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Discover the Benefits of Caribbean Fluid in Kidney Diet

Discover the Benefits of Caribbean Fluid in Kidney Diet

1. Understanding Kidney Health

Kidneys perform many vital functions in the body. They filter blood, remove excess fluid and waste, and maintain a healthy balance of electrolytes. Kidneys also produce the erythropoietin hormone that stimulates the production of red blood cells, controls blood pressure, and keeps the bones strong and healthy. 

Chronic kidney disease is a condition in which the kidneys stop filtering waste from the blood and decline to perform their function. It is a progressive condition that worsens over time. While CKD is a progressive condition, timely management is helpful to slow its progression. Changes in lifestyle and medical treatment can preserve kidney functions in the early stages of CKD. The ISN Public Affairs reported the prevalence of CKD was about 11.9% in Caribbean and North American regions. 

What are the early signs of CKD?

These are the common symptoms of kidney damage, and some people do not experience them in the early stages. 

  • Nausea
  • Vomiting
  • Fatigue and weakness
  • Sleep problems
  • Muscle cramps
  • Dry, itchy skin
  • Loss of appetite
  • Urinating more or less
  • Swelling of feet and ankles

The symptoms of kidney disease are often non-specific and become severe in later stages of chronic kidney disease (CKD). So, timely intervention and dietary modifications are important to maintain kidney health and its normal functioning. 

The relationship between diet and kidney health

Diet plays an important role in maintaining kidney health. Proper nutrition reduces the strain on kidneys, especially in people with other diseases such as hypertension or diabetes. A healthy diet rich in fruits, vegetables, and whole grains, with controlled protein, phosphorus, and sodium intake, helps manage kidney issues. Similarly, diets high in processed foods and salt also contribute to kidney damage, which increases blood pressure and worsens kidney disease.

The Centres for Disease Control and Prevention highlighted that CKD is common in people with diabetes, and 1 in 3 adults with diabetes has CKD. According to NIH, CKD affects approximately 13.4% of the global population (2023 data), with a higher incidence in people of Afro-Caribbean descent.

2. The role of kidneys in fluid regulation

How do kidneys balance fluid levels in the body?

Adequate water balance in the body is the most important factor for the survival of living organisms. 

Proper fluid balance is necessary for all living organisms. A human cannot survive more than three days without consuming water. Renal nephrons filter blood and determine how much water the body needs and how much to excrete as urine.

Sufficient intake of water also regulates normal bowel movements in the colon and is necessary for waste removal. Therefore, it is crucial to maintain a balanced water intake, as the kidneys are responsible for maintaining fluid levels and preventing dehydration or fluid overload.

What is fluid overload, and how do you balance it?

Fluid overload, medically known as hypervolemia, is a condition in which excessive fluid accumulates in the body. It occurs when the kidneys fail to properly filter excess fluid from the body. Different conditions, such as heart failure, renal failure, or cirrhosis, can cause it. In CKD, hypervolemia is common because the kidneys can’t filter excess fluids from the body. The common symptoms of fluid overload are swelling, high blood pressure, shortness of breath, discomfort, chest pain, and weight gain. 

Several studies have shown that CKD decreases the kidneys' ability to regulate fluids. Studies published in PubMed (PMC) revealed that the nephrons lose their effectiveness in filtering waste and maintaining fluid balance as CKD advances. It results in an increased risk of both dehydration and fluid retention, which worsens the CKD condition. 

Similarly, sodium and potassium are electrolytes that also help to maintain fluid and blood volume. Sodium maintains fluid levels outside the cell, while potassium maintains fluid levels inside of cell. Potassium also ensures proper nerve and muscle functioning. When the kidneys are unable to properly balance these electrolytes, it can lead to dangerous conditions such as hypernatraemia (too much sodium) or hyperkalaemia (too much potassium). Both conditions are harmful and negatively impact fluid balance and overall health.

3. Importance of Hydration

Healthy hydration refers to getting the right amount of water to maintain proper body health. Lower water intake leads to dehydration, and excessive water leads to fluid overload. In CKD, dehydration is harmful because it makes kidneys work harder and worsens the condition.

