Eating Out with Kidney Disease

One of the questions I’m asked most often by my CKD clients is what they should eat when they dine out or travel.  It can be a real dilemma, but with the right guidance, you can have a plan for what to eat when you’re not at home. 

I’m a big fan of eating at home because when you do, you are in control.  You can eat real food, you can control the sodium, you can prevent the consumption of phosphate additives and you can avoid oils and food additives that promote inflammation. My advice? Save your eating out for special occasions, time with friends, and when you’re traveling. But eating out with kidney disease is possible, and I’ll show you how.

It’s all about mindset

When it comes to traveling and occasional eating out with kidney disease, it’s all about mindset.  There are really 3 ways to look at it:

1. You can go all out and eat everything you wouldn’t normally eat and risk sabotaging the progress you’ve made in maintaining your kidney health.

2. You can be terrified you’re going to eat the wrong thing and have a miserable time.

3. You can recognize that while you’d like to stick with your usual healthy diet, you’re probably going to have to eat some things you wouldn’t normally eat, and that’s ok. 

I recommend the third option.

Consider taking some food with you

Kidney-friendly food can be difficult to come by at restaurants. If you’re only eating out every now and then, you can probably find some foods that won’t send you over the edge.

But when you travel, it’s important to have a workable plan to avoid taking in more sodium, phosphate additives, inflammatory oils, and protein than your kidneys can handle over a longer period of time. I’d like to propose that you consider taking some of your own food with you when you travel. Gasp! Yes, I just said that. Believe it or not, this is a common practice for many people. Consider the following tips before you rule it out, and don’t be mad it me. We’ll get to the actual eating out later in the blog.

Plan ahead

Planning ahead can take a lot of pressure off and help you be ready to go when the time comes. Prepare anything that can be frozen well ahead of time, and place in individual baggies or containers whenever appropriate. Chop vegetables, boil eggs, bake muffins, make Mason jar salads, etc. a day or two in advance. 

Remember…You can also visit grocery stores during your travels instead of eating at a restaurant for every meal.

Portable ovens save the day!

Having a way to heat your food in the car is something you may have never thought of, but it can expand your food options while traveling quite a bit. A portable oven plugs into your car’s cigarette lighter and can warm your food in about 30 minutes. Just pack your food in aluminum loaf pans, cover with foil, label, and place in gallon freezer bags for a ready-to-eat meal that you can warm up while you’re driving down the highway.  It’s the best thing since sliced bread for people who want to bring their own food along on trips.

The foods you can take with you will depend on the equipment you are using. Here are my suggestions for travel-friendly food based on equipment you have available.

If you have a cooler but no way to heat your food…

Foods you make well ahead of time and freeze

Muffins, pb&j, sweet potatoes, energy balls, fat bombs, smoothies, waffles, and hummus are a few examples of foods you can make well ahead of time and freeze in preparation for a trip. Also overnight oats, pasta salads with oil-based dressings, guacamole, chia pudding, wraps, quinoa salad, fruit such as  berries, melon, pineapple, or mango, and frozen yogurt bark. All of these are foods that you can make and freeze a month or more ahead of time, then just thaw and eat.  No heating required!

Items you can make the day before the trip

Some foods are best prepared the day of or the day before a trip: cut up vegetables, mason jar salads, hard boiled eggs, veggie wraps, tuna or chicken salad, low sodium cheeses, low sodium cottage cheese with fruit, yogurt parfaits.

Purchase along the way

My family will sometimes stop at grocery stores instead of restaurants when we travel. These are some examples of foods that can be purchased along the way at a grocery store: coconut yogurt, Mush Overnight Oats, boiled eggs, veggie trays, pre-made salads (choose oil and vinegar instead of a pre-made dressing to save on sodium), low sodium cottage cheese, packaged cheese, nut, and fruit packs with less than 300mg Na, ripe avocadoes with low sodium pretzels or crackers or veggies.

If you have a cooler and a portable oven (or a hotel microwave)…

So many foods can be made in advance, frozen, and warmed in a portable oven or microwave. Freeze in disposable aluminum loaf pans if using a portable oven. These are just a few examples: quesadillas, stir fries, casseroles, homemade soups, chili, chicken or other meat and vegetables, stuffed peppers, frittata muffins.  The possibilities are endless!  Remember to use recipes that use low sodium ingredients and aim for main dishes that have less than 700 mg per serving.

