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Low potassium diet – incorporating African and Caribbean foods ContentsIntroductionThe diet advice in this booklet has been developed by experienced registered dietitians with knowledge of the diets of ethnic groups to help individuals with high blood potassium levels.What is potassium?Potassium is a mineral that is found naturally in many foods. Some potassium is needed as part of a healthy diet. It is required to ensure healthy functioning of muscle, including your heart muscle. Your potassium level should be 3.5 – 5.5mmol/l (3.5 – 6.0mmol/l if on haemodialysis)Why is the level of potassium in my blood too high?The level of potassium in your blood is usually controlled by the kidneys. When your kidneys are not working properly, the potassium level in your blood may rise. It is quite common for people with kidney problems to have too much potassium in the blood. Your bowels also remove some potassium, so if you are constipated, the potassium in your blood may also rise.Why do I need to control the amount of potassium in my blood?Too much potassium in your blood can be dangerous as it affects the rhythm of your heart and can cause a heart attack if levels are very high.Can I tell if my potassium is high?There are usually no symptoms to indicate if your potassium is high and the reliable way to tell is a blood test.What should I do to control my blood potassium levels?You can control your potassium levels by:Following a low potassium dietEnsuring regular bowel habitsIf you are diabetic, ensuring good sugar control If you are on dialysis, keeping to your scheduled sessions How do I follow a low potassium diet?This booklet provides information on which foods are high in potassium and need to be limited and offers lower potassium alternatives. Your dietitian will give you individualised advice on the changes you need to make.Carbohydrate Carbohydrates, also known as starchy foods, provide energy, vitamins and fibre. You should try to include something starchy at each meal to provide you with energy.Examples of carbohydrates:Potato, sweet potato, cassava and yamRice, Pasta and other GrainsBreadsBreakfast CerealsStarchy VegetablesSome starchy vegetables like potato, sweet potato, cassava and yam are particularly high in potassium and need to be limited in the diet (choose only one per day). Other starchy foods based on wheat or rice are low in potassium and are good alternatives to opt for. If you do not routinely include high potassium starchy vegetables in your diet, you may be able to allow for a higher intake of potassium elsewhere in your diet. Your dietitian can discuss this with you on an individual basis.LowHighRice/rice flour/tuwo masa/tuwo shinkafaSteamed/fried/baked yamSemolina/Semovita fufuSteamed/fried/baked cassavaCornmealSteamed/fried/baked plantainMilletSteamed/fried/baked breadfruitCouscousSteamed/fried/baked dasheenAbolo (made with rice or maize)QuinoaUgaliKenkeyBreadBagelCocobread CroissantBreads with seeds/nuts/dried fruit/chocolateBunHard dough breadPitta breadWholemeal/white/granary breadCerealsOgiCereals with dried fruit/nuts/chocolatePap/MielepapRice KrispiesCornflakes/Kooko/Tombrown/AkamuPorridgeShredded wheatShreddiesCoco popsBranflakesStarchy vegetables- only have once per day (contains 11mmols or less)Cassava (boiled)160gTaro/dasheen (boiled)140gPotatoes (boiled, new) 170gSweet potato (boiled)145gBreadfruit (boiled- data not available)Yam (boiled)165gPlantain (boiled)100gIf you are having foods made with these ingredients, e.g. plantain fufu or amala made with cassava/gari, please include these foods in the allowance. Many may have larger portions than the above for starchy carbs. The dietitian could look at baseline K level when the patient was last eating these portions and use this to guide them as to whether they can be included.Fruit and VegetablesFruit and vegetables are a good source of vitamins, minerals and fibre and form a large part of a healthy balanced diet. The potassium content of all fruits and vegetables vary and these are listed in the table below as low, medium and high. Vegetables with very high potassium content as listed below should be avoided.Aim for a total number of 4-5 portions of fruits and vegetables daily (or as advised by your dietitian). Make most of your choices from the Low or Medium category from the table below. If you are choosing from the High column, you may need to reduce the number of fruit and vegetable portions you have that day.All vegetables should be boiled, rather than steamed or microwaved. Boiling allows some of the potassium to leach into the water which should be thrown away and NOT used for gravy or stock. Vegetables can be blanched by boiling for approximately 1 minute and draining