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When, how much and what to eat in diabetic kidney disease

Published:Wednesday | April 1, 2015 | 4:00 AMMarsha N. Woolery

Diabetes mellitus (sugar) is a disease that is no secret nowadays. Most of us know someone with diabetes - it is one of the most popular chronic non-communicable diseases globally. Diabetes, if not controlled, may damage the kidneys and result in kidney disease (nephropathy).

Three things may delay or prevent diabetic kidney disease. These include:

- Quality of meals - what is consumed.

- Quantity of food - how much is consumed.

- Timing of meals and snacks - when foods are consumed.

What is consumed has to do with the composition or food items that make up the meal. It is recommended that persons with diabetes eat a variety of foods from the Caribbean's six food groups. When the kidneys are affected, there are foods that are to be avoided and limited in the diet.

The food group 'legumes' - peas, beans and nuts - should be avoided or limited, based on the professional guidance of a registered dietitian or registered nutritionist. Other foods that the person with diabetic kidney disease are to avoid are those that are high in sodium and limit the intake of protein and potassium rich foods.

A variety of foods are to be consumed to prevent poor nutrition, weight loss, build-up of waste in blood, control blood pressure, blood cholesterol, blood lipids (fats in blood), and blood sugars.

Meals for someone with diabetic kidney disease should include staples, fruits, vegetables, foods from animals and fats and oils.

n Staples should include white rice, white bread, leached yam, potato, green bananas, and unrefined cornmeal. Leached foods are soaked overnight with water thrown off three to four times to reduce the potassium content. These foods are good sources of carbohydrates and provide energy and fibre to prevent constipation.

- Fats and oils should be from plant sources that are low in saturated fat so as to lower risk of heart disease. Please note that avocado, ackee and coconut milk are fats that should be avoided by the diabetic with kidney disease because these foods are high in potassium.

- Fruits and vegetables should be consumed everyday to provide vitamins, minerals and fibre. Choose the fruits and vegetables that have moderate to low potassium to prevent irregular heartbeat. Fruits and vegetables to avoid include naseberry, pumpkin, callaloo, spinach, mustard greens, bush cabbage, sweet sop, sour sop, custard apple, and papaya.

- Foods from animals to avoid are processed meats such as corned beef, bacon, ham, salt mackerel, saltfish and smoked meats. These foods are high in sodium and may increase blood pressure. Choose fresh meats, poultry, fish, cow's milk, and eggs. Season foods with natural herbs and spices instead of powdered seasonings that have salt in the mix.

The amount of food consumed by a person with diabetic kidney disease is based on factors such as:

- Body weight

- Treatment - dialysis or not, insulin or tablets.

- Physical activity

When meals are consumed depends on:

- Type of medication - persons on insulin would need three meals and snacks, especially a bedtime snack, whereas persons using the tablets to control diabetes would require three meals per day. Meals should be taken before or after meals, as recommended by a licensed medical doctor and/or registered pharmacist.

- Physical activity - persons who are more active would need to eat a little more food either during meal times or as a snack before and or after activity to prevent hypoglycemia or low blood sugars.

Diabetic kidney disease can be prevented and, or managed by making healthy food choices, taking medication as prescribed by a medical doctor and by monitoring blood sugars or glucose, blood pressure, blood lipids and waste products in the blood.

This year, the University Diabetes Outreach Programme (UDOP) Conference is focusing on diabetes and kidney disease. It is all about quality, quantity and timing of meals - choose wisely, live healthier with diabetes!

- Marsha N. Woolery, RD, is a registered dietitian/nutritionist at Fairview Medical and Dental Centre, Montego Bay, and adjunct lecturer at Northern Caribbean University; email: yourhealth@gleanerjm.com