Think About Potassium - Asian Diet

Leicestershire Nutrition and Dietetic Services

Think about potassium - Asian diet

Having a healthy, well balanced diet will help keep you feeling fit and well.

Potassium is a naturally occurring mineral found in most foods. Your kidneys control the amount present in your blood, but because these are not functioning properly it is necessary to reduce the amount of potassium in your diet. Abnormal levels of potassium in your blood are not good for your heart.

The following guidelines encourage plenty of variety and a regular meal pattern whilst restricting the amount of potassium you eat.

Contact number for the Renal Dietitian: see the contact information displayed in the Unit

Produced by UHL Renal Dietitians August 2017

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Summary of main points

- COOKING METHODS o Potatoes, yam, taro tuber, cassava and many vegetables are high in potassium. o Boiling helps to lower the potassium content before they are added to a curry o Throw the water away after boiling o Do not steam or microwave potatoes, yam, taro tuber, cassava or vegetables

- STARCHY FOODS o Chapatti’s, rice, pasta, plain naan, noodles and couscous are all low in potassium and may be eaten freely

- FRUIT AND VEGETABLES o These foods naturally contain potassium o Keep to 4 portions of fruit and vegetables per day o Choose either potatoes or tomatoes in a curry. Adding both will provide too much potassium.

- PROTEIN o Dahl is allowed on a low potassium diet o However, some peas/beans are recommended less frequently due to the potassium they provide

- HERBS AND SPICES o Fresh herbs are lower in potassium than dried. Try to use fresh herbs where possible. o Spices may be used as required

2 COOKING METHODS

Potassium naturally occurs in a wide variety of foods, especially starchy foods and vegetables. The way you cook these foods can affect the potassium content. By boiling starchy foods and vegetables, you can reduce the potassium. It is very important to discard the water after boiling. Do not use the cooking water to make curries or sauces.

STARCHY VEGETABLES

Potatoes, yam, taro tuber and cassava are particularly high in potassium. The potassium content will be reduced if they are peeled, cut into smaller pieces and then boiled in a big pan of water. The water must then be discarded. Once cooked, they can then be used to make curry but do not make a curry based just on potatoes.

Do not steam or use a pressure cooker or microwave to cook the potatoes, yam, taro tuber or cassava.

The table below shows which starchy foods can be eaten and how to cook them to reduce their potassium content.

CHOOSE AVOID Boiled potatoes / taro tuber / Baked starchy vegetables e.g. yam / cassava (discard the jacket potato water) Boiled then fried or roasted Frozen, oven, retail or ‘chip potatoes / yam / taro tuber / shop’ chips cassava / sweet potato Home made chips (if pre-boiled) Manufactured potato products e.g. potato waffles Mashed potato (not instant) Steamed starchy vegetables Microwaved starchy vegetables Pressure cooked starchy vegetables

You may have 100g (4oz) boiled potatoes/yam/taro/cassava or sweet potato per day.

3 STARCHY FOODS

Low in Potassium High in potassium CHOOSE AVOID Chapattis, puris, plain naan and Peshwari naan breads made with chapatti, wheat Gram / chickpea / bean flour. flour or cornflour Products made from this flour Pasta, rice, noodles, couscous, such as poppadom’s and bharji's. bulgur wheat. (Do not add the flour to kudhi or raita) Cereals (e.g. Cornflakes, Rice All bran, Bran buds Krispies , porridge oats, Cereals & cereal bars containing Weetabix, Shredded Wheat) chocolate, dried fruit & nuts Samosas can be eaten. Remember to boil potatoes first if used in the recipe. Khitcherie (rice plus red/green lentils) may be eaten but do not eat with dahl or with a potato based curry.

OTHER VEGETABLES

Some vegetables are higher in potassium than others, so when you are making curries use vegetables from the choose lists rather than the vegetables in the avoid list. Wherever appropriate, boil vegetables first and throw away the water before proceeding to make a curry. Do not steam or use a pressure cooker or microwave to cook the vegetables. Please note that the canned vegetables will often contain salt and therefore should not be taken too frequently. Alternatively, choose canned vegetables in water with no added salt.

