Eating a low protein diet has been shown to benefit people with kidney disease. The average American eats A LOT of protein. Generally much more than is needed and definitely too much for someone with kidney disease. Therefore, switching to a low protein diet is often recommended.
Disclosure: This post is sponsored by Flavis, maker of low protein kidney friendly products. As always, all opinions are my own and current as of day of post. Opinions may change as new research, evidence, or products are released.
What is a low protein diet?
“Low protein” can mean many things. In medical literature, the main low protein diet approaches to preserve kidney function include:
- Vegetarian diet (different variations, but primarily no meat)
- Vegan diet (no animal products)
- Low protein diet (0.6-0.75 gm/kg)
- Very low protein diet (0.3-0.4gm/kg)
Each of these four different low protein diet approaches to preserve kidney function have merit, but in different ways and for different stages of kidney disease.
Who needs a low protein diet?
People with kidney disease that are not on dialysis can help protect the health of their kidneys with a low protein diet. Eating less protein means less work for your kidneys to filter out wastes.
Reducing the burden placed on the kidneys will help preserve their function. This is why as kidney disease progresses (as in later stage kidney disease or GFR<20), a low protein diet is often recommended as a therapeutic approach.
The average protein intake of most Americans is around 100 grams of protein or more per day. In comparison, people with kidney disease should be aiming for less than 60 grams or even 40 grams or less if following a very low protein diet with ketoanalogues.
Is a low protein diet hard to follow?
Without guidance, a low protein diet may be confusing for some. It can be tricky to know where to start: to know your protein, calorie, as well as vitamin and mineral needs. Too much or too little can be dangerous for your health.
Getting help from an expert Renal Dietitian can make your journey to a low protein diet much easier to follow.
Success with a low protein diet
A renal dietitian can be very helpful in planning a low protein diet. They will help you get started by providing you your nutrient goals. They will help you find ideas for breakfast, lunch, and dinner that excites you. They will also teach you how to modify your favorite foods to “fit” your new lifestyle and nutrition plan.
Here are 8 strategies you can use to work toward a low protein diet
1. Get more healthy fats!
Fat is a critical component of a low protein diet and an essential component of a very low protein diet. Fats helps to curb hunger and prevent weight loss. Easy ways to add more healthy fats include: tossing rice or pasta with olive oil, drizzling olive oil over steamed veggies or salads, or sauteeing vegetables in avocado oil.
2. Power up with coconut
Coconut milk, coconut cream and coconut oil are great sources of fat that also have an incredible flavor. Coconut milk and coconut cream is relatively high in potassium, but a little goes a long way.
My clients have used a splash of coconut cream in their coffee or whipped up coconut cream over desserts. Adding toasted coconut flakes on your breakfast parfait also adds fat and extra fiber to keep you fuller even longer!
3. Avocado can fit too
Avocado can be a big player in the low or very low protein diet. Not only is it a great source of healthy fat and calories that is low in protein, it’s also rich in fiber and many other beneficial nutrients. Half of an avocado (about 100 grams) contains 160 kcal, 2 grams of protein, and 6.7 grams of fiber!
Some people with kidney disease need to limit potassium intake. Avocado is high in potassium, providing about 480 mg of potassium per half an avocado.
4. Cauliflower for the win
Cauliflower is an incredibly versatile vegetable, you can add it to anything and everything. It’s good in savory dishes like stir-fried “riced” cauliflower, cauliflower pizza crust, or cauliflower mash in place of mashed potatoes. It’s also surprisingly good as a thickener in smoothies!
Since cauliflower is almost tasteless, it can be enjoyed even by those who don’t like vegetables. This is important because fresh produce contributes directly to proper acid-base balance that preserves kidney health.
Cauliflower fits particularly well in a low or very low protein diet because it’s low in protein and potassium, while being a good source of fiber and antioxidants. 1 cup of cooked fresh cauliflower contains 2.3 grams protein, 176 mg potassium and 2.9 grams of fiber.
5. Creamy dishes without the cream
Creamy dishes can be a comfort food for many, but dairy is often off the list for those on a low or very low protein diet. However, there are many ways to substitute dairy in meals that can get the job done as well or even better.
Our clients have tried using coconut cream or coconut milk in creamy soup dishes. Unsweetened dairy-free yogurt with some spices with blended avocado or soaked cashews also provides creaminess in many pasta dishes. They’re good even as dips and dressings!
6. Flavors to make you love your food
Food must taste good in order to start and maintain a new lifestyle. Because a lot of people with kidney disease need to lower their sodium intake, we have to get creative in flavoring dishes without much (or any) salt. We’ve got three answers: herbs and spices, aromatic vegetables, and acid.
Herbs and spices can add so much flavor and depth to your dishes. For instance, adding basil, oregano and some red pepper flakes in your pasta sauce will add a lot of flavor without adding extra protein, potassium, or sodium.
