NKF KDOQI GUIDELINES

KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease

APPENDIX 1: NUTRITIONAL MANAGEMENT OF DIABETES AND CHRONIC KIDNEY DISEASE

Sample meal plan

MENU

Breakfast
Peanut Butter Oatmeal
Fresh Sliced Pears
Very Berry Smoothie

Lunch
Baked Salmon on a Toasted Hamburger Bun
Roasted Asparagus Spears With a Spicy Tofu Hollandaise^a
Sliced Pineapple With Strawberry Lemon Thyme^b Sorbet^c

Snack
Cucumbers With Horseradish and Dill Dip
Mixed Nuts

Dinner
Grilled Vegetables on Bulgur Pilaf^d
Sliced Avocado
Rum-Baked Apples

1. Hollandaise is traditionally a butter, egg yolk, and lemon juice emulsified sauce.
2. Lemon thyme is a fresh herb that has a lemon wood like flavor.
3. Sorbet is frozen fruit juices or fruit puree with no milk product.
4. Bulgur is a wheat berry with the bran removed, steam-cooked, dried, and ground.

RECIPES

Peanut Butter Oatmeal
1 ⅓ cups uncooked oatmeal
4 tablespoons peanut butter
¼ cup honey

Cook oatmeal in water following the directions on the package, omit the salt. Divide cooked oatmeal into 4 bowls and dollop 1 tablespoon of peanut butter and 1 tablespoon of honey in each bowl.

Analysis
4 servings per recipe, serving size ⅔ cup, calories 258, total fat 10 g, saturated fat 1.7 g, monounsaturated fat 4.5 g, polyunsaturated fat 0.53 g, omega-3 fat 0 g, cholesterol 0 mg, calcium 1.3 mg, sodium 76 mg, phosphorus 123 mg, potassium 210 mg, total carbohydrates 39 g, dietary fiber 3.7 g, sugar 19 g, protein 7 g.

Table 58. Nutrient Composition of This Full-Day Meal Plan

Very Berry Tofu Smoothie
1 lb fresh strawberries, cleaned and hulled
2 cups blueberries
9 oz tofu, silken, extra firm
½ teaspoon ground ginger
2 pinches of red pepper flakes
¼ teaspoon rum extract
1 tablespoon honey
1 teaspoon lemon juice
½ cup ice

Blend all together and serve.

Analysis
4 servings per recipe, serving size 1 cup, calories 125, total fat 1.8 g, saturated fat 0.2 g, monounsaturated fat 0.3 g, polyunsaturated fat 0.8 g, omega-3 fat 0.1 g, cholesterol 0 mg, calcium 44 mg, sodium 42 mg, phosphorus 100 mg, potassium 339 mg, total carbohydrates 22 g, dietary fiber 6 g, sugar 15.5 g, protein 6 g.

Baked Salmon With Roasted Asparagus on Cracked Wheat Bun
16 oz. fresh salmon fillet
1 tablespoon lemon juice
1 tablespoon Butter Buds^®
12 oz. fresh asparagus spears (woody stems removed), washed
1 tablespoon olive oil
4 cracked wheat or whole grain hamburger buns, toasted

Preheat oven to 400ºF. Place asparagus spears on a cookie sheet and spray with olive oil. Roast in the oven for 10 minutes or until tender and slightly brown. Remove from the oven and allow to cool.
Spray baking dish with olive oil. Place salmon filets in baking dish and drizzle lemon juice over the top of each filet. Bake 15 to 20 minutes until the salmon is flakey to the touch. Serve salmon on a toasted hamburger bun, sprinkle with Butter Buds, roasted asparagus and Habanero Hollandaise Sauce.

Habanero Hollandaise Sauce
6 oz tofu—silken, extra firm, drained and crumbled
¼ cup vegetable stock
¼ cup fresh lemon juice
½ teaspoon sugar
¼ teaspoon turmeric
½ teaspoon diced habanero chili (out of the jar), more if you like it spicier

Combine all ingredients in a food processor and process until smooth. Refrigerate overnight before serving.

