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Recommendations for patients needing to follow a low potassium diet
What is potassium and why is it important? Potassium is a mineral which is found naturally in many foods. It is important to ensure healthy functioning of muscles, including your heart muscle.
Why is my potassium level high? Normally, any excess potassium is removed by the kidneys in the urine. Unfortunately as your kidneys are not working well, the potassium level in your blood has risen.
Why is a high potassium level a problem?
A high potassium level or a sudden large increase in your potassium level can be dangerous, as it can stop the heart from beating.
How can I reduce the level of potassium in my blood?
- Low potassium diet – The dietary advice given depends on your blood results and medical condition
- Dialysis (if necessary)
- Avoid constipation
How long will I have to follow this diet? It will depend upon your treatment. Some people will need to follow this diet long term, others will only need to follow it for a short while. Therefore it is important to see your dietitian regularly to review your diet.
What can I eat?
This is a guide to help you identify foods which are high in potassium. You are not aiming to avoid all foods containing potassium. A few simple changes to your diet can help to reduce potassium levels in your blood.
The way in which food is cooked can affect its potassium content. When potatoes, yams, sweet potatoes and vegetables are boiled in water they lose some potassium.
- Boil all potatoes, yams, sweet potatoes and vegetables in large amounts of water until cooked and discard the water;
- Avoid using vegetable water for gravy, sauces, curries or casseroles;
- When making curry or stew, firstly par-boil the potatoes and vegetables. Then discard the water and add the vegetables/potatoes to the stew/curry;
- When making a stir fry, try to make sure that all vegetables are par-boiled;
- Ensure all vegetables are cut into small pieces before boiling;
- Do not microwave, pressure cook or steam vegetables or potatoes.
You can re-heat vegetables that have already been boiled.
The daily allowance is 3 egg sized, (150g/6oz).
All potatoes should be peeled and boiled before they are chipped, roasted or sauteed.
Alternatively you may choose a portion of boiled yam or sweet potato, instead of potato, or 100g/4oz boiled plantain.
Choose Avoid Boiled potatoes Frozen/ oven/ retail chips Mash potatoes lnstant mash Homemade chips Jacket potatoes Homemade roast potatoes Microwave chips Pasta Oven chips Rice Potato flour Noodles Manufactured potato products Couscous e.g. hash browns, waffles, Maize wedges Corn meal
Carbohydrate (Starchy food)
Most breads and cereals are good choices as they are low in potassium.
Choose Avoid Bread All types including white, brown and granary Any bread or cereals with added fruit, nuts & chocolate as these will significantly increase the potassium content Breakfast cereals Weetabix, branflakes cornflakes, porridge oats (not instant), shredded wheat, special K All bran / bran Flours Plain, self raising, corn flour, arrowroot, sago, tapioca powdered starchy vegetable
Vegetables and Salads
All vegetables contain potassium but some can be eaten in moderation. The daily allowance for vegetables/salads is ………… portions. A portion of vegetables is approximately 2 tablespoons (85g/3oz)
- Half a tin of plum tomatoes can be used per portion to flavour dishes, the juice should be thrown away.
- All vegetables when used in composite dishes should be par-boiled, and the water thrown away.
Choose Choose Avoid Mange tout, Green/french beans Peas, Spring greens Ackee Bean sprouts Swede Artichoke Broccoli, Sweetcorn Beetroot Cabbage Asparagus (3 spears) Brussel Sprouts Carrots, Aubergine (1/o) Celeriac Cauliflower Celery (2 sticks) Drumstick Courgette, Cucumber Fennel Leeks Radish Karela Lettuce, Tomato (1 small or 4 cherry) Mushroom Marrow Okra Mixed vegetables Parsnip Onions, Spinach Peppers Tomato puree Pumpkin,
All fruits contain potassium but some can be eaten in moderation.
Your daily allowance is ………….. portions,
Choose Avoid Apple Avocado Apricot (2) Bananas Blackberries Blackcurrants Blueberries (20) Coconut Cherries (14) Damson Clementine’s (2) Dried Fruit Grapes (15) Elderberries Kiwi Fruit Figs Kumquats (14) Grapefruit Lychees (8) Greengages Nectarine / Peach Guava Olives (10) Loganberries Orange (small) Mango Passion Fruit Melon Pear (small) Papaya Pineapple (2 small slices) Paw-paw Plums (2) Pomegranate Raspberries (15) Redcurrants Satsuma Rhubarb Strawberries (8) Sharon Fruit Tinned Fruit 120g/small tin – Juice drained
NB Starfruit can be toxic for kidney patients therefore it should be avoided at all times
Meat, fish and alternatives
Meat and fish contain a moderate amount of potassium. However because they are an important source of protein, they are not restricted on a low potassium diet.Avoid adding fruit or nuts to main dishes.