Do not add more than half a tin of tomatoes OR 2 x medium sized fresh tomatoes OR 10 x cherry tomatoes to a curry serving four people.

Do not have potatoes and tomatoes in the same curry as this will increase the potassium content.

4 VEGETABLES

All vegetables based on 100g (4oz) serving. You may have 2 servings of vegetables per day:

Lower in potassium CHOOSE Asparagus – 3 spears Marrow Aubergine Methi Baby sweetcorn Onions Beansprouts Peas (frozen then boiled) Broccoli Pumpkin Carrots Red/yellow/green peppers Cabbage Runner beans Cauliflower Spring greens  Courgette Spring onions Cucumber Swede Curly Kale Tindora (Ivy Gourd) Frozen mixed vegetables Canned ackee Gourd – Ash Canned karela Gourd – Bottle (Dhoodi) Canned kantola Gourd – Round (Tinda) Canned mushrooms Green beans Canned Okra Leeks Canned waterchestnuts Lettuce

High in potassium AVOID Artichoke Guar Baked beans Karela Beetroot Kantola Brussel Sprouts Okra  Callaloo Parsnips Canned or fresh spinach Sweetcorn Drumstick pods/leaves

5 FRUIT

It is recommended that all patients with renal disease avoid star fruit as it may cause adverse effects.

Fruit is quite high in potassium so limit fruit to 1-2 portions daily and use the following list to help choose fruits which are lower in potassium. (Portion sizes are shown in brackets).

Lower in potassium High in potassium CHOOSE AVOID Apples (1) Apricots  Bilberries/blueberries (20) Avocado Blackberries (15) Bananas  Cherries (12) Blackcurrants Clementines (2) Custard apple Cranberries (20) Damsons Fig (1 fresh) Dried fruit-all (e.g. Gooseberries (12) Sultanas, prunes, raisins) Grapes (15) Elderberries Grapefruit (half) Guava Kiwi (1) Loganberries Lychees (6) Mangoes Melon - water & galia (1 Melon – Cantaloupe small slice (100g) – Honeydew Nectarines (1 small) Papaya Oranges (1 small) Pomegranate Peaches (1) Redcurrants Pear (1 small) Rhubarb Pineapple (2 small slices) Sharon fruit Plums (1) Raspberries (15) Strawberries (8) Tangerines/Satsuma’s (1) Tinned fruit (1 small tin – drain juice)

6 PROTEIN

Use the list below to guide you as to which peas/beans are suitable for making dahl. Those on the left should be used more frequently. Use those on the right only once per week. If your potassium level is high, you may be asked to avoid the beans on the right.

Lower in Potassium Higher in Potassium CHOOSE CHOOSE ONCE PER WEEK Black Gram Aduki beans Blackeye Beans Pigeon Peas (Toor dahl) Chick Peas (Chana dahl) Red Kidney Beans – dried and Masoor dahl (red lentils) boiled Mung Beans Pinto beans Other whole lentils (green/brown) Soya beans Red kidney beans – canned

Guide for portion sizes Allowance up to: Lean meat/poultry 100g (4oz) - main meal / 50g (2oz) - snack meal Fish 150g (6oz) - main meal / 75g (3oz) - snack meal Eggs Eat freely – no restriction Quorn/Tofu 150g (6oz) per meal If meat, poultry, fish or dahl are taken at a meal, have a maximum of 100g (4oz) vegetable curry If you have no dahl, meat, poultry or fish, you may increase the portion of vegetable curry to 200g (8oz)

• A small salad 50g (2oz) of the following may be taken with a meal: lettuce, cucumber, onion, peppers, coleslaw • Try to avoid cured or salted meats as these are high in salt.

DAIRY PRODUCE

Allowance up to: Milk / Soya Milk 200ml (1/3 pint) Per day Yogurt / Lassi 250g per week Cheese / Paneer 50g (2oz) Per week

Avoid using condensed milk, evaporated milk, coconut milk, coconut cream and dried milk.

