Acknowledgements
The idea and support for this book came from Richard Warner who has a unique passion and drive in providing nutrition information for the wider public. We are also grateful to our editor, Richenda Milton-Thompson, for guiding us throughout the process with her customary wisdom, patience and understanding. Over much of the eighteen months, she has coped admirably with having three authors in entirely different places, geographically, professionally and domestically.
A special acknowledgment is due to Annie Cassidy for her extensive work on earlier drafts of several chapters in the present book. She was an invaluable co-author on our previous book and has had a most positive influence on this one.
We have been fortunate to have a number of expert professional and patient advisers who have helped us in planning, writing and reviewing the book. They have been so generous in giving their time to review the manuscript and the book has benefited enormously from their insightful comments and contributions. We are also very grateful to those people who contributed and tested recipes for the cookery section of the book and to those who have helped in other ways. Particular thanks go to Yajnik Bhageerutty, Naomi Cohen, Gillian Green, Michael Green, George Hartley, Sam Kanisius, Clare Jackson, Ronnie Jackson, Althea Mahon, Andrea McManus, Helen Millar, Freddy Rebello, Joe Ross, Sirak Sargent and Paul Slater.
We greatly appreciate the help and support of our renal and dietetic colleagues at St George’s Hospital, London and at Middlemore Hospital, New Zealand. A heartfelt thanks also goes to our friends and families for their unstinting love, help and support. Without all of them, this book would have never been completed (although some of the younger members could have been a little more obliging at times).
Last, but not least, we are grateful for the invaluable experience gained through our work as renal dietitians in sharing the questions, knowledge and advice of people living with chronic kidney disease. They have informed us and inspired us in writing this book. We hope that, in return, we have succeeded in helping to make eating for health as easy and enjoyable for a far greater number of people than we, as clinicians, could ever hope to see.
Helena Jackson, Claire Green and Gavin James
London, 2009
Appendix 1
Useful addresses and web
National Kidney Federation
The Point
Coach House
Shireoaks
Worksop
Notts S81 8BW
Tel: 01909 544999
Fax: 01909 401723
Helpline: 0845 601 02 09
Website: www.kidney.org.uk
Kidney Research UK
King’s Chambers
Priestgate
Peterborough
PE1 1FG
Tel: 0845 070 7601
Helpline: 0845 300 14 99
Email: info@kidneyresearchuk.org
Website: www.kidneyresearchuk.org
Nephronline
Website: www.nephronline.org
Gives information on various aspects of kidney disease and CKD, including specialist advice on dietary issues.
The Food Standards Agency
Website: www.eatwell.gov.uk
Government Department’s dietary information page aimed at the person who wants to choose a healthy diet.
The Marine Stewardship Council
Website: www.fishonline.org/advice/eat
Provides information on where to buy fish from sustainable sources.
Diabetes UK
10 Parkway
London
NW1 7AA
Tel: 020 7424 1000
Fax: 020 7424 1001
Helpline: 0845 120 29 60
Website: www.diabetes.org.uk
The British Dietetic Association
5th Floor
Charles House
148–9 Great Charles Street
Queensway
Birmingham
B3 3HT
Tel 0121 200 8080
Fax 0121 200 8081
Website: www.bda.uk.com
British Heart Foundation
14 Fitzhardinge Street
London
W1H 6DH
Tel: 020 7935 0185
Fax: 020 7486 5820
Website: www.bhf.org.uk
Appendix 2 – Nutritional analysis of recipes per portion
Per portion |
Per 100 g |
||||||
Recipe |
Calories kCal |
Protein g |
Fat g |
Saturated fat g |
Potassium mg |