If you don’t have a cooler or a portable oven (or a hotel microwave)…

You can still bring shelf-stable foods with you.  Here are some examples:

Low sodium whole grain crackers, unsalted nuts, whole fruit, unsalted pretzels, rice cakes, unsalted popcorn, unsalted nut butters, low sodium whole grain bread, avocados, applesauce, peaches, pears, or pineapple, tuna, salmon, or chicken pouches, clean protein bars, homemade oat bars, seaweed snacks, and unsalted seeds.

Actually dining out

The rest of this blog will help you make the best choices when you do have to eat out. Whenever possible, avoid fast food. Instead, choose a sit-down restaurant.  You will have more control over what you are served and are less likely to overdo it on the sodium and phosphorus. You WILL have to think about your protein intake though.

general tips for eating out with kidney disease:

Don’t be too shy to ask. Many restaurants will accommodate special dietary requests if you notify them in advance or ask your server to relay your needs to the kitchen.

Request custom dishes. You can often ask for dishes to be prepared without added salt, sauces, or butter. 

Avoid processed meats and cheese. These are the biggest culprits for hidden phosphates.

Stick to simple grilled, steamed, or sautéed dishes: fish, chicken, and vegetables prepared this way are generally lower in sodium and additives.

Check nutrition information online. Some restaurants have nutrition calculators or detailed menus online that can help you navigate sodium and phosphate content.

Salads are almost always an option and can be ordered without high sodium items like cheese, croutons, meat, and bacon and can be dressed with a low sodium option such as oil and vinegar.

Eat small portions (or share a meal)…you can always eat more when you get home or when you can access healthier food options. Limiting your portion size will inevitably limit your intake of sodium, phosphate, and protein.

Some people like to figure things out for themselves and make the best choice based on their knowledge.  But some people just want to be given specific options that don’t require them to put energy into a decision.  If that’s you, the following information is going to make you happy.  Well…a little happy.  You probably won’t find your favorite foods in the following points, but at least you’ll have some specific guidance on what to eat when you go out to eat at certain restaurants. All of the following selections contain less than 700mg sodium and are free of phosphate additives (at least based on their published ingredients).

Disclaimer: I am not recommending these restaurants. But if you must go out to eat, the best choices at some common restaurants are listed for your convenience and because…life happens.

Sit-Down Restaurants

Olive Garden: Herb-Grilled Salmon (lunch portion): Request no added salt or sauces and ask for steamed vegetables without seasoning. Minestrone Soup (small portion). House Salad (without dressing or croutons): Ask for oil and vinegar on the side.

Applebee’s: Grilled Chicken Caesar Salad: Request dressing on the side and no croutons. Shrimp Skewer with Steamed Vegetables: Ask for no added butter or seasonings to lower the sodium. Garlic Mashed Potatoes: Request no gravy and confirm sodium content.

The Cheesecake Factory: Tuscan Chicken: Ask for no added sauce or salt; confirm the portion size for sodium. Evelyn’s Favorite Pasta: Request no cheese or added salt; avoid creamy sauces. Fresh Grilled Fish: Choose a simple grilled fish with steamed vegetables and no added seasoning.

Chili’s: House Salad (with oil and vinegar): Hold croutons and cheese. Margarita Grilled Chicken: Request no sauce or added salt. Santa Fe Chicken Salad: Ask for no cheese or dressing; use salsa as a dressing alternative.

Red Lobster: Wood-Grilled Shrimp Skewers: Ask for no seasoning or butter. Steamed Broccoli: With no added seasoning or butter. Garlic Shrimp Scampi (lunch portion): Request less butter and no added salt.

Outback Steakhouse: Grilled Chicken on the Barbie: Request no seasoning or sauce. Ahi Tuna: Served raw or seared with no added sauces. Plain Baked Sweet Potato: Ask for it without butter, sour cream, or seasoning.

P.F. Chang’s: Buddha’s Feast (steamed): A mix of steamed vegetables, tofu, and rice; ask for no sauce. Egg Drop Soup (small portion): Often lower in sodium, but confirm the serving size. Vegetable Spring Rolls (ask for no dipping sauce): Generally lower in sodium and phosphate additives.