7 HERBS & SPICES

• Fresh herbs are lower in potassium than dried so try to use fresh where possible. • Spices including ginger and garlic may be used as required

Do not use salt substitutes such as Lo Salt, Selora or Ruthmol as these contain potassium. Use ordinary salt but be careful about the quantity.

BEVERAGES

If you are on a fluid restriction then all drinks should be included as part of this restriction. Have diet/sugar free drinks if you have diabetes.

Lower in Potassium Higher in Potassium CHOOSE AVOID Fizzy drinks (e.g. cola, lemonade) Fruit juice & vegetable juice Squashes (including homemade) Tea & herbal teas Blackcurrant drinks Spirits (e.g. whisky, gin, brandy) if Coconut based drinks e.g. taken. coconut milk, coconut water Cocoa & drinking chocolate Malted milk drinks (e.g. Horlicks, Ovaltine) Coffee is higher in potassium - limit to 1 cup per day Limit wine, sherry, port, lager, beer or stout to one small glass per day, if taken. Check with your doctor to see if it is alright for you to drink alcohol.

SWEETS/CONFECTIONERY

Sweets made with condensed milk, evaporated milk, dried milk, coconut milk, gram flour or ground nuts (e.g. burfi) are high in potassium, similar in fact to chocolate and should be avoided. Use the list below to guide you. Choose sugar-free sweets if you have diabetes.

8 Lower in potassium High in potassium CHOOSE AVOID Boiled sweets Chocolate Pastilles / jellies Toffees Chewing gum Liquorice Jalebi Fudge Jelly Carob Gulab jamun Burfi Marshmallows Sesame snacks Mints

If you have diabetes you may want to consider avoiding these foods as they will cause a rapid rise in your blood glucose levels. You could choose sugar free options if you wish.

BISCUITS AND CAKES

Lower in Potassium Higher in Potassium CHOOSE AVOID Doughnuts Biscuits and cakes containing Jam tarts chocolate, dried fruit and nuts Plain or cream sponge cake Biscuits – plain, wafer, ginger, shortbread, jam or cream filled Meringue Swiss Roll

SAVOURY SNACKS

Lower in potassium High in potassium CHOOSE AVOID Corn/Maize/wheat based snacks Potato crisps e.g. Quavers, Wotsits, Vegetable crisps Monster Munch, Doritos, Bombay mix Onion Rings, Wheat Crunchies Sev Tortilla chips Gathia Pretzels Chevra Popcorn Nuts (peanuts, cashews, Breadsticks / crackers pistachios, betel nuts etc.) Meat samosa Vegetable samosa Rice snacks / rice cakes

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Note: Many savoury snacks are high in salt so even those lower in potassium should not be included too frequently.

MISCELLANEOUS

Lower in Potassium Higher in Potassium CHOOSE AVOID Jam Black treacle Marmalade Bovril Honey Marmite Syrup Vegemite Butter Tomato puree Margarine Soups (tinned & packet) Low fat spreads Oils Pickles (lime, mango etc.), tomato ketchup and brown sauce are high in potassium – limit to 1 tsp only. Pan can be taken if betel nuts are excluded from the recipe or if only a small amount is taken.

Remember this is not an exhaustive list and if there are foods you would normally eat which are not mentioned on this sheet please ask the dietitian if it is all right to carry on eating them.

If you have diabetes it is very important that you are also controlling your blood glucose (sugar) levels. Diet can impact on your control; it is the carbohydrate foods/drinks that breakdown into glucose (sugar) when you eat them so will cause a rise in your blood glucose levels. Carbohydrate foods/drinks include: sugars such as full sugar drinks, sweets, sugar honey, fruit and starches such as breads, potatoes, pasta, rice, and foods made with flour. If your blood glucose levels are high you could try reducing your sugar intake and/or your starchy carbohydrate portions.

Developed and produced by Leicestershire Nutrition and Dietetic Services – Partial update May 2020 LNDS081 Crown Copyright – Leicestershire Partnership NHS Trust and University Hospitals of Leicester NHS Trust Access our website on www.lnds.nhs.uk

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