Analysis
4 servings per recipe, serving size approximately 3 oz, calories 475, total fat 20 g, saturated fat 3 g, monounsaturated fat 10 g, polyunsaturated fat 5.5 g, omega-3 fat 2.6 g, cholesterol 62 mg, calcium 230 mg, sodium 495 mg, phosphorus 364 mg, potassium 810 mg, total carbohydrates 43 g, dietary fiber 5 g, sugar 8 g, protein 32 g

Fresh Pineapple With Strawberry Lemon Thyme Sorbet
30 oz. fresh sliced pineapple

Strawberry Lemon Thyme Sorbet
2 cups fresh ripe strawberries, hulled, washed, and dried
1 cup lemon thyme simple syup
2 tablespoons orange juice
2 tablespoons lemon juice


In a food processor add strawberries, ½ cup lemon thyme simple syrup and process until smooth. Add the other ½ cup of simple syrup, orange and lemon juice. Mix and pour into ice-cube trays. Freeze. When frozen, remove cubes into the food processor and mix thoroughly. Pour back into the same ice-cube trays, cover, and freeze until needed.
Arrange fresh pineapple on a chilled plate. Soften sorbet, spoon 2 tablespoons over the pineapple and allow to melt before serving.

Lemon Thyme Simple Syrup
1 cup water
1 cup sugar
6 to 8 sprigs of fresh lemon thyme

Mix water and sugar in a sauce pan, bring water and sugar to a boil, and turn down the heat to a slow simmer so that the bubbles just break the surface, and cook for 10 minutes. Remove from the heat and steep lemon thyme sprigs in the syrup as it cools to room temperature. Strain the sprigs and keep refrigerated up to 4 weeks.

Analysis
10 servings per recipe, serving size approximately 2 heaping tablespoons over 3 oz. of sliced pineapple, calories 127, total fat 0 g, saturated fat 0 g, monounsaturated fat 0g, polyunsaturated fat 0 g, omega-3 fat 0 g, cholesterol 0 mg, calcium 20 mg, sodium 1.7 mg, phosphorus 15 mg, potassium 156 mg, total carbohydrates 33 g, dietary fiber 1.9 g, sugar 29 g, protein 1 g

Cucumbers With Horseradish Dill Dip
1 ½ teaspoons shallots, minced
1 ½ teaspoons dried dill
2 tablespoons fresh dill
8 oz tofu, extra firm, drained and crumbled
2 teaspoons horseradish, creamy style
Pinch of dry mustard
⅛
1/8 teaspoon turmeric
⅛
1/8 teaspoon cayenne pepper
¼ cup rice milk
1 teaspoon Dijon mustard
2 teaspoons lemon juice
2 teaspoons Miran sweet rice wine
⅛
1/8 teaspoon onion powder
2 tablespoons white cider vinegar
2 English cucumbers
Fresh dill sprigs for garnish (2 tablespoons)

Mix all ingredients except the cucumbers in a food processor. Refrigerate overnight. Slice cucumbers, serve with dip spooned over the top, and garnish with fresh dill sprigs.

Analysis
6 servings per recipe, serving size approximately 2 oz, calories 52, total fat 1 g, saturated fat 0.15 g, monounsaturated fat 0.2 g, polyunsaturated fat 0.5 g, omega-3 fat 0 g, cholesterol 0 mg, calcium 37 mg, sodium 71 mg, phosphorus 68 mg, potassium 241 mg, total carbohydrates 8 g, dietary fiber 0.7 g, sugar 4 g, protein 4 g

Bulgur Pilaf
2 tablespoons olive oil
½ onion, diced
2 medium carrots, diced
1 teaspoon dried basil
½ teaspoon dried oregano
½ teaspoon dried thyme
1 clove garlic, minced
½ cup brown rice
¾ cup bulgur wheat
¼ cup milled flax seeds^a
4 cups vegetable stock

1. Milled flax seed are ground seeds from the flax plant that have a nutty flavor; milled seeds are a source of omega-3 oils.

In a medium sauce pan heat olive oil over medium heat, add onions, carrots, and cook until onions become translucent. Add basil, oregano, thyme, and garlic; cook for another minute. Stir in rice and keep stirring until rice starts to turn brown. Add vegetable stock, bring to a boil, cover, and turn down to simmer and cook for 15 minutes. After cooking for 15 minutes stir in bulgur and flax seed and simmer for another 30 minutes or until the stock is absorbed. Fluff pilaf with fork. Let stand 10 minutes before serving.

