Eating out on a renal diet

Dining out is a lot of fun.  It is possible to choose from most menus when following a renal diet.  The suggestions below will help your child choose well and prevent high potassium, phosphorous and salt intake as well as fluid overload.

It may be helpful to contact a restaurant or hotel before your visit to discuss your child’s diet.

General tips

• Soups are generally high in potassium and salt and will form part of your fluid restriction and should be avoided
• Most vegetables are high in potassium and request if possible these are boiled rather than steamed
• Bread or garlic bread is a good option as a starter or side dish
• Avoid free refills for drinks
• If your child takes a phosphate binder remember to take this with you to the restaurant
• If your child has a poor appetite, phoning the restaurant before your visit may enable you to explain the situation and come to some agreement, eg sharing your meal with your child or requesting a smaller portion at a     reduced cost     

Asian

Asian food such as Chinese, Thai, Malay, Japanese and Vietnamese usually consist of meat, fish or poultry combined with fresh vegetables.  Steaming, deep frying or stir fry are common cooking methods; vegetables cooked in this way will be high in potassium.

Top tips:

• Ask for your food to be cooked to order so that it may be prepared without soy, fish, black bean, hoisin or oyster sauce.  Ask for food to be cooked in ginger, chilli or garlic instead to add flavour or you could ask for a small   serving of sauce on the side
• Try choosing dishes with sweet and sour, lemon, orange, plum sauce
• Order plain boiled or steamed rice or noodles as they contain less salt than fried rice or noodles
• Avoid soups
• Choose meat and fish dishes but avoid dishes that contain prawns or tofu
• ·Nuts and green leafy vegetables such as bok choi, Chinese spinach or Chinese cabbage should be avoided due to their high potassium content
• Ideas for starters: omelette, prawn or sesame toasts, prawn crackers, dim sum, spring rolls, sushi, tempura, duck pancakes, crispy wontons
• Ideas for main courses: lemon chicken, duck in plum sauce, chow mein, sweet and sour dishes, meat or fish kebabs
• Ideas for desserts: pineapple or apple fritters, toffee apples or sorbet

Indian

Indian food often combines meat, fish or poultry with fresh vegetables and potatoes.  Sauces are often tomato based and are made using fresh herbs and spices; they are therefore often high in potassium.  Indian dishes can often be large and filling.  Ask for small portions or share your dish

Top tips

• A portion of boiled rice, chapaati or naan bread makes a filling accompaniment.  This will therefore limit your intake of sauce
• Ideas for starters: poppadoms are okay but limit the toppings such as raita, mango chutney or lime pickle.  Pakoras or samosas, naan bread (avoid peshwari naan due to the dried fruit content), chappaatis
• Ideas for main courses: dishes without a sauce, eg biryani, tandoori, tikka, bhurji, bhuna, meat kebabs are good options.  Keema, dupiaza and korma are cream-based sauces and therefore good alternatives.  Avoid dhal or dhansak dishes or dishes containing sea food.  Basmati, saffron, biriyani rice dishes are good choices
• Ideas for desserts: jelabi
• Avoid main courses and side or rice dishes containing dried fruits or nuts

Mexican

Mexican food gives you the option to prepare your own dish, eg fajitas/tacos/tostadas.  Avoid dishes with lots of cheese, eg quesadillas or nachos

Top tips

• Ideas for fajita fillings include minced meats, beef or chicken and salad vegetables such as lettuce, cucumber, onion
• Avoid refried beans, salsa and guacamole.  Sour cream can be used in moderation
• Avoid chilli con carne as this contains kidney beans and tomatoes making it a high potassium dish
• A dessert option would be churros.  Ask for chocolate sauce on the sideIdeas for fajita fillings include minced meats, beef or chicken and salad vegetables such as lettuce, cucumber, onion
• Avoid refried beans, salsa and guacamole.  Sour cream can be used in moderation
• Avoid chilli con carne as this contains kidney beans and tomatoes making it a high 

Spanish tapas

Tapas provides a wide range of small dishes some of which will be renal friendly.  Some dishes can be high in salt, eg olives, manchego cheese and smoked/cured meats such as chorizo and salami.

Ideas for tapas dishes: calamari, tortilla Espanola, pescado blanco frito (deep fried white fish), rice-based dishes such as paella, ensalada mixta (without tomatoes)

Italian

• Limit antipasti dishes containing cheese, olives, smoked/cured meats and marinated vegetables as these can all be high in sodium
• Avoid adding extra hard cheese to dishes, eg parmesan or parmegianno regianno
• Add black pepper, olive or chilli oil for flavouring dishes
• Ideas for starters: breads, eg ciabatta, focaccia, herb or garlic bread, dough balls or sticks are good choices with olive oil and balsamic vinegar.  Insalata mista (without tomatoes).  Avoid olives, cured meats (eg parma ham) or cheese or tomato-based dishes can be high in potassium and salt

Pizza

Pizza is usually both high in salt and potassium.  Salt is found both in the pizza base and in the toppings.  If you choose to have pizza have 2 slices with a small salad and some bread.  Vegetable toppings such as spinach, tomatoes, mushroom, artichoke and sweetcorn can all be high in potassium; choose lower potassium alternatives such as green peppers, onions, leeks or pineapple.  Meat and fish toppings such as chicken, tuna, beef are lower in salt than salami, pepperoni, ham, bacon, anchovies, sausage or olives.  Avoid pizza with extra cheese as a topping

Try garlic or pesto as an alternative to the traditional tomato topping

Pasta

Pasta is low in potassium, phosphate and salt and makes a good choice when eating out.  If possible, order the sauce on the side to allow you to control how much you add.  Olive oil and garlic, cream, white wine sauce or pesto are good choices.  Sauces such as marinara, Napoli or arrabiatta are all tomato-based and high in potassium.  Lasagne and spaghetti bolognese are both tomato-based and high in potassium.  Rice-based dishes such as risotto are an alternative option but avoid mushroom risotto and request a small portion as this is high in salt

British

British food encompasses a diverse range of foods these days.