Denny’s: Fit Fare Veggie Skillet: Request no cheese or seasoning. Oatmeal with Fresh Fruit: Request without brown sugar or added toppings. Egg White Omelette: Add vegetables and ask for no cheese or salt.

Panera Bread: Mediterranean Veggie Sandwich (half): Ask for no cheese or spread to reduce sodium. Low-Fat Garden Vegetable Soup: Verify sodium content depending on the portion size. Steel Cut Oatmeal: Available plain or with minimal added sugar or toppings.

Fast Food

general tips

Finding fast food options that are low in sodium (less than 700 mg) and free from phosphate additives can be tricky, as fast food items tend to be higher in sodium and may contain additives. However, some chains offer healthier options. Here’s a list of possible choices, though it’s essential to check with individual restaurants for ingredient specifics, as recipes can vary by location.

But first, some general Tips for Reducing Sodium and Phosphate intake:

Customize your Order: Many fast food restaurants allow you to customize orders, so you can ask for items with no added salt or sauces.

Avoid Processed Proteins: Avoid meats, cheeses, and processed sauces, which often contain phosphates.

Stick to Veggies: Opt for salads, fruit cups, and vegetable-based sides.

Always check nutritional information online or ask staff about specific ingredients. Many restaurants provide detailed nutrition info, which can help you avoid hidden phosphates and excess sodium.

Disclaimer: I am not recommending these restaurants.  I’m in favor of what was discussed earlier in this blog…packing your own food, going to grocery stores, etc. But if you must go out to eat, the best choices at some common restaurants are listed for your convenience and because…life happens.

McDonald’s: Fruit & Maple Oatmeal (without brown sugar); Side Salad with low-sodium dressing

Subway: 6-inch Veggie Delight Sandwich (ask for no cheese, and a small amount of vinegar as dressing)

Chick-fil-a: Kale Crunch Side Salad (without dressing); Fruit Cup

Chipotle: Burrito Bowl with black beans, lettuce, fajita veggies, and mild salsa (avoid meats, cheese, and sour cream)

Taco Bell: Fresco Bean Burrito (ask for no cheese); Pintos & Cheese (without cheese)

Wendy’s: Plain Baked Potato if you don’t have a potassium restriction (ask for no sour cream, butter, or cheese); Garden Side Salad (with light dressing)

Starbuck’s: Classic Oatmeal: A solid breakfast choice with no sodium or phosphate additives (avoid toppings with added sugar). Fresh Fruit Bowl: A simple mix of seasonal fruits. plain bagel: No cream cheese or butter; check sodium content. Avocado Spread: Low in sodium and free from phosphates, great on a plain bagel. Egg White & Red Pepper Sous Vide Bites: Lower in sodium, but verify sodium content to ensure it’s under 700 mg.

Dunkin: Wake-Up Wrap with Egg Whites (ask for no cheese or sausage); Hash Browns

Burger King: Garden Side Salad (with no croutons or dressing); Apple Slices

Airport Travel

Finding low-sodium, phosphate-free foods at airports can be challenging due to the limited availability of fresh, unprocessed options. However, many airports have introduced healthier choices. Here’s a list of potential foods that may meet the criteria of less than 700 mg sodium and be free from phosphate additives based on common airport food outlets. Always check labels and ask vendors about ingredients.

Tips for Airport Dining:

Ask for Nutrition Info: Many airport chains and kiosks have nutrition information available upon request or online. This can help you make more informed choices.

Customization: Request no added salt, sauces, or cheese to keep sodium and phosphate additives down.

Choose Fresh and Whole Foods: Opt for fresh salads, fruits, and simple vegetable dishes over pre-packaged or highly processed foods.

Avoid Sauces and Dressings: These are often where sodium and phosphates are hidden.

Carry Snacks: If you have dietary restrictions, it might be worth bringing your own low-sodium, phosphate-free snacks, such as unsalted nuts, fruit, or plain rice cakes, to avoid limited airport choices.

Pre-Packaged Grab-and-Go Items (typically found at airport convenience stores or kiosks):

Fresh fruit cups: Pre-cut melon, berries, and mixed fruit (no added preservatives).

