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Old 07-12-2013, 09:55 AM   #1
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How to Low Carb when everything is restricted?!

I restarted Monday and so far have lost 7 pounds (water, I know, but still). My fasting blood sugar has dropped from 223 to 85. I don't want to change my LC way of eating. Yesterday my family doctor said my diabetes type 2 has caused kidney disease and I now have to limit: protein, dairy (inc. cream, cheese, and butter), nuts, anything with sodium and potassium (as much as possible). Up til then I had been having one ounce of nuts every evening and a slice of cheese at lunch. I asked the dr. what I can eat and he said "lots of fruit and salad," except I can't eat fruit because I'm diabetic and all raw vegetables give me G.I. issues! And this coming from a man who says I should look up all my nutrition info on the internet. I know I have to be very good with food choices so I can improve my kidney function, and I read a study that said ketogenic (low carb, high fat) diets had wonderful results in mice with kidney disease BUT how am I supposed to follow that plan with such limited food choices?! PLEASE give advice if you have any...
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Old 07-12-2013, 10:17 AM   #2
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This is really hard, imo. I am also diabetic and have kidney issues (GFR of 58 but not spilling protein). So far I am choosing to go full hog on a ketogenic diet. I eat about 45 to 50 g of protein a day, which is perfect for kidneys. I cut out diet coke bc dark sodas bc of the phosphorus. I don't eat any processed foods at all, which is where most people get the lion's share of their phosphorus, so that's a bonus with NK. I'm drinking a lot more water.

I have not cut back on salt bc I can't figure out whether it's really necessary. I have read that it doesn't actually cause damage to the kidneys but that if it contributes to high blood pressure, that's hard on your kidneys. I don't have high blood pressure, so I'm not cutting salt for now.

Is the butter and cheese thing bc of phosphorus? I don't think people usually have to cut out all dairy on a renal diet. I wonder if the butter thing is just bc of saturated fat, which I would ignore.

Everyone has to have some phosphorous in their diet, but you're trying to limit it. So I think that means cut out things that are very high in phosphorous or not good for you otherwise (diet coke), but then limit the dairy and nuts a bit. I really think that cutting out processed foods makes all the difference, but the truth of the matter is that I don't know a lot about it. My doctors have not even suggested that I start eating a renal diet yet. I'm putting all my eggs in the NK basket in the hopes that I can turn it around a bit, like the mice.

Do you know what stage you're in? What are your labs like? Are you spilling protein?
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Old 07-12-2013, 10:51 AM   #3
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I hesitate to give advice to persons under doctor's care.

That being said...
it may be hard to reconcile a low-carb eating style with your doctor's advice because most doctors don't know the first thing about the benefits of low carbing. Correct (moderate) protein does not impair kidneys. And if LC is improving your blood sugar, which IS hard on kidneys, why not stay on it?

Also, the body reacts completely differently to sodium when on a LC diet, so the rules against sodium are off the table (but like I say, I hate to advise someone w/a medical condition). And LC actually depletes potassium due to the composition of the diet and the way stuff is metabolized, so a lot of folks on LC have to supplement it ( so that's a way to cut potassium as your doctor mentions, which I don't agree with because we're talking about the workings of an LC person, not a SAD person).

I urge you to read "The Art and Science of Low Carb Living" by Phinney and Volek. It has a lot of good, easy-to-read science in it, including stuff about kidneys like this:


Quote:
Brittle Bones and Kidney Crisis Issue: I have heard that diets like Atkins which are low in carbohydrate and high in protein may cause my bones to weaken and my kidneys to fail. Response: First of all, a well-formulated low carbohydrate diet like Atkins is not really that high in protein. We recommend protein between 1.5 and 2.0 grams per kilogram reference body weight (0.7 to 0.9 grams per pound reference weight). This translates to between 90 and 150 grams per day for a range of adults, which is about what the average adult in the US is already eating. This level is well tolerated and is not associated with adverse effects on bone, kidney or other health indictors. The reason that protein intakes higher than the minimum recommended (0.8 grams per kilogram) were thought to negatively impact bone is because they cause a small but measureable increase in urinary calcium excretion. On the surface, this could indicate a higher risk for bone loss over time and development of osteoporosis. However, we now know that increasing dietary protein above the minimum also causes greater intestinal absorption of dietary calcium, which balances the slightly greater calcium loss in the urine. In fact, recent research suggests that diets higher in protein are associated with healthier bones as people age. Similar to the situation with bone health, the concern about kidney problems stems from a belief that high protein diets contribute to renal disease. This belief is based on studies of restricting protein in people who already have severely damaged kidneys. However, there is no data linking the moderate protein intake range listed above to damage in people with normal kidney function. In technical terms, despite some evidence that higher protein intakes can increase glomerular filtration rate, the evidence linking this normal physiologic response to progressive loss of kidney function in healthy people is completely lacking.

Phinney, Stephen; Volek, Jeff (2011-07-08). The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable (p. 44). Beyond Obesity LLC. Kindle Edition.


