Four Principles of Food Safety for Individuals with CKD

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Food Safety and CKD

Marika Wamback, BSc. R.D.,
Registered Dietitian

Who doesn’t love good, tasty food?  

Good nutrition is important at any age and stage of life, and food is essential for it.   When there are health issues and/or compromised immunity, nutrition and food safety become even more important.  Contaminated food can result in illness, can exacerbate current health issues, and can increase risks and mortality in immunocompromised populations.  

The World Health Organization states that 600 million people per year get sick from contaminated food and 400 thousand of them die.  With a global food system, there is a risk of contaminated food due to different regulations, handlers, transportation needs, and growing methods.

In Canada, the Canadian Food Inspection Agency is our federal agency that ensures the safety of our food supply. (The FDA regulates the United States).  We have some of the most stringent guidelines in the world. It can be frustrating to see items pulled off of grocery shelves, but this is for public safety.  It’s too risky to try and cook or wash off the potential bacteria. Food poisoning can have effects that may last for years and can cause death.

What does this mean when a person has kidney disease?

With compromised kidney function, foodborne pathogens can cause further organ damage.  E-coli 0157:H7 can affect the kidneys. Other bacteria such as listeria, salmonella, bacillus cereus, and botulism can also cause life-threatening illness.  

When you are on dialysis or receive a transplant, there are open sites into the body that can increase the risk of infection.  With transplant, there may be an increased risk of infection due to wound healing, new organ function, and anti-rejection medications.  This can increase the risk of illness and the severity of illness from bacterial contamination in food as your body may be weakened from recent surgery.  The new organ may be compromised due to bacterial infection, and your immune system may not be able to fight the bacterial infection, due to being suppressed by medications to prevent organ rejection.   

If you have diabetes, poorly controlled blood sugars may be ‘food’ for harmful bacteria, causing them to reproduce more quickly.  Foodborne illness can cause diarrhea, vomiting, dehydration, malnutrition, electrolyte imbalance, all of which can exacerbate kidney disease and may increase the risk of mortality.

Food Safety for Individuals with CKD

Four Principles of Food Safety to Ensure Safety and Nutrition for CKD, Dialysis, and Transplant

What can be done at home to ensure maximum food safety and nutrition, while minimizing risk of illness through bacterial contamination?  To prevent foodborne illness, there are 4 core or basic principles to follow:

Clean:

  • Wash your hands before and after handling food, using the washroom, changing diapers, handling garbage, or pets.  Wet hands, apply soap, and wash for 20 seconds (sing happy birthday twice).
  • Clean all utensils and kitchen equipment with hot, soapy water.  Anything that has been in contact with raw animal products can be placed in the dishwasher.  
  • Clean all surfaces with hot, soapy water or a disinfectant.  Wash all clothes and towels in a hot wash.
  • Rinse and scrub all fruits and vