Heart Health: Ticker Talk with Renal Disease

Marika Wamback, BSc. R.D.
Renal Dietitian |

Heart Health: Ticker Talk with Renal Disease

Did you know that February is Heart Health Month?  Since February is usually associated with love, flowers, chocolates, and hearts for Valentine’s Day, it is also associated with keeping a vital muscle and pump system in tip top shape!

Your Heart’s Function

The heart is a muscle in the body that operates like a pump; pumping blood to every single part of the body through arteries and veins.  Blood carries oxygen, nutrients, fluids, and electrolytes, all of which are vital for survival.  These nutrients are also essential for a healthy heart.  Without them, the heart cannot function optimally, reducing pumping and blood flow.  Or, it must work harder, increasing stress on the heart.

Unfortunately, heart disease is the primary cause of death with kidney disease.  It is also the primary cause of death for diabetes; 50% of which will also develop kidney disease.  To keep the heart healthy, kidney disease must be managed.  Although it can feel overwhelming, there are things that you can do to keep your heart as fit as a fiddle!

Take Care of Your Heart

Home Cooking

Home cooking reduces the consumption of processed foods, which are loaded with sodium, fat, additives, and are lower in fibre and nutrients.  If you cook your own meals, you are aware and in control of what you are consuming.  This helps nourish your body by giving it the nutrients it needs and protects your heart.  Pre-plan your meals and snacks to help with time and budget.

Reduce Sodium

Too much sodium (salt) increases blood pressure by increasing fluid volume.  This causes the heart and the arteries to contract harder to move the fluid around.  The increase in the pressure causes an increase in the blood pressure readings.  The higher the pressure, the higher the risk of a heart attack or stroke.  With kidney disease, the kidneys are no longer able to control the blood pressure, further increasing the risk to the heart.

To reduce your sodium intake, eat more whole and unprocessed foods.  Sodium is a ‘natural preservative’.  It keeps food fresh and it makes everything taste good.  ALL salts contain the same amount of sodium, regardless of color or manufacturing.  Seventy-seven percent of our sodium intake is coming from processed foods.  The salt shaker only accounts for 12% of added sodium.  The other 11% is naturally occurring in foods.  Use herbs and spices instead of sodium.  See your dietitian and this Kidney Chef article for ideas and suggestions.

Add Fiber

Fiber intake is important in the management of heart health, as fiber helps lower bad or lousy cholesterol (LDL), and it helps increase the good cholesterol or healthy cholesterol. (HDL).  This is important because the HDL helps clean out the LDL.  The LDL cholesterol is the cholesterol that causes blockages, which can result in a heart attack.  Fiber can be found in whole grains, nuts, seeds, fruits, vegetables, lentils, and beans.  The more ‘whole’ or unrefined the food is, the more fiber it is likely to have.

Vegetarian diets usually have more fiber, nutrients, anti-oxidants, and less saturated fat, which is why they are recommended for heart health management.  A flexitarian diet style that incorporates some vegetarian diet practices such as the Mediterranean diet also has heart health benefits.  The North American diet typically has more saturated fat and trans fat, is lower in fiber and nutrients, and is higher in sodium, all of which are detrimental to the heart.

Kidney patients can find getting enough fiber difficult due to diet restrictions.  By ensuring adequate fruit and vegetable intake within the renal diet, vegetarian proteins (so long as phosphorus levels are stable), and the use of raw, natural bran, fiber needs can be met.  See your dietitian.

Potassium

Potassium is a mineral that is vital to heart health.  It helps the heart beat regularly while keeping blood pressure down.  Potassium is found in many fruits and vegetables.  Try adding more fruits and vegetables to your diet.  Some simple strategies may be adding a piece of fruit with lunch, or making sure half of your plate is vegetables at lunch and at supper.  These simple strategies will benefit your heart.

Renal diet restrictions often include restricting potassium, but it does not eliminate it.  The diet is designed to allow enough dietary potassium to benefit the heart and cardiovascular system without risking excess potassium.  Excess potassium can be dangerous to the heart.  See your dietitian regarding your renal diet to see what potassium containing foods are possible for you.

Types of Fat

Fat is an essential nutrient in the diet.  Different fats have different functions.  Fats that benefit the heart are monounsaturated and polyunsaturated fats.  They are generally liquid at room temperature, meaning, they can be poured.  The exceptions are avocados, nuts, seeds, and fish fat.   They are solid at room temperature but they are heart healthy fats.  All of these types of fats help lower the lousy or bad cholesterol (LDL) and can increase the healthy or good (HDL cholesterol).   Some examples are olive oil, canola oil, sunflower oil, corn oil, peanut oil, sesame oil, avocado oil, and omega-3 oils.