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Old 07-12-2013, 11:11 AM   #4
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I feel for you. It's really tough. I'm also diabetic with kidney disease, which unfortunately continues to get worse. I spill lots of protein, which doesn't help. Rubidoux's has offered some wonderful advice.

I'm not sure what stage you're in, but I'm guessing stage 3. I had to limit everything at an early stage, including protein, phosphorus, and potassium. I've had to learn to eat smaller portions and up the fat. I know your Dr said to eat lots of fruits and veggies, but they have tons of potassium. What I did was found a list of those foods ranked by levels of phosphorus and potassium and eliminated all the high ones (avocado, tomato, oranges, dark greens, etc.). I only eat from low to medium foods, and try to eat as little of them as possible. Processed meats have a lot of phosphorus, so eat as clean as possible. Red meat is much harder on the kidneys than white, so I restrict it to 1 serving a week, if at all. Dairy and nuts are also high in phosphorus, so I limit that to a tbsp hwc in coffee and 1 oz of nuts 2x/week. I suggest logging all your food into a tracker that tracks phosphorus and potassium to get a feel of how much you're eating. Then see where you can make any cuts.

Good luck! Feel free to msg me anytime if you wanna talk. ((HUGS))
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Old 07-12-2013, 11:30 AM   #5
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How hard it is depends on your perspective. Sure, if you compare it with what everyone else eats then you will feel deprived.

I don't have any medical issues but I don't eat most of the things that people talk about here- lc products, artificial sweeteners, sodas, dairy, etc.

I eat eggs, meat, fish, butter, evoo, and lots of vegetables with a little dairy sometimes and I can't remember the last time that I had nuts.

You still have plenty of things to eat. Eggs, chicken, beef, pork, all kinds of fish, olive oil, and cooked vegetables.

If you aren't eating processed things your sodium intake will decrease dramatically.

good luck.
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Old 07-12-2013, 11:34 AM   #6
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Thanks so much to all of you for your insight and helpful replies. I was at Stage 3 but now I'm at stage 4 due to my own stupidity and inability to stick to anything. I'm so scared of dialysis and dying, I am very paranoid about eating ANY food now. And don't worrt, I know you aren't doctors so I'm not going to try to hold anyone responsible for any advice, it's just that my doctor doesn't have a clue about LC. He is also diabetic and he will tell me things like "no one is perfect - I ate Oreos yesterday." - well that's inspiring! If any of you are so inclined as to post some meal examples I would be very grateful. I usually either skip breakfast or eat two or three egg yolks mashed with mayo, mustard, and a spoon of bacon bits. Lunch is often a hamburger patty with cheese, sometimes in a lettuce wrap but lettuce usually upsets my stomach, and dinner is either chicken or beef and a vegetable, last night it was a loaded zucchini (a whole zucchini with a little butter, sour cream and a few bacon bits). Sometimes I have an Atkins meal but I guess the sodium will be too high on that now. I will be starting back to work in a couple weeks so I would like to have a meal routine in place by then - deli turkey was always convenient for work but now that's a no-no too. UGH! Thanks so much for your support - depression is definitely setting in - quickly! I appreciate you all very much.

Last edited by doxielove; 07-12-2013 at 11:38 AM..
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Old 07-12-2013, 11:52 AM   #7
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the good new is that you have a few weeks before work to figure this out.

You can do this and improve your health. You are already low carbing so it shouldn't be too hard to make a few more changes so that you are following the new restrictions.

Breakfast- cut out the bacon bits. have a cooked vegetable with your eggs.

Lunch- have the burger but eat it with a fork with some cooked onions and peppers.

Some of the most healing foods are stews and soups. If you make it from scratch you control the amount of sodium and then you have meat, cooked vegetables, and broth to drink for a few days and you can easily take it to work in a thermos.

I also cannot recommend a ronco rotisserie enough. You can make your own chickens in 60 mins, control the amount of sodium, and have meat to take to work in place of deli turkey.

Last edited by nolcjunk; 07-12-2013 at 11:53 AM..
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Old 07-12-2013, 11:56 AM   #8
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You might want to get ahold of Dr. Bernstein's "Diabetes Solution". I have a vague recollection of reading that he reversed his diabetic nephropathy with a low carb diet...and he recommends eat 4-5 oz of protein at a meal. I don't remember the specifics.
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Old 07-12-2013, 11:58 AM   #9
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Quote:
Originally Posted by nolcjunk View Post
the good new is that you have a few weeks before work to figure this out.

You can do this and improve your health. You are already low carbing so it shouldn't be too hard to make a few more changes so that you are following the new restrictions.

Breakfast- cut out the bacon bits. have a cooked vegetable with your eggs.

Lunch- have the burger but eat it with a fork with some cooked onions and peppers.

Some of the most healing foods are stews and soups. If you make it from scratch you control the amount of sodium and then you have meat, cooked vegetables, and broth to drink for a few days and you can easily take it to work in a thermos.