Breakfast is one of the easiest meals to eat out.  Good options include porridge, cereal, bread (eg crumpets, toast, English muffins, croissants, bagels), waffles and pancakes which can be served with jam, honey and syrup.  Hot food options include omelette, scrambled egg, boiled egg, small portion of baked beans, fried bread.  Limit cured or salted meats eg ham, bacon or sausages and black pudding.  Mushrooms, tomatoes and hash browns are high in potassium and should be avoided

Avoid fresh fruit juices.  Choose tinned (drained of juice) or stewed fruit – apple, pear, mixed berries are a good option.  Avoid bananas, melon and any dried fruit

Lunch – sandwiches (French bread, sliced bread, ciabatta, bread roll, tortilla wrap etc) choose white bread and select roast beef & mustard, tuna mayonnaise, chicken, turkey, egg salad, cottage cheese

Main meal

• Where possible choose a meal that is prepared to order
• Ask that salt and salt seasonings are not added
• Ask for sauces and gravies to be served on the side instead of over the food so that it can be added sparingly
• Remove batter or coating from breaded items to reduce the salt content, eg fish in breadcrumbs or batter
• Choose: grilled or roasted steaks, chops, lamb shank, chicken or fish seasoned with black pepper, lemon, garlic or ginger.  Mashed potato topped pies, eg shepherd’s pie or cottage pie.  Roast dinner are good choices.  Serve with roast potatoes that have been pre-boiled first or mashed potato

Salad or salad bars

Salads can be a healthy choice as a main meal or side dish.  As a main meal salad can be served with bread, pasta or rice

• If you are creating a salad from a salad bar choose from the following low potassium options: lettuce, carrots, radishes, cauliflower, green peppers, celery, apple, onions, cucumber, beetroot, noodles, pasta or rice salad, cottage cheese, canned fruit cocktail, canned peaches and pears, canned pineapple.
• Choose olive oil, lemon, balsamic vinegar or vinegar as a dressing
• Avoid raw spinach, olives, pickles, bacon bits, tomatoes, fresh mushrooms, cheese, kidney beans, chickpeas, seeds, nuts, potato salad, bean salad, relishes

Fast foods

Fast food can be an option for an occasional treat on a renal diet.  It does require some planning.  Many fast food items are pre-salted; asking for a portion of fries without salt is a better option

Subway – choose 6” sub; good ideas for fillings include chicken breast, tuna, ham, egg mayo, beef, turkey breast, club, sweet onion teriyaki and salad.  The wraps available are all okay for those following a low salt diet.  Avoid subs and wraps with extra cheese, dressings and those which double-up the filling, eg turkey breast and ham

Burger King – choose a plan hamburger or Angus burger, ocean catch, chicken bites or chicken fillet strips.  The chicken burger, cheeseburger and veggie beanburger all contain more salt and may also be a source of potassium and phosphate.  Ask for fries without salt

Pizza Hut/Dominoes Pizza – see Italian section for lower salt and potassium pizza topping ideas.  Limit pizza to 2 slices and serve with garlic bread, dough balls and small side salad

McDonalds – choose a hamburger/mayo chicken/grilled chicken salad.  Avoid Big Macs/big tasty/chicken legend burgers as they have a very high salt content.  Ask for fries without salt

KFC – grilled chicken wings are the lowest salt option at KFC although remember that if you eat more than one the salt content can get very high.  Another better option is the KFC snackers.  Avoid fillet burgers, double downs and crispy twisters as they are extremely high in salt

Cornwall Pasty Co/Greggs – most pies, pasties, sausage rolls are very high in salt

Fish and chips – remove batter from battered fish as this is high in salt.  A small portion of chips can be eaten as a treat but remember these are not pre-boiled so will be high in potassium.  Serve with bread and side salad to fill you up.  Avoid battered sausages and burgers as these are high in salt.

A note about fries: Remember fries can not only be covered in salt but are also high in potassium as they are not pre-boiled.  They are therefore recommended as strictly an occasional treat only!

Coffee shops, eg Starbucks or Costa Coffee  

Try to choose tea, fruit tea or cold fruit squash, eg Fruit Shoot instead of coffee options which are high in potassium and often served with milk which will also make them high in phosphate.  Coffee shops offer a range of snacks – try to choose toasted bagel, plain muffin, sandwich filled with chicken, turkey, beef, tuna or salmon.  Sweet options include a slice of plain shortbread or a doughnut.


Remember – eating regular take-aways is not recommended.  The information given here is only to guide you to make better choices when having a take-away as an occasional treat