Fats that are detrimental to heart health are saturated fats and trans fats.  These fats are generally solid at room temperature, meaning the must be cut or spread with a knife.  The exception is soft tub margarine that says ‘Non-hydrogenated.’  This label indicates healthy fats.  If the soft tub margarine does not say that, it may contain trans fat.  Look for a soft tub margarine that says ‘non-hydrogenated’ and contains less than 2 grams of saturated fat per serving.

These types of fats increase the lousy or bad (LDL) cholesterol and can decrease the healthy or good (HDL) cholesterol.  This can increase the risk for blockages which can increase the risk for a heart attack.  Some examples are coconut oil, butter, lard, shortening, animal fat such as beef fat or pork fat, chicken skin, and hard block margarine.

Plant-based Diet

Vegetarian and vegan diets are becoming more popular because of their health benefits.  They are lower in added fats, sodium, cholesterol, and are richer in antioxidants, fibre, and nutrients, pending that the food choices are whole ones and not refined ones.  The evidence strongly correlates a plant-based diet to better health including improved heart health.  Often, vegetarians have lower cholesterol levels, healthier weights, and lower blood pressure all of which benefit the heart.  Many vegetarian items can be used in place of animal proteins.  For example, chick peas can be used in place of beef or chicken in a curry dish.

Renal diets can contain restrictions on the use of vegetarian proteins due to their high phosphorus content.  That is because if your phosphorus level is difficult to control, too much phosphorus can cause blood vessels to harden, creating serious risk of cardiac disease.  The risk of cardiac disease and damage due to excess or unstable phosphorus outweighs the benefits of the vegetarian diet.  See your dietitian on how to incorporate more vegetarian items into your renal diet if your phosphorus is well controlled, if you’re practicing a vegetarian or vegan diet, or if you want to incorporate more vegetarian foods into your diet to benefit your heart.

Fluid Intake

Best Choices

We need fluids daily for our bodies to function optimally.  Water is the best choice, but we like variety too!  Fluids consist of tea, coffee, soups, Jell-O, popsicles, yogurt, pop, lemonade iced tea, milk, ice-cream, and some fruits and vegetables.  Fluids are consisting of 20% of our daily calorie intake, making it essential to choose them wisely.  That many calories in a fluid can cause weight gain, creating more stress on the heart.  Fluids that are high in sugar and/or salt (sodium) can create more thirst, increasing our fluid intake.  Too much fluid puts stress on the arteries and on the heart, as they have to contract harder and more frequently to move the fluid throughout the body.

Wise fluid choices include coffee and/or tea for their antioxidants, milk for protein and B vitamins, water, flavored water with fruit pieces, small amounts of pure fruit juice, low sodium soups, fruit, and vegetables.  These fluids nourish the heart and reduce its workload.  If you are on a very strict fluid restriction, your choices will be further limited.  If your fluid allowance is more liberal, healthy fruit or vegetable juice consumption is no more than 1 cup per day to limit calories, sodium and sugar.  Low sodium soups should contain no more than 400 mg of sodium per serving; a serving is usually 1 cup.

Fluid Restrictions for CKD Patients

Renal diets can include fluid restrictions.  This is to protect the heart.  The kidneys control blood pressure, but when the kidneys are not functioning optimally, blood pressure must be controlled by medical and nutrition intervention.  Your dietitian can help you choose the best fluids for you within the amounts allowed in your renal diet.

Your optimal choices help achieve and maintain your optimal heart health.  Keep your ticker ticking well with the tips above and your health care team.  Together, they will help you achieve your healthy lifestyle.  Your heart will thank-you.

Disclaimer

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. KidneyChef urges you to seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. KidneyChef advises you to never disregard professional medical advice or delay in seeking it because of something you have read on the Website.

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References:

1.  https://www.health.harvard.edu/staying-healthy/the-truth-about-fats-bad-and-good

2. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke

3. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/heart-disease

4. https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight

5. https://www.heartandstroke.ca/get-healthy/healthy-eating

6. https://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/The-Skinny-on-Fats_UCM_305628_Article.jsp

7. https://www.kidney.ca/Nutrition

8. https://www.kidney.org/atoz/content/cholesterol

9. https://medlineplus.gov/cholesterol.html