Aromatic vegetables like garlic, onions, scallions, and ginger can transform your dishes and make it more fragrant and flavorful. They are typically used a lot in Asian stir-frys. Simply mince them, fry them in some oil, then toss in your vegetables and optionally rice or noodles.
Finally, acid. This is the key to balance and brighten flavors in addition to making any flavors pop. Try adding a squeeze of lemon to sautéed mushrooms, some lime juice on your veggie tacos, or balsamic vinegar on tomatoes or even strawberries. It will change your life.
7. Missing meat?
Saying goodbye to meat may be a difficult change for some people. Meat is extremely protein dense so it is essential to limit on the low or very low protein diet. It can be challenging to balance the needs of the kidneys with the needs of the taste buds. Here are some ideas for meat swaps our clients have included:
- Tofu: when frozen and thawed will provide a chewy texture
- Tempeh: cooked as a steak or sliced in stir-fry’s
- Seitan: closest substitute to meat, but it can be high in sodium
- Jackfruit: cooked in BBQ sauce to mimic pulled pork
- Grilled cauliflower steaks or Portobello mushroom: so full of umami!
- Beans and quinoa: spiced and shaped into patties for your plant-based burgers
8. Missing “normal” food?
When your protein goals are low or very low, it can be hard to even include your normal starches like noodles, rice, breads, or crackers. Starches and grains are often the next highest protein contributors after meat, dairy, and other high protein foods like beans, nuts, or tofu. This is where specialty products like Flavis come in!
9. When following a VERY low protein diet, consider using low protein food items
When getting your protein levels down very low (as in <30-40 grams/day) it can be helpful to utilize some low protein foods on the market. This can often give you some wiggle room to add in some really nutrient dense whole foods such as nuts while still keeping your protein level at goal.
When to use low protein foods and why you’d invest in these products:
Flavis provides a range of starches that are especially low in protein, including noodles, rice, breads, pizza crusts, and crackers. They are also a good source of fiber and low in potassium and sodium, so they can be enjoyed by everyone. Lowering protein intake from your starches means there is more room for higher protein foods like beans, nuts, and tofu. Win-win solution!
- Easy rice and noodle swaps
Flavis offers low protein rice and many variants of low protein pasta. As a comparison, one serving of Flavis low protein rigatoni only contains 0.3 grams of protein while whole grain pasta provides 8.3 grams of protein per serving. That’s a difference of 8 grams of protein wiggle room (which is a lot if your goal is around 30-45 grams of protein daily)! By using a low protein pasta, you could include more beans with your meal. Check out Flavis’ recipe for Rigatoni with Roasted Red Pepper Pesto Broccoli & White Beans. OR Saffron Mushroom Risotto
- Yes, you can have bread
Sandwiches normally includes two slices of bread. Without using specialty products, two slices of whole wheat bread adds up to 9 grams of protein (not including your sandwich fillings). On the other hand, two slices of Flavis’ low protein brown bread provides only 0.6 grams of protein. This provides 8.4 grams of protein wiggle room! This means you can add another tablespoon (or two!) of peanut butter or hummus. Check out Flavis’ recipe for Mediterranean Bruschetta which highlights some of their delicious bread!
Yes! One serving of Flavis low protein pizza crust is only 0.5 grams of protein compared to the same amount of whole wheat pizza crust that provides 4.7 grams of protein. This frees up some extra toppings! Maybe a little bit more mushrooms on a layer of marinara sauce, or a little extra cashew cheese?
- Simple snack ideas
Most clients like to allocate their protein “allowance” for larger meals of the day and minimize protein for snacks. But when hunger strikes, who could resist crackers? Flavis low protein crackers provides only 0.3 grams of protein, while a serving of regular whole wheat crackers contains 3.3 grams of protein. Choosing the lower protein option means you could have more crackers AND more toppings or dips. Try this recipe from Flavis for Carmelized Onion Dip. These crackers also pair really well with guacamole, hummus, or olive tapenade. They are also delicious dipped in dairy-free ranch or cashew cheese dip!
If you have kidney disease, following a low protein diet can reduce the stress on your kidneys and preserve kidney function. Some of our most practical tips to help you be more successful with following a low protein diet include:
- Adding fat and flavoring foods with low sodium seasonings is essential to making a low protein diet more satisfying and enjoyable.
- Plant-based proteins such as Tofu, mushrooms, and beans and quinoa are a great substitute for meats!
- The Renal Dietitians at the KidneyRD are here to help! Book a consultation with a KidneyRD practitioner to help you successfully implement a Low Protein or Very Low Protein Diet.
- Finally, using specialty Low Protein products such as Flavis gives you more freedom to add higher protein foods like beans, nuts, and Tofu.