Dehydration also leads to other complications such as kidney stones, urinary tract infections, kidney failure, electrolyte imbalances, clogged kidneys, and the buildup of wastes and acids. These are some common symptoms of dehydration specific to CKD. 

  • Swelling 
  • Shortness of breath
  • Cramping
  • Headaches
  • Stress on the heart
  • High blood pressure

Other symptoms of dehydration also involve

  • Dry mouth, lips, and tongue
  • Nausea and vomiting
  • Concentrated dark urine
  • Dizziness or light-headedness

According to the World Health Organisation (WHO), safe hydration levels depend on factors such as age, climate, activity level, and overall health. The U.S. National Academies of Sciences recommends 3.7 litres for men and 2.7 litres for women, including all beverages and foods, per day.

4. Safe Fluid Consumption Strategies

How much fluid intake is safe in CKD stages?

Fluid requirements in people with chronic kidney disease (CKD) depend on the stage of the disease. Healthcare providers usually recommend fluid restrictions, especially in later stages (stages 3-5), due to the kidneys reduced ability to filter waste and fluids.

 

  • Stages 1 and 2: In CKD stages 1 and 2, fluid intakes may remain close to normal unless there are complications such as swelling or high blood pressure. The American Kidney Fund recommends drinking eight glasses (64 ounces) of water daily.
  • Stages 3 and 4: In the advanced stages of CKD (stages 3 and 4), it is necessary to limit fluid intake to prevent fluid buildup and other complications, such as oedema or heart failure.
  • Stage 5 (End-Stage Renal Disease): In stage 5 CKD, strict fluid management is necessary. People with ESRD are often treated with regular dialysis, where fluid is removed from the body during treatment sessions.

Patients with CKD are advised to consult with their healthcare team or dietitians to determine their specific fluid needs based on their health condition and other factors, such as activity level and climate.

How to distribute fluid intake throughout the day?

It is important to distribute fluid consumption throughout the day to lower the strain on the kidneys. Here are some practical ways to evenly distribute the fluid all over the day. 

  • Morning: Start your day with a moderate amount of water to keep the body hydrated.
  • Midday: Take small sip throughout the afternoon to maintain hydration levels without stressing the kidneys.
  • Evening: Try to limit fluid intake in the evening to prevent swelling and urination during bedtime.

For CKD patients on fluid restrictions, it is advised to use small water or measuring cups to regulate fluid intake and prevent them from exceeding the daily limit. 

How do you manage fluid intake during hot climates?

It is important to hydrate the body in hot climates but should not exceed the limit. Hot climates, such as the Caribbean, increase fluid loss due to sweating. It increases the thirst of CKD patients and causes them to consume more water. However, excessive intake in such conditions worsens kidney complications. Here are some tips to manage fluid intake for CKD patients, especially during hot weather.

  • Hydration in Hot Climates: Consume fluids slowly throughout the day to replace lost fluids (such as sweating) without burdening the kidneys.
  • Electrolyte Balance: In hot climates, it is recommended to take electrolyte-rich fluids (like oral rehydration solutions, ORS) to avoid dehydration and maintain kidney health.
  • Avoid salty foods: Salty foods increase thirst. Therefore, we recommend avoiding salty foods like chips or pretzels.
  • Shade and Cool Spaces: CKD patients should stay out of direct sunlight and extreme heat because sweating increases fluid loss.
  • Chill or freeze fruit for a refreshing snack: Consuming chilled or frozen fruit provides cooling delight without added sugars.
  • Chew gums or sugar-sour candy: Chewing gums makes more saliva and also reduces thirst during hot climates. 

How to Track Fluid Consumption?

It is helpful to track the consumption of fluid intake to maintain fluid balance and prevent overhydration or dehydration. It is most beneficial for CKD patients in which the fluid intake is restricted and needs to be strictly monitored. There are many tools available online to track fluid intake, such as 

  • Smartphone Apps: Apps like MyFitnessPal or WaterMinder help patients record their daily fluid intake and receive reminders to track consumption.
  • Diaries: Keeping a personal or digital diary is another way to ensure patients stay within their recommended intake limits.
  • Measuring Containers: Use a customised container for all beverages throughout the day. It ensures fluid intake does not exceed recommended levels.