Phosphorous mg |
Sodium mg |
Apple crisps with cinnamon yoghurt dip |
131 |
5 |
1 |
1 |
339 |
151 |
29 |
Apple crunch crumble |
245 |
4 |
6 |
0 |
379 |
103 |
9 |
Baked tomatoes |
140 |
5 |
5 |
1 |
669 |
127 |
70 |
Balsamic fish |
126 |
19 |
2 |
0 |
395 |
204 |
123 |
Blueberry orange muffins |
261 |
4 |
14 |
2 |
86 |
141 |
121 |
Cannelloni |
314 |
17 |
12 |
6 |
762 |
292 |
49 |
Carrot mashed potatoes |
100 |
2 |
3 |
0 |
315 |
38 |
30 |
Cheat’s soufflé |
123 |
6 |
2 |
1 |
241 |
125 |
92 |
Chicken and sweet potato curry |
402 |
28 |
5 |
1 |
1158 |
368 |
33 |
Chicken with leek and green bean vinaigrette |
410 |
35 |
28 |
4 |
870 |
370 |
27 |
Chilli con carne with baked sweet potato |
467 |
37 |
5 |
1 |
1874 |
502 |
86 |
Cinnamon oatmeal muffins |
146 |
4 |
4 |
1 |
143 |
155 |
229 |
Colcannon |
360 |
15 |
13 |
3 |
1249 |
211 |
84 |
Courgette and carrot soup |
111 |
3 |
6 |
1 |
506 |
66 |
7 |
Courgette cake |
281 |
4 |
13 |
2 |
216 |
130 |
87 |
Cucumber and dill salad |
46 |
1 |
3 |
0 |
135 |
42 |
4 |
Cumin chicken |
230 |
34 |
8 |
2 |
719 |
402 |
57 |
Grilled aubergine dip |
28 |
2 |
1 |
0 |
384 |
39 |
3 |
Haddock with red pepper sauce |
435 |
38 |
8 |
1 |
958 |
442 |
23 |
Homity pie |
280 |
10 |
16 |
6 |
580 |
199 |
63 |
Honey and ginger lamb |
400 |
25 |
22 |
8 |
946 |
285 |
22 |
Hot vegetable wraps |
336 |
15 |
6 |
1 |
792 |
248 |
75 |
Jerk pork with pineapple rice |
532 |
34 |
11 |
2 |
801 |
384 |
69 |
Lemon and coriander houmous |
138 |
5 |
5 |
1 |
311 |
72 |
84 |
Lemon glazed chicken |
231 |
30 |
7 |
1 |
620 |
299 |
31 |
Lentils with spinach |
465 |
19 |
9 |
2 |
1176 |
420 |
12 |
Mackerel with mango salsa |
357 |
29 |
24 |
5 |
584 |
324 |
41 |
Melon and mint granita |
51 |
1 |
0 |
0 |
269 |
21 |
31 |
No-mayo coleslaw |
43 |
2 |
1 |
0 |
239 |
57 |
22 |
No-salt pesto |
1657* |
8* |
178* |
23* |
575* |
302* |
2* |
Old-fashioned winter soup |
224 |
10 |
4 |
0 |
746 |
179 |
7 |
Orange and mango ice-cream |
82 |
2 |
2 |
1 |
258 |
45 |
9 |
Pan-fried trout with watercress and walnuts |
624 |
38 |
35 |
4 |
879 |
496 |
116 |
Pasta with a rich bolognese sauce |
550 |
32 |
9 |
2 |
1229 |
421 |
30 |
Pizza pronto |
557 |
24 |
18 |
7 |
739 |
402 |
131 |
Quick lentil curry |
132 |
8 |
4 |
1 |
662 |
128 |
17 |
Ratatouille |
138 |
5 |
7 |
1 |
997 |
112 |
11 |
Red onion, thyme and ricotta potato tart |
313 |
10 |
15 |
4 |
489 |
266 |
77 |
Roasted vegetables with bulgar wheat |
360 |
11 |
5 |
1 |
795 |
326 |
3 |
Rosemary baked potatoes |
219 |
5 |
6 |
1 |
673 |
83 |
6 |
Rum and raisin apple strudel |
179 |
2 |
4 |
0 |
168 |
26 |
48 |
Salmon with pea and watercress tagliatelli |
496 |
35 |
14 |
3 |
743 |
474 |
30 |
Spiced salmon |
208 |
21 |
14 |
2 |
409 |
258 |
40 |
Stuffed cabbage leaves |
279 |
15 |
10 |
3 |
1076 |
277 |
24 |
Summer butterbean and tomato salad |
124 |
8 |
2 |
0 |
564 |
103 |
237 |
Summer fruit terrine |
35 |
4 |
0 |
0 |
221 |
46 |
7 |
Summer pudding |
148 |
6 |
1 |
0 |
235 |
76 |
200 |
Sweet potato, leek and rosemary soup |
132 |
3 |
4 |
1 |
587 |
86 |
14 |
Traditional red cabbage |
81 |
1 |
6 |
1 |
216 |
31 |
5 |
Upside-down lemon cheesecake |
146 |
10 |
2 |
1 |
112 |
137 |
80 |
* Total recipe value as portions vary. |
All nutrient analyses in the table on pages 142–3 have been calculated using Dietplan6 with additional data from the USDA website (United States Department of Agriculture – www.usda.gov). They are based on food weight and food selection according to available data, recipe specification or standard food portion sizes as defined in Food Portion Sizes, 2nd edition, by the Ministry of Agriculture, Fisheries and Food, 1993). It should be borne in mind that food portions served at home are likely to vary slightly in size, but every effort has been made to be as accurate within this limitation.