I also cannot recommend a ronco rotisserie enough. You can make your own chickens in 60 mins, control the amount of sodium, and have meat to take to work in place of deli turkey.
Great advics - thank you! You wouldn't be able to point me to any of those soup/stew recipes, would you?
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Old 07-12-2013, 12:08 PM   #10
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You may want to do a Google about Benfotiamine and kidney disease. This is a special
fat soluable form of vitamine B1 that at least in some studies reverses some kidney dammage.
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Old 07-12-2013, 12:15 PM   #11
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Quote:
Originally Posted by doxielove View Post
Great advics - thank you! You wouldn't be able to point me to any of those soup/stew recipes, would you?
sorry, no. I learned to cook by watching my mom and now I just make things the same way. I love stews because you can't mess them up and every change makes for a new stew, plus you can eat it for a week. I cook garlic and onions in a pan with oil until translucent then you put them into a big pot, then brown meat in a pan with some oil, then put the meat in the same pot with the onions and with enough water to cover it and spices. Keep cooking the meat in the water and spices, later add vegetables and keep cooking until the meat and veg are soft and keep adding water so that everything is covered. I love putting in mushrooms, onions, garlic, cabbage, carrots, turnips, and potatoes. You can also do zucchini and parsnips.

My ronco is my fave kitchen appliance- I wash a whole chicken, rub it with salt, and set it for 60 mins and that's it.
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Old 07-12-2013, 02:46 PM   #12
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Quote:
Originally Posted by E.W. View Post
You may want to do a Google about Benfotiamine and kidney disease. This is a special
fat soluable form of vitamine B1 that at least in some studies reverses some kidney dammage.
I just ordered some...even if it doesn't help my kidneys it sounds like it might help with the neuropathy! Thanks!
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Old 07-12-2013, 02:46 PM   #13
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Quote:
Originally Posted by Aomiel View Post
You might want to get ahold of Dr. Bernstein's "Diabetes Solution". I have a vague recollection of reading that he reversed his diabetic nephropathy with a low carb diet...and he recommends eat 4-5 oz of protein at a meal. I don't remember the specifics.
Thanks for reminding me about Dr. Bernstein - I'll check into it right away.
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Old 07-13-2013, 08:24 PM   #14
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Quote:
Originally Posted by E.W. View Post
You may want to do a Google about Benfotiamine and kidney disease. This is a special
fat soluable form of vitamine B1 that at least in some studies reverses some kidney dammage.
I'm gonna order some of this next pay day, too. Thanks for mentioning it.

Doxielove, Dr. Bernstein is a great idea for you. He's pretty inspiring and I am so thrilled to hear of anyone reversing complications. After I take the bar exam in a couple of weeks I'm going to attack my diet w renewed vigor -- and the first thing I'm gonna do is dig out my old copy of his book. When I read it for the first time in 2000, I thought I could never do something as restrictive as he suggests, but I am now to the point that I am probably more restrictive. I love intermittent fasting, so I probably won't follow his plan exactly, but the last time I read it, I picked up several habits that are now totally ingrained. If I pick up a few more, I'm sure they'll serve me well.

I was wondering if you guys who have kidney disease would like to have a support thread. I feel like I know so much now about controlling blood sugar (not that I'm good at it, though) and low carb nutrition, but not much about how to take care of my kidneys. It would be nice to have a little network of low carbers to share ideas with.
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Old 07-14-2013, 02:40 PM   #15
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Quote:
Originally Posted by rubidoux View Post
I'm gonna order some of this next pay day, too. Thanks for mentioning it.

Doxielove, Dr. Bernstein is a great idea for you. He's pretty inspiring and I am so thrilled to hear of anyone reversing complications. After I take the bar exam in a couple of weeks I'm going to attack my diet w renewed vigor -- and the first thing I'm gonna do is dig out my old copy of his book. When I read it for the first time in 2000, I thought I could never do something as restrictive as he suggests, but I am now to the point that I am probably more restrictive. I love intermittent fasting, so I probably won't follow his plan exactly, but the last time I read it, I picked up several habits that are now totally ingrained. If I pick up a few more, I'm sure they'll serve me well.

I was wondering if you guys who have kidney disease would like to have a support thread. I feel like I know so much now about controlling blood sugar (not that I'm good at it, though) and low carb nutrition, but not much about how to take care of my kidneys. It would be nice to have a little network of low carbers to share ideas with.
I would love a kidney disease support thread - it is a terrible, frightening thing to be going through and no one in my family understands. Anyone else?
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Old 07-14-2013, 08:46 PM   #16
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I agree, it's really scary. Have you run into Cora on any of the kidney or diabetes forums? She has type I and developed ckd back in the 80s, I think, or even a little earlier. She's had a kidney transplant (or maybe even two, can't remember) and has a new pancreas as well, so she's no longer diabetic. But she is a very comforting person to "talk" to online. She's been through it all and she's okay, yk? Before I found her, I felt like ckd was pretty much a death sentence, but she makes it out to be not *so* bad.

Anyway, I'm gonna go ahead and start a support thread and I'll put a link to it in my sig... We can share our information and hopefully feel a little better informed. Right now, I feel like none of us have a clue! lol Maybe rouxroux knows more and we can get her to join. I can't tell if any of the other posters in this thread actually have ckd.
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