before using in stir fries, casseroles, stews, curries and soups.Vegetables:________ portions of vegetables can be taken daily. A portion of vegetables is 80g. The potassium content of all vegetables varies and these are listed below as low, medium and high. There are a number of vegetables where the potassium content is very high and these should be avoided. If one portion of vegetables is not taken, then you can swap for an extra portion of fruit.Low <3mmols/80gMedium (3-5mmols/80g)High (5-7mmols/80g)Avoid (>7mmols/80g)canned mushrooms Broad beans cannedMangetout peas raw/friedAmaranth (raw)canned green beansCourgette boiledMixed vegetables cannedcassava leaves (raw)marrowCarrots young boiledOkra boiledTaro leaves (raw)canned okraColeslawCocoyam leaf boiledLentils red boiledDrumstick leaves (raw)Cabbage boiledCurly kale Pepper yellow rawLettuce average rawcocoyam leaf (Xanthosoma sagittifolium)- rawPeas frozen boiled Leeks boiledSweetcorn canned AsparagusAsparagus - raw/fried (tough base removedJute leaves (raw)Cauliflower boiledPepper red rawSpring onions raw edible partsVernonia leaves (raw)- bitter leafPepper green rawSpring greens boiledCabbage rawOkra (fried)Mixed vegetable - frozenGreen salad lettuce, cucumber, pepper, celeryChick peas boiledAvocadoPeas - sugar snap rawAubergine - fried/bakedmung beans boiledBaby spinach (boiled or raw)Peas cannedBroccoli boiledPeas split boiledPumpkin rawChicory rawTomatoes (tinned)Runner beansMangetout boiledDrumstick leaves (boiled)Butternut squash - boiledSweetcorn - baby boiledcocoyam leaf (Xanthosoma sagittifolium)- boiledCucumber rawGreen/French beansJute leaves (boiled)Marrow rawSquash e.g. butternut boiledVernonia leaves (boiled)mung beans sproutedBroad beans cannedPumpkin leaves (boiled)Onion raw Sweetcorn - weighed on the cobCelery boiledAckee (canned)Water chestnuts cannedMixed vegetables stir friedSpinach boiled (not the baby type)Pumpkin (boiled)Spinach boiledTaro boiledWatercress rawCassava boiledAsparagusAmaranth boiledLentils red boiledLettuce average rawCho-cho/christophene (boiled)Pepper yellow rawSweetcorn cannedCelery boiledMixed vegetables stir friedSpinach boiledWatercress rawBeans and peas such as kidney beans, gungo peas and foods that contain beans such as akari and moin-moin can be high in potassium. Please discuss these with your dietitian as this will depend on what your potassium levels were like when you had them in the diet and also your current kidney function.FruitLOWMEDIUMHIGHApples, 1 smallApples, baked 1 mediumApple (dried)Blackberry & apple (stewed) 3 tbspApricots (canned) 3 halvesApricots (stewed), 4 halvesBlueberries, 40Blackberries, raw, 16Apricots, 2Cherries (canned) 1/3 large tinBlackberries (stewed) 2 tbspBanana, 1 smallClementine, 2 small/1 mediumBlackcurrants (canned), 2-3 tbspcoconut, dessicated, 1 tbspCranberries, (dried) 1 tbspCherries, 20Currants, 1 tbspCranberries, fresh, 2 tbspCherries (stewed), 2 tbsp Damsons, 3 fruitFig, 1 fruitFruit salad, homemade, 2 tbspDried mixed fruit, 1 tbspFruit pie fillingGooseberries (stewed), 2 tbspElderberriesFruit cocktail (canned) 1/2 small tinGrapefruit, 1/2 fruitLoganberries (stewed) 2 tbspGooseberries (canned) 3 tbspGrapes, 16Mulberries, 2 tbspGooseberries (stewed) 2 tbspGreengages, 1 fruitNectarine, 1 mediumGrapefruit (canned) 1/4 tinGuava, 1 smallOranges, 1 mediumGuava, (canned) 1/2 tinKiwi fruit, 1 mediumOrtaniques, 1 fruitLemonKumquats, 10Pear (dried)LimeLoquats, 6Pineapple (dried)Loganberries (canned) 1/2 tinLychees, 5Plum, 2 small Longans, (canned) 1/3 canMango, 2 slicesPomegranate, 1/2Lychees (canned) 6 fruitMedlars, 1Prickly pears, 1 medium fruitMandarin oranges (canned) 1/2 small canMelon, 1/2 slicePrunes (dried) 3Olives, green, in brine, drained, 20Mulberries (stewed), 2 tbspPrunes (stewed), 6 fruitOranges, 1/2 mediumPapaya, 1/2 sliceQuinces, 1/2 fruitPassion fruit, 2 fruitPear, 1 smallSharon fruit, 1 fruitPeach, 1 smallPhysalis, 10 fruitSugar apple (custard apple), 1/2 med fruitPeach (canned) 2 halvesPineapple, 1 sliceTamarillos, 1 fruitPear (stewed), 2 halvesPlums (stewed), 3 halves?Pear (canned) 2 halvesRaspberries, 16Very High (avoid)Pineapple (canned) 2 rings/12 chunksRaspberries (stewed), 2 tbspApricots (dried)Plums (canned) 4 halvesSapodilla, 1 fruitAvocado, 1/2 pearPomelo, 1/4 fruitStrawberries, 7-9 fruitBlackcurrants (stewed)Rambutan 8?Baobab Raspberries (canned) 1/2 can?Dates (fresh/dried) 5Rhubarb (canned) 1/3 tin?Figs (dried)Satsuma, 2 small?Goji berries (dried)Strawberries (canned) 1/2 tin?Greengages (stewed)Tangerine, 1 medium?Grenadillas, 2 fruitWatermelon, 1/2 slice?Longans (dried)??Prunes (canned/stewed)??Raisins??Redcurrants (stewed)??Rhubarb (stewed)??Sultanas ??Whitecurrants (stewed)ProteinProtein is necessary for growth and repair and the building