Analysis
6 servings per recipe, serving size approximately ⅔ cup, calories 180, total fat 7 g, saturated fat 0.8 g, monounsaturated fat 3.7 g, polyunsaturated fat 1.7 g, omega-3 fat 0.8 g, cholesterol 0 mg, calcium 42 mg, sodium 24 mg, phosphorus 124 mg, potassium 266 mg, total carbohydrates 28 g, dietary fiber 8 g, sugar 1.5 g, protein 5 g

Grilled Vegetables
3 medium zucchinis, sliced
2 heads of anise (fennel), sliced
8 button mushrooms, quartered
4 Roma tomatoes cut into eighths
1 red onion, cut in half and then sliced
2 tablespoon fresh basil leaves, shredded
1 teaspoon fresh thyme
1 teaspoon fresh oregano

Dressing:
1 clove garlic, minced
2 ½ teaspoons Dijon mustard
3 tablespoons lemon juice
4 tablespoons olive oil
½ teaspoon fresh black pepper

Make the dressing by adding all of the ingredients together in a mixing bowl and whisking.

In a large mixing bowl add all the vegetables together. Pour cup of dressing over the vegetables and stir until all the vegetables have been lightly coated. Then cook vegetable mixture either on a grill or in your oven.

Outdoor Grilling
While your grill is heating to 400ºF, oil a grill basket to cook the vegetables in and place the basket on the preheating grill. When the basket is hot add your vegetable mixture to your basket and cook until the vegetables turn golden brown. Remember to stir them every 5 to 7 minutes to allow the browning to occur evenly with all the vegetables.

Oven Broiling
Turn your oven to broil. Spread vegetables out into a single layer on a cookie sheet and broil until vegetables begin to turn golden brown. Turn vegetables over and keep broiling until vegetables are tender.
When the vegetables are brown, pour grilled vegetables into a serving bowl and add the remaining dressing and fresh herbs.

Analysis
4 servings per recipe, serving size approximately ½ cup, calories 198, total fat 15 g, saturated fat 2 g, monounsaturated fat 10 g, polyunsaturated fat 2 g, omega-3 fat 0.19 g, cholesterol 0 mg, calcium 54 mg, sodium 96 mg, phosphorus 138 mg, potassium 887 mg, total carbohydrates 16 g, dietary fiber 4 g, sugar 8 g, protein 4.5 g

Rum-Baked Apples
4 Granny Smith apples, peeled, cored, and sliced
2 teaspoons lemon juice
1 teaspoon ground cinnamon
½ cup brown sugar
⅛ teaspoon ground nutmeg
¼ teaspoon ground cloves
1 tablespoon all-purpose flour
6 tablespoons rolled oats
2 teaspoons honey
1 teaspoon canola oil

Sauce:
2 cups rice milk
3 tablespoons cornstarch
¼ cup cold water
½ teaspoon rum extract

Coat sliced apples with lemon juice. Mix dry ingredients together, cinnamon, sugar, nutmeg, cloves, flour, and oats. Mix dry ingredients with apples and place in a nonstick baking dish. Drizzle honey over the top and spray the top with canola oil. Bake in a preheated 350ºF oven for 40 to 50 minutes until the apples are tender.

Sauce
Heat rice milk to a simmer, mix cornstarch in cold water together until the lumps are dissolved. Whisk the cornstarch mixture into the simmering rice milk and keep whisking until mixture thickens. Remove from heat and add rum extract. Serve warm over the baked apple mixture.

Analysis
4 servings per recipe, serving size approximately ⅔ cup, calories 283, total fat 3 g, saturated fat 0.2 g, monounsaturated fat 1.5 g, polyunsaturated fat 0.7 g, omega-3 fat 0.11 g, cholesterol 0 mg, calcium 42.7 mg, sodium 55 mg, phosphorus 86 mg, potassium 277 mg, total carbohydrates 65 g, dietary fiber 4.3 g, sugar 40.3 g, protein 2 g

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© 2007 National Kidney Foundation, Inc.