Written by Debbie Sutton- Renal Dietitian

Are your trousers too tight ?

This Guide shows the proportions of food groups and how much of each we should be eating daily. According to Public Health England these breakdown roughly into starchy 37%, fruit/veg 39% oils 1%, beans, pulses, meat 12%, dairy 8%, occasional foods 3%.

If healthy eating has come to mean the same as a slimming diet we can blame the press for this and this impression is not helpful. So, for a change, let’s think about what we all actually need. Old or young, well or ill, fat or thin, we all need a well balanced diet.

Weight loss can only be achieved if energy going ‘in’ (calories) is less than energy being expended ‘out’. So, if your weight is unchanging then you have the balance just right. If it has increased you need to reduce the number of calories going in (eat differently) and increase the amount of energy going out (do more) until that balance is restored - and your trousers don’t feel like they are going to split you in half. 

You can reduce energy in all sorts of ways but not all the suggestions you read about ensure that you maintain a well balanced diet. You could eat four chocolate bars a day and lose weight, but you will not be meeting your requirements for several nutrients. That is why dietitians adopt an approach of encouraging you to eat sensibly and lose weight gradually.

We know it sounds dull and there are no magic solutions on offer and no 10-day diet miracle that will see you sashaying in a disco or strutting along the beach!

It also explains why renal dietitians work so hard to give as much variety as possible. They give daily allowances of foods high in potassium or phosphate rather than cutting out foods high in these altogether and offer alternatives when some foods are best avoided, and refer to chocolates as ‘treats’ ! Of course your kidney does not

know whether your potassium is coming from chocolate or fruit, but fruit contains vitamins, fibre and anti-oxidants whereas chocolate does not provide much other than calories.

A well balanced diet means one that provides our bodies with essential nutrients. To say we are what we eat is true.

What do we need? Look at the plate model picture and follow the different sections to find out which group provides which nutrients and how to ensure you eat them all in the correct proportions.

The main nutrients are shown around the plate, but there are many others that are needed in tiny amounts. The good thing is that if you eat a variety of foods from all the groups, you will automatically be getting everything you need ... and may get those trousers to fit more comfortably into the bargain!

The proportions are important. It helps your body to make efficient use of what you offer it. For example, protein is needed for growth and repair and for kidney patients particularly, for a healthy immune system. But your body can use protein for energy. If you don’t eat enough foods that are primarily energy providers, such as the starchy carbohydrate group, a by-product of protein is urea, which can leave you feeling tired, sick and with a nasty taste in your mouth.

Portion size is vitally important. Many people do eat a well balanced and healthy diet but they are still overweight because they eat too much. Requirements differ but if you think you are following the advice above, maybe you just need to reduce the amounts you eat. It may seem unfair - you eat the same as your family does but you are the only one who gains weight. Often it is unfair, but we need to accept that we are individuals and what is too little for one person is too much for another.

If you know you have a poor appetite, use the plate to identify what you may be short of. Concentrate on eating energy giving, plain food for vegetables it might be sensible to use a vitamin supplement. Not all products are suitable for kidney patients, so check with your renal unit to find out which ones they recommend.

The main message are to :

• eat at least 5 portions of a variety of fruit and vegetables every day
• base our meals on potatoes, bread, rice, pasta or other starchy carbohydrates, choosing wholegrain and higher fibre versions where possible.
• have some dairy or dairy alternatives (such as soya drinks), choosing lower fat and lower sugar options
• eat some beans, pulses, fish, eggs, meat and other proteins (such as tofu and mycoprotein), including 2 portions of fish every week, one of which should be oily
• choose saturated oils and spreads and eat in small amounts
• drink 6-8 cups/glasses of fluid a day, choosing lower sugar options
• If foods high in fat, salt and/sugars are part of the diet, they should be consumed less often and in small amounts

Fats
Foods which are high in fats, salt and sugars should be consumed occasionally and in small amounts. Although these foods add palatability, they aren’t an essential part of a healthy diet.

A small amount of unsaturated oils and spreads (plant/vegetable oils like rapeseed, olive and nut oils and lower fat spreads) are allowed. Some fats are essential for health but while unsaturated fats and oils are healthier choices, all fats are high in calories so should be consumed in small amounts.

Hydration
Keeping well hydrated is important but drinks contribute to our daily energy intake. The best choices of drinks (particularly for dental health) include water, low fat milks, unsweetened tea and coffee. Some fruit juices and smoothies can be counted as one of your five-a-day target but combined should be kept to a maximum of 150ml/day as they provide free sugars,

More information about Eatwell Guide and other dietary information can be found on Gov.uk webiste by Clicking here

Dietary Information pack : To request our Dietary Information Pack call 0800 169 09 36, or e-mail us at: [email protected] 

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Food with thought recipe book

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.