Text © Helena Jackson, Claire Green and Gavin James 2009
Typography © Class Publishing Ltd 2009
All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of the publisher of this book.
The authors have asserted their rights as set out in Sections 77 and 78 of the Copyright Designs and Patents Act 1988 to be identified as the authors of this work wherever it is published commercially and whenever any adaptation of this work is published or produced including any sound recordings or files made of or based upon this work.
The authors and publishers welcome feedback from the users of this book. Please contact the publishers.
Class Publishing, Exchange House,
Express Park, Bristol Road, Bridgwater TA6 4RR UK
Tel 44 (0)1278 427800
Fax 44 (0)1278 421077
email: post@class.co.uk
www.class.co.uk
The information presented in this book is accurate and current to the best of the authors’ knowledge. The authors and publisher, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency or completeness of such information or recommendation. The reader is advised to consult a doctor regarding all aspects of individual health care.
A CIP catalogue record for this book is available from the British Library
Ebook ISBN: 9781859592113
Print-ISBN: 9781859592045
Edited by Richenda Milton-Thompson
Illustrations and artwork by David Woodroffe
Designed and typeset by Martin Bristow
Ebook conversion by JVR Creative, India
The National Kidney Federation (NKF) is a charity representing all kidney patients in the United Kingdom, it is run by kidney patients for kidney patients. The Federation campaigns for increased renal provision and improved treatment. The charity also provides national services to assist all kidney patients.
Publications recommended by the NKF have to be of a high standard and easily readable; the recommendation is not given lightly and is highly prized. The NKF recommendation of this book was made at the time of its publication and has to be renewed at subsequent prints in order to retain the NKF endorsement and recommendation. Further information about the NKF and books it recommends can be found on its website www.kidney.org.uk
Foreword
In February 2005 the Department of Health published The National Service Framework for Renal Services Part Two: Chronic Kidney Disease (CKD). Until that date, the only people identified with kidney disease were the 40,000 who had progressed right through to complete renal failure, and who could therefore survive only because of dialysis or a transplant. The National Service Framework was to change all this, making it the intention to identify and manage everyone with early stage kidney disease by means of blood tests in GP practices. It is thought that upwards of 3 million people might be identified in this way, suffering early stage chronic kidney disease, their condition being either stable or deteriorating.
A pattern is quickly emerging, picked up by the NKF Helpline, showing clearly that people who have been given this news by their GP want to do whatever they can to stabilise their condition and prevent deterioration toward end stage renal failure. It is all about living a healthier life and, in particular, eating in an appropriate way that helps not hinders the condition.
There is much that can be done. Some foods are quite harmful to kidneys, while others are undoubtedly beneficial. Kidneys do amazing work filtering and cleaning 200 litres of blood a day. If yours need a helping hand, this book will tell you how to look after them.
Food is a joy, restrictions can be tiresome. This book shows you how to ‘bypass tiresome’ and eat well!
Timothy F Statham OBE
Chief Executive
National Kidney Federation
Foreword
Food should be enjoyable, but if you’ve been found to have chronic kidney disease it can be difficult to know which foods are best to choose that will still taste great.
Healthy eating is an important part of the treatment for chronic kidney disease, as controlling your weight, blood pressure and diabetes all help to protect your kidneys. You need a reliable and informative source of expert advice to help you with your food choices. Dietitians can provide you with up-to-date personal advice but it can be difficult to find additional recipes and information specifically designed for people with chronic kidney disease.
All three authors are experienced registered renal dietitians and are well placed to provide this information. Using their expertise, they have produced practical, easy to follow advice and plenty of tasty recipes.
As an experienced renal dietitian, I highly recommend this book to people with early chronic kidney disease. For those with more severe kidney problems, I also recommend their companion book, Eating Well with Kidney Failure.
This book shows you that food can be both healthy and enjoyable!
Sue Perry BSc, Pg Dip, RD
Chair of the Renal Nutrition Group
of the British Dietetic Association
Introduction
This book is about eating, drinking and good food. It is full of quick, simple and great-tasting recipes for people with chronic kidney disease (CKD), along with their friends and families. Our focus is on healthy eating, and why this is so important in helping to manage CKD. We want to show those of you living with CKD that eating for health can be an easy and effective way to improve your chances of living long and active lives.
The advice in this book is broadly aimed at those people with mild to moderate CKD, categorised as CKD Stage 1 to 3, or for those with kidneys working up to 30% normal (see the Box below). People with more severe kidney disease and those needing dialysis are likely to require further or alternative advice. They may find the following book more helpful: Eating Well with Kidney Failure by Helena Jackson, Annie Cassidy and Gavin James. Full details of this and other useful resources are given in Appendix 1.