Many online sources and podcasts provide advice on kidney health, such as the National Kidney Foundation (NKF) and the American Kidney Fund, on fluid management and tips for living with kidney diseases. The National Kidney Foundation also offers clear guidelines on fluid restrictions for different stages of CKD and ways to stay hydrated and prevent overhydration.

5. Manage potassium and sodium intake while maintaining fluids.

Sodium and potassium are minerals that play an essential role in the body. These electrolytes regulate fluid balance, muscle contractions, and nerve signals. In chronic kidney disease, the kidneys are unable to perform their function and maintain electrolyte balance, which leads to fluid buildup. They cause complications and put strains on the kidneys, increasing blood pressure and heart problems. 

When potassium levels increase in the blood, it leads to hyperkalaemia, which causes muscle weakness, irregular heart rhythms, and even cardiac arrest. Similarly, high sodium levels also cause fluid retention and high blood pressure, which burden the kidneys and increase the risk of cardiovascular diseases.

These are some lists of foods that are high in potassium, and CKD patients are required to restrict them and consume their alternatives. The alternative foods are kidney-friendly and low in potassium.

High-Potassium Food

Low-Potassium Substitute (Kidney-friendly foods)

Bananas

Apples, berries

Potatoes (white/sweet)

Cauliflower, rice, pasta

Spinach

Green cabbage, lettuce

Avocados

Cucumber, zucchini

Tomatoes

Bell peppers, cucumber

Oranges

Grapes, apples

Mushrooms

Onions, eggplant

Beans (kidney, black)

Green beans, peas

Melons (cantaloupe, honeydew)

Pineapple, watermelon

Dried fruits (raisins, apricots)

Fresh fruits like apples

How to Lower Sodium Levels in the Blood through Diet?

To lower sodium levels, people with CKD can use substitutes of sodium to maintain the flavour of meals. There are several ways to enhance flavour without consuming high-sodium ingredients.

  • Use fresh herbs like basil, thyme, and rosemary.
  • Try garlic and lemon juice for a tangy flavour boost.
  • Use spices like cumin, paprika, or turmeric.
  • Opt for low-sodium broth or salt substitutes as advised by the dietitian or healthcare provider.

According to Healthline, CKD affects an estimated 37 million people in the U.S., with an increased risk for heart disease due to poor management of potassium and sodium levels. DaVita also reported that patients with CKD who consume foods higher in sodium are more likely to suffer from heart failure than normal individuals.

6. Enjoy Traditional Caribbean Foods

Caribbean cuisine is known for a variety of dishes with vibrant flavours and local ingredients. For kidney disease patients, choosing these Caribbean dishes allows them to enjoy the tastes of their meal while protecting their kidney health.

People can modify Caribbean dishes by modifying meals to reduce sodium content and limit the potassium-rich ingredients. For example, jerk seasoning can be modified by reducing the amount of salt and using fresh herbs and spices like thyme, garlic, and ginger. 

Nutritional benefits of local ingredients in Caribbean cuisine

Several traditional Caribbean ingredients provide many nutritional benefits, and with a few changes, a person can make this cuisine into a kidney-friendly diet. For example, yams are a starchy root vegetable rich in fibre, vitamins, and antioxidants; portion control should be considered for CKD patients due to their high potassium content. Similarly, callaloo is also a leafy green vegetable that is rich in vitamins A and C. However, due to its high potassium content, one should consume it in moderation.

Recipes for kidney-safe versions of popular dishes:

These are some popular dishes that are kidney-friendly and tastier to consume.

  1. Codfish with eggplant

A Creole sauce cooks the stewed codfish and eggplant with garlic and onion. It is a kidney-friendly, low-protein recipe that provides a perfect combination with brown or white rice. The preparation time for this dish is 8 min, and the cooking time is 18 minutes.