Beans and Pulses
A portion of cooked beans or pulses can replace a portion of meat or fish for example, baked beans, dahl, chickpeas.
lf you are a vegetarian continue having beans and lentils as usual.
Dairy products are an important source of calcium but contain potassium. They should be taken in moderate amounts.
An equivalent of 1/2 pint (300m1) milk may be taken daily. Milky puddings and yoghurts must be counted within this allowance. Soya milk and products made from soya should also be included in your milk allowance.
Eggs and cheese can be eaten as usual on a low potassium diet, but may need to be restricted if on a low phosphate diet, lf you are unsure please consult your dietitian.
Rice milk freely within fluid restriction
Coconut milk Condensed milk Dried milk Evaporated milk
Most renal patients need to follow a no added salt diet. lf you need more information on this please ask your dietitian. * Salt substitutes for example Selora, Lo Salt and pan salt are all made from potassium salts and must not be used.
Choose pepper, herbs and spices to flavour dishes.
* Foods that are processed are high in salt as are soya sauce, MSG (Mono Sodium Glutamate) and stock cubes e.g. Maggi and Knorr. Keep these foods and seasoning to a minimum.
Choose Avoid Biscuits
Ginger nut Jam/ cream filled biscuits Plain biscuits e.g. Digestive, Rich Tea, Shortbread
Biscuits containing nuts/ chocolate/ dried fruit Cakes/ Desserts Cake e.g. sponge, Cheesecake*, Doughnut Jam tart, Jelly, Custard* Meringue, Swiss roll, Trifle Plain ice cream* Creme Caramel Cakes/ Desserts Cakes/ desserts containing nuts/ chocolate/ dried fruit
Boiled, Chewy Fruit gums and pastilles, Jellies, Marshmallows, Mints, Sherbert, Turkish Delight Fudge Liquorice Peanut brittle Seseme snacks Toffee Asian sweets Aggala, Asmi, Gulab jamun Halva, Jalebi, Payasan Shandesh, Zarda Sweets containing evaporated or condensed milk/ nuts/ dried fruit/ dried milk/ coconut milk/ gram flour Chocolate All standard chocolate bars
Choose Avoid Bread sticks Cream crackers Crisp breads Monster Munch Papadums* Prawn crackers Pretzels Rice cakes Skips Tortilla chips Water biscuits Wotsits All manufactured potato products e.g. Crisps / French Fries Nuts Oatcakes Quavers Rye crisp breads Seeds Twiglets Vegetable Crisps
Avoid foods marked with * if you are on a low phosphate diet.
Choose Avoid Tea Herbal tea Fruit squash (not high juice) Fizzy drinks Coffee (1 weak cup filter coffee per day) Brita filtered water Chocolate drinks Complan or Build up drinks Fruit juice Hi-Juice fruit squash lnstant coffee Malted drinks Nourishment Nutrament Ribena Smoothies Vegetable juice
Choose Avoid All spirits Vermouth Liqueurs Sherry Port Shandy Ale Bitter Cider Stout Guinness Red Wine
lf you drink white wine and/or lager, please discuss with your dietitian.
Eating out ideas
Starters Garlic bread Sesame chicken or toast Garlic prawns* Pasta dishes Main Course
Plain meat, fish, soya, tofu, beans or lentils. Pasta or rice dishes/naan/chapatti Small portion of vegetables or salad Boiled or mashed potatoes
Dessert Crdme caramel Mousse or ice cream* Jelly Trifle Plain sponge pudding and cream A portion of fruit from daily allowance may be eaten either as fruit salad or as a fruit pudding. e,g. lychees, apple crumble Drinks Tea Water Fizzy drink Shandy Gin/Whisky/Vodka/Rum White Wine limit to …………. glasses
* These foods may need to be avoided or limited if you are on a low phosphate diet.
lf you need further information on eating out, please ask your dietitian.