Unsalted nuts: Almonds, walnuts, or mixed nuts.

Plain popcorn: Single-serve bags of air-popped, unsalted popcorn.

Plain Greek yogurt: Check labels for low sodium and protein content (less than 20 g protein).

Vegetable sticks with hummus: Look for low-sodium hummus brands.

Hard-boiled eggs: Sometimes available in refrigerated sections, though confirm no added preservatives.

Oatmeal cups: Instant oatmeal with no added salt or sugar (add water from a coffee shop).

Plain rice cakes: Single-serve or pack varieties without added flavorings or salt.

Fresh salads: Choose options with vegetables and ask for dressing on the side; avoid cheese, meats, and processed toppings.

Unsweetened applesauce: Look for single-serve cups with no added sugars or preservatives.

Specific airport outlets

Disclaimer: I am not recommending these restaurants.  I’m in favor of what was discussed earlier in this blog…packing your own food, going to grocery stores, etc. But if you must go out to eat, the best choices at some common restaurants are listed for your convenience and because…life happens.

Starbuck’s: Classic Oatmeal: A solid breakfast choice with no sodium or phosphate additives (avoid toppings with added sugar). Fresh Fruit Bowl: A simple mix of seasonal fruits. Plain Bagel: No cream cheese or butter; check sodium content. Avocado Spread: Low in sodium and free from phosphates, great on a plain bagel. Egg White & Red Pepper Sous Vide Bites: Lower in sodium, but verify sodium content to ensure it’s under 700 mg.

Pret a Manger: Vegetable Soup: Look for vegetarian or vegan options and ask about sodium levels. Fresh fruit: Pre-cut fruit bowls or whole pieces like apples and bananas. Avocado and Veggie Wrap: Ask for no added sauces and confirm sodium content. Super Greens Salad: A simple salad made of mixed greens, often with quinoa or lentils.

Cibo Express: Raw Veggie Packs with Hummus: Look for low-sodium hummus options. Whole Fresh Fruit: Available at most CIBO locations. Chia Seed Pudding: Often free from sodium and phosphate additives. Quinoa Salad: Look for versions without cheese or processed dressings. Kale Salad: Avoid cheese, and check for light dressings to minimize sodium. Grilled Vegetable Wrap: Choose wraps with veggies and minimal sauce.

Panda Express: Steamed Vegetables: Ask for plain steamed veggies with no added sauces. Steamed Brown or White Rice: Typically lower in sodium unless pre-seasoned. Vegetarian Spring Rolls: Check sodium content and avoid sauces.

HMS Host: Grilled Chicken Salad: Ask for no cheese, croutons, and dressing on the side. Roasted Vegetable Wrap: Request no sauces and minimal salt. Fruit & Nut Snack Packs: Look for unsalted versions. Mediterranean Veggie Plate: Common in healthy-themed kiosks; opt for plain hummus and raw veggies. Greek Yogurt with Fresh Fruit: Look for brands without added sweeteners or flavoring.

Panera: Mediterranean Veggie Sandwich (half): Ask for no cheese or spread to reduce sodium. Low-Fat Garden Vegetable Soup: Verify sodium content depending on the portion size. Steel Cut Oatmeal: Available plain or with minimal added sugar or toppings.

Au Bon Pain: Small Garden Salad: Opt for oil and vinegar on the side, avoid processed toppings. Steel-Cut Oatmeal: A healthy breakfast or snack option. Vegetable Soup: Choose small portions to stay within sodium limits. Fresh Fruit Cups: Typically pre-packaged with no preservatives.

Recap

1. Save eating out for times it is necessary, such as on special occasions, spending time with friends, or traveling.

2. Take some of your food with you if you can.

3. Choose sit-down restaurants over fast food.

4. Be most mindful of sodium, phosphate additives, unhealthy oils, and protein intake when eating out.

5. Choosing vegetables or salads is usually a good option.

6. Eat small portions.

I really hope you have found the information here valuable.  Remember it’s all about mindset.  Enjoy yourself but don’t go overboard! Quality of life matters, and only you can decide how much you’re willing to sacrifice for your kidney health for convenience or taste.  I hope the content of this blog has helped you see that you have many options when you eat out and when you travel.