Ingredients: (yields 4 servings)

  • • 1 medium-sliced yellow onion.
  • 4 cups eggplant into small cubes
  • 2 tbsp olive oil
  • ½ cup unsalted tomato sauce
  • ½ cup water
  • • 1 tbsp. Sofrito
  • 4 cloves minced garlic
  • 1 tsp dried parsley
  • 8 oz. codfish fillet without phosphorus additives
  • ¼ tsp salt
  • ½ tsp. ground black pepper
  • Puerto Rican hot sauce, for taste

Directions

  • Cover a big skillet and place it on the stove over medium heat to preheat.
  • Add eggplant, onion, and oil. For ten minutes, cook with a lid on. Stir two or three times and then cover again.
  • In a small bowl, combine tomato sauce, water, sofrito, dried parsley, and minced garlic and mix well.
  • Add the liquid to the skillet after ten minutes and stir well.
  • Add codfish fillets to the skillet on top of the cooked onion and eggplant. Add salt and pepper to season the cod. Cook and cover for 4 minutes.
  • Flip the cod fillets, cover them, and cook for an additional 4 minutes.
  • Flake the codfish and mix well.
  • Serve hot over white or brown rice. Finish with hot sauce, to taste.
  1. Kidney-Friendly Pad Thai

Made with healthy ingredients, this meal is also kidney-friendly and safe to consume. It takes 30 minutes to prepare the ingredients and 30 minutes to cook the whole meal.

Ingredients: Yields 4 servings.

  • ¼ cup dried tart cherries
  • ½ cup of hot water
  • • 1 tsp. white miso paste.
  • 1 tablespoon of olive oil
  • 1 onion, chopped
  • • 2 cloves of minced garlic.
  • 2 tbsp coconut aminos
  • 2 tbsp. rice vinegar
  • 1 tbsp. brown sugar
  • 1 tbsp. tamarind paste
  • • 1 tsp. ground turmeric.
  • • 1 tsp. ground ginger.
  • 1/4 tsp. red pepper flakes
  • 1 (14-oz.) package of rice noodles, cooked
  • 1 cup shredded cabbage
  • 1 cup of bean sprouts
  • 1, 16 oz package of Extra Firm Tofu in cubes
  • 1/4 cup chopped peanuts (optional)
  • Fresh cilantro for garnish

Directions:

  • Combine the miso paste, cherries, and hot water in a small bowl and cover.
  • Allow to settle for 5 to 10 minutes, or until the cherries are soft and delicate. 
  • Add rice vinegar, brown sugar, tamarind paste, turmeric, ginger, red pepper flakes, and coconut amino in the bowl.
  • Combine the rice vinegar, brown sugar, tamarind paste, turmeric, ginger, red pepper flakes, and low-sodium soy sauce in a small bowl.
  • In a big skillet or wok, heat the olive oil over medium heat. Cook the onion for around five minutes, or until it becomes tender. Cook the garlic for an additional minute until it becomes aromatic.
  • After adding the sauce, sauté the garlic and onion for two minutes, or until the sauce has thickened.
  • Add the tofu, cabbage, bean sprouts, and cooked noodles. Cook until the vegetables are crisp-tender, 3 to 5 minutes.
  • Add the cilantro and peanuts and stir. Serve immediately and enjoy the meal.

For CKD patients, it is important to consume food according to portion control. As many Caribbean dishes are high in starches and sauces, practicing portion control is helpful to prevent excess potassium and phosphorus. Therefore, by limiting the portion size of starchy foods like yams, plantains, and rice, people can better manage their electrolyte balance. 

People can also follow online resources like the National Kidney Foundation and Kidney Kitchen to get kidney-friendly recipes. They also provide alternatives for many Caribbean dishes to help people with better management of CKD without compromising their health.

7. Create a Sustainable Kidney-Friendly Diet

To maintain kidney health, it is important to follow a proper meal plan. Creating a sustainable, kidney-friendly diet requires a proper balance of nutrients, consistency, and accessibility. Here are some strategies for creating a sustainable, kidney-friendly diet that is both budget-friendly and balances essential macronutrients.

How to Make an Affordable Kidney-Friendly Meal 

It is challenging to eat healthy while sticking to a budget. Cooking healthy on a budget requires careful planning without compromising on the quality of your food and ingredients. Here are some ways to spend less on a food shop while staying on a budget.