and maintaining of muscle. Your dietitian will suggest the amount of protein required according to your current nutritional status. General advice on protein foods include:Choose either lean meat or chicken or fish or eggs or beans or lentils two to three times a day.Cured and salted meats, chicken, fish are high in salt. These foods must be kept to a minimum.Nuts and seeds are high in potassium and may need to be restricted. If you need to use small amounts in cooking, please discuss with your dietitian.A portion of beans or lentils such as, baked beans, chickpeas and black beans can replace a portion of meat or fish. If you are vegetarian, continue having beans or lentils as usualDairy ProductsMilk and dairy products play an important role within our diet as they contain essential nutrients such as calcium, which is needed for healthy bones, and protein which is needed for growth and repair of tissues. However milk is quite high in potassium therefore milk should be limited.An equivalent of ? pint (300ml) milk may be taken daily. This includes cow’s, sheep’s, goat’s and soya milk. Milky puddings, yoghurts and milk-based sauces should be counted within this allowance. For example, milk on cereal (100ml) and a small pot yoghurt would be equal to ? pint milk allowance. Rice and oat milk are very low in potassium and can be taken freely (please note rice and oat milks are not a protein source). Milkshakes, dried milk powder, evaporated milk, condensed milk, coconut milk and coconut cream are all high in potassium and therefore should be restricted.Eggs, creams and cheeses may be eaten as usual on a low potassium diet, but may need to be limited if on a low phosphate diet. If you are unsure please consult your dietitian.Snacks?Snacks are generally high in energy (calories), and many are high in salt or sugar and fat, and therefore should make up only a small part of your overall diet. Fruits within your fruit and vegetable allowance are a healthier, lower calorie, low sugar and low salt snack.?Please note, if you have a poor appetite or are losing body weight, snacks can play a helpful role in maintaining or improving your health. Your dietitian will be able to guide you in making the best choices for you.?As with all food items, the potassium content varies and so they are listed below as low, medium and high. In accordance with your dietary intake, your dietitian will guide you as to which snacks that are safe for you to consume. Savoury snacksCrisps can be high in potassium for a number of reasons. Potato is naturally high in potassium, as are other root vegetables such as parsnip and beetroot used in vegetable crisps. Some new varieties made with lentil flour are also high in potassium. Additionally, some crisp varieties have potassium chloride added as a salt substitute as part of the government drive to reduce sodium content in foods. This may depend on the flavour but should be displayed on the ingredients list.LowHighPopcornPotato crispsTortilla chipsKuli KuliNutsSeeds (if you are adding to soups/stews e.g. egusi, ogbono- please discuss with your dietitian)Mini Cheddars/cheese flavour crackersKelewelePretzelsMany non-potato crisps e.g. Monster Munch, Wotsits etc. change ingredients very frequently by adding a salt substitute which can be high in potassium. For this reason, these foods have not been included in the diet sheet but please ask your renal dietitian who can provide more up-to-date information about this.Sweet snacksLow Potassium <2mmolHigh potassiumBiscuits - plainDigestiveBiscuits containing nuts,Rich TeaChocolate, dried fruitshortbreadGingernutWafer Sandwich biscuitCream filledJam filledBiscuit – semi-sweetMarieCakes and DesertsSponge cake – plain, cream, jamRing doughnutScone containing dried fruitPlain sconeRich fruit cake1 slice Swiss rollBanana breadMeringueFlapjackJellyCheesecakeBullaTrifleSweetsBoiled, chewy, fruit pastillesFruit gumsJellies, marshmallowsLiquorice AllsortsMints, sherbert, Turkish Delight28g PopcornChinchinShuku ShukuMilky puddings (from dairy allowance)120g Custard66g Ice cream125g YoghurtDrinksLow <1High >1Barley water, squashMiloCola drinksPeanut punchCoffee, infusionEgg nogFruit squashDrinking chocolate with milkHerbal Tea, infusionJuicesHorlicks LemonadeCarrot juice/vegetable juiceLucozadeEvaporated milk/condensed milkOvaltine with waterMalted drinkTonic waterMilk shakeTeasOvaltine with milkTomato juiceAlcoholLow <1High >1GinBeer, bitterVodkaCider, dry & sweetWhiskyLagerLiquersLager, alcohol freeShandyPortStout, GuinnessRed wineSherry, small glassRose wineVermouth, dryWhite wineOther ingredientsAkaun/akawn (Nigerian Potash) is high in potassium, so avoid using this as a meat or okra tenderiser. ................
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