niacin and no more flushing.
Fast forward twenty years, the aspirin caused massive bruising at seemingly the slightest bump or rub up against anything. My skin became so fragile it would split or tear open, bleeding for a long time before finally clotting off. My dog constantly wants attention, takes his paw and grabs at my arms, leaving long 'lines' of like blood blister if I am lucky, otherwise I bleed as if sliced open with a knife tho it is but a thin scratch.
Just a few months ago I had a talk with my Primary Dr as I was seriously worried about bleeding out if ever seriously injured. She agreed I should stop the Niacin, and the aspirin.
My arms are almost normal again. And now learning this I may have to seriously think about trying Niacin again, only at even smaller dose. But have to wonder if it is worth it in my case as I see in this study the mean dose was increased until they were taking 750 daily. I can't take that much without severe flushing. And I am NOT going to start taking aspirin like that again. The current 5MG bay aspirin is all the cardio people say I need.
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they do make niacin without flush. You can google or check amazon for No FLush Niacin. There is also time release niacin which release withing 7-8 hours. Niciniamide does not cause flushing, if Im not mistaken, but not sure if its affect on cholestrol. As a phosphorus binder their has been research studies documenting its phosphorus binding capacity.
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If anyone does decide to to ask their Dr. about proteinex tablets a OTC protein pill.
There is a prescription drug "protonics" the Dr. will likely think that is what your taking about. And no protonics will not help your protein.
Best way to ask is to take a print out of what proteinex is so there is no confusion.
Just a little FYI.
I know 6 gram of protein seems like not enough but read about "absorption of protein".
The proteinex is already broken down into amino acids your body can readily absorb.
(http://jtpotteryusa.com/sagagjf.png)
Sorry if I seem like I'm selling the stuff.
I'm not it's just that I have seen it work.
I believe the only reason it is not used more is the fact it it OTC and not a prescription.
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they do make niacin without flush. You can google or check amazon for No FLush Niacin. There is also time release niacin which release withing 7-8 hours. Niciniamide does not cause flushing, if Im not mistaken, but not sure if its affect on cholestrol. As a phosphorus binder their has been research studies documenting its phosphorus binding capacity.
You may want to check out this article;
http://chealth.canoe.com/channel/Nutrition/Supplements-and-nutraceuticals/Dont-be-fooled-by-no-flush-niacin
It well explains the differences in Niacin and the No-Flush Niacin as they are NOT the same and their effect on cholesterol are NOT the same.
I see also how the Niacin that I had been taking may have been contributing to my gout (Ouch!) but the No-Flush may still be advantagous to me in that it can assist in energy.
I will have to dig into this deeper.
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ChRlieB53 for cholesterol checkout out the sustained release
http://www.berkeleywellness.com/supplements/vitamins/article/niacin-and-cholesterol
"
Sustained-release/extended-release niacin causes less flushing. However, some over-the-counter formulations may be less effective and increase the risk of liver toxicity. The extended-release form sold by prescription (Niaspan is the best-known brand) is effective, least likely to cause intense flushing and safer for the liver—but it costs even more than brand-name statins. An over-the-counter sustained-release preparation called Slo-Niacin is similar to Niaspan but much less expensive."
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I can be pretty dense sometimes and concepts escape me. What I am having a problem with is figuring out exactly what plant based proteins, and HOW MUCH of each will I need to replace much of the animal flesh that I currently eat.
PD is striping an amount of protein nightly as well as the massive protein I still lose through my residual kidney function. That is a BIG protein leak!
I am also curious to know how different, if any, are the protein demand for those on hemo vs PD?
Oh, and I imagine my 225 pound body requires more protein than say a 100 pound female, so our sizes must be a consideration, I'm sure.
There are a number of reasons that I should seriously start replacing animal protein with plant based, most all boil down to health. So I seriously have a lot to learn and really need to pay attention. So everything you all tell me will be seriously taken to heart as I try to incorporate all into good use.
Meal plans suck, it's almost like trying to follow a recipe. I don't follow recipes. I read them to get an idea of what the author is using and how they are putting it together. Then I check the refrigerator and cupboards to see what I have that can be used, and wing it from there. I haven't had to make any trips to the hospital so I think I must be doing all right as I've managed to feed both the Wife and I, and we are BOTH still here! So I think I must be doing something right, but I don't doubt that I could do better, eating healthier, with less meat.
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CharlieB53 I love the phosphorous guide you linked. I have printed it and added it to my ongoing eating healthy while on dialysis information I am slowly gathering for myself.
It is going to help me in streamlining my food inventory I have made on Xcel on my computer. I may add a phosphorus column to the foods.