  • Shop sale items: Purchasing expensive foods on sale or stocking up on necessities can help you spend less money over time.
  • Plan meals around less expensive ingredients: Planning before buying is important. People can also make a checklist around less expensive ingredients, like nutrient-dense ingredients with affordable options recommended. High-quality meats and seafood are also expensive, but cheaper options for proteins are also available, such as Greek yoghurt, cheese, and eggs. Similarly, substitutes for healthy carbs within the affordable range include sweet potatoes, whole-grain bread, and beans. To consume fat within budget, affordable options are available, such as avocado and natural peanut butter. Some vegetables, such as kale, frozen corn, frozen green beans, beets, carrots, and broccoli, are also healthy options and budget-friendly to consume. 
  • Plan meatless meals: Consuming protein with meatless meals is a budget-friendly option that is helpful to balance vegetarian meals. Plant-based proteins such as dairy, eggs, lentils, pasta, and beans are kidney-friendly foods within the affordable range. 
  • Make more from scratch: Making food from scratch is time-consuming, but it is a cheaper option than consuming processed food items. People can also add ingredients to make a larger quantity to freeze for future weeks.
  • Stick to your list: Make a proper list of ingredients with the quantity and stick with the list before going to the market. It is helpful to shop within a budget by sticking with the list of ingredients.
  • Shop at farmer’s markets when available (produce lasts longer): It is a wonderful option to buy fresh fruits and vegetables from a farmer’s shop. Fresh foods are healthier to consume and also last longer. However, it might be a little costly, but it reduces food waste. 
  • • Reduce food waste: Purchase only the foods and ingredients required for the meal plan to minimise food waste.
  • Use your freezer: The freezer is a lifesaver option for food because it prevents it from spoiling. It increases the shelf life of foods, such as fresh fruits and vegetables, for later consumption. Vegetables like kale, broccoli, cauliflower, spinach, corn, and berries are excellent frozen options to consume later.

Balancing macronutrients for kidney health

It is essential to properly balance macronutrients, including protein, carbohydrates, and fats, to manage the complications of kidney disease. These options are kidney-friendly and healthy options to consume.

  • Protein: It is important to limit the protein intake to lower the strain on kidneys. Focus on high-quality sources like fish, eggs, and tofu. Moderate protein consumption is important for long-term kidney health.
  • Carbohydrates: Complex carbohydrates are a better option to consume than refined carbohydrates such as quinoa, oats, and barley. It provides sustained energy and fibre, which promote digestion without overloading the kidneys.
  • Fats: Consume healthy fats to maintain kidney health. Consume avocado, olive oil, and nuts in moderate amounts. These fats are anti-inflammatory and beneficial for overall health.

How to Address Common Challenges in Adopting a New Diet?

Following a kidney-friendly diet can present common challenges.

  • Taste Preferences: It is challenging for many people to eat tasteless foods that are low in sodium. To overcome this challenge, they can substitute salt with low-sodium seasoning blends and fresh herbs to enhance flavours.
  • Cost of Ingredients: Purchasing fresh and healthy foods is mostly costly. They can also buy ingredients in bulk and shop at local markets to reduce expenses.
  • Staying Motivated: It is difficult to maintain motivation and remain consistent. To overcome this, they can join a community group or work with a dietitian to stay motivated and consistent.

How do you remain consistent while following a meal plan?

Consistency is key while following a meal plan. It is important to stay consistent and avoid foods that are not kidney-friendly. Below are some ways to remain consistent while following a meal plan. 

  • Stay consistent with meal timing: It is an effective way for an individual to track their healthy eating habits and take control to nourish the body. People should eat food at regular intervals. This strategy helps maintain blood sugar levels and prevents kidney strain.
  • Track your meals and eating habits: It is important to monitor and track your meals and eating habits. Tracking helps you to maintain a healthy diet and focus on things that make it difficult to follow. It is an effective way to help you maintain consistency. 
  • • Focus on balanced and whole-meal options: Meal-planning whole-food meals is a great way to remain consistent with your daily nutrition and to keep track of healthy eating habits. 
  • Practice intuitive and mindful eating: The goal of intuitive and mindful eating is to increase your awareness of consumed foods to improve overall health. 
  • Staying consistent with working out and your diet: Make the necessary adjustments to become more regular with your daily exercise and nutritious diet. 

According to the African Caribbean Kidney Education Enterprise (ACKEE), many Caribbean communities face challenges in following their dietary habits and maintaining kidney health. The research conducted in the Caribbean highlighted that African Caribbean communities are five times more likely to suffer from chronic kidney disease (CKD) than other groups.