The five stages (categories) of chronic kidney disease (CKD)
Stage 1 Kidney damage with normal function
Stage 2 Kidney damage and slight decrease in kidney function
Stage 3 Moderate decrease in function – kidneys working at 30–59% normal
Stage 4 Severe decrease in function – kidneys working at only 15–29% normal
Stage 5 Established renal failure. Function of less than 15% normal. Approaching the need for/already on dialysis
Some people with kidney disease will have the opportunity to discuss what they eat with a dietitian. This book is not designed to replace this personal advice. Rather, it aims to help you be better informed when you see your doctor, dietitian or other health professionals. We hope that it will answer some questions that you may not think of or have time to ask in clinic, and that it will provide you with additional information and support.
The book is divided into two sections. The first gives some factual information about food and nutrition in relation to kidney disease. The second includes over 50 delicious recipes, to show you that eating can still be pleasurable. There are hints and tips on choosing and eating meals, including takeaways, pre-packaged meals and food for celebrations and special occasions.
As well as being tasty and simple to produce, the recipes have been chosen to help you to adapt favourite recipes and make them suitable for your particular diet. They have all been tried and tested – the finished dishes have been tasted by our friends, relatives, colleagues and patients. We are grateful for the help of all our ‘tasters’ in producing the end result.
Few of those with CKD will need to make drastic changes to what they eat. Reading this book will reassure some of you that your diet is fine as it is, or that small changes only are needed. A few readers, however, may benefit from making more changes to their diet. This will usually be either because they have other health problems, or because they wish to reduce the risk of developing such problems in the future. We hope that the recipes in this book will help those for whom this is a concern.
We have based this book on our experience as people who enjoy food, as well as our experience as dietitians working with people who have CKD. We hope that it will help you take control of this important aspect of your life, and use food in a way that successfully combines health and enjoyment.
Comments on Eating Well for Kidney Health from readers
‘I like the book and think it reads nicely. I’m sure it’ll go down well.’
GEORGE HARTLEY, Chief Renal Dietitian,
Freeman Hospital, Newcastle-upon-Tyne
‘This book could easily be used by anyone who wished to follow healthy eating guidelines and was looking for some new inspirational meals. I have already tried out a few of the recipes and thoroughly enjoyed them.’
HELEN MILLAR, Specialist Diabetes Dietitian,
Glasgow
‘As an experienced renal dietitian, I highly recommend this book to people with early chronic kidney disease. For those with more severe kidney problems, I also recommend their companion book, Eating Well with Kidney Failure.’
SUE PERRY, Chair of the Renal Nutrition Group
of the British Dietetic Association
‘I am far from being a cook of any sort, but I have gone through the recipes and the clarity of the instructions is such that I would not be deterred from “having a go” . . . excellent!’
SIRAK SARGENT, London
‘I have noted a number of recipes that I would like to eat, and which are fairly easy to make . . . I would both buy the book and recommend it.’
PAUL SLATER, London
Part 1 – FOOD FACTS
Part 2 – RECIPES
Recipe coding
All our recipes are controlled for salt, fat and saturated fat in order to be suitable for inclusion in a chronic kidney disease (CKD) healthy eating diet. Nutritional analysis of all recipes can be found in Appendix 2 (pages 140–41).
Fat Fat content has been controlled by selecting low-fat ingredients, limiting added fats and avoiding added saturated fat. ‘Vegetable oil’ refers to rapeseed oil (often labelled as ‘vegetable oil’). Otherwise use corn oil, sunflower oil or similar polyunsaturated oil of your choice. Olive oil is also a suitable choice and adds flavour to savoury recipes but may tend to burn at higher temperatures.
Low sodium/salt All dishes have no added salt and have a sodium content of less than 0.3 g per 100 g. If you prefer to use stock instead of water in some recipes, it is advisable to use low-salt stock cubes.
Fruit and vegetable portions The approximate minimum number of portions per serving is indicated by graphic representing apples:
= one portion
= half portion
Fruit and vegetable portions are based on 80 g serving or follow government guidelines (see www.eatwell.gov.uk) or manufacturer’s labelling.
For Diabetes Suitability as part of a balanced, low-sugar diabetic diet. Only desserts are coded as all savoury dishes would be suitable. Any necessary modifications to the recipe are noted.
APPENDICES
Eating Well
for
Kidney Health
A practical guide and cookbook
Helena Jackson, BSc, PgDip, MSc, RD
Renal Dietitian, St George’s Hospital, London
Claire Green, BSc, RD
Renal Dietitian, St George’s Hospital, London
Gavin James, BSc, MSc, RD
Clinical Services Manager,
St George’s Hospital, London
CLASS PUBLISHING • LONDON
1
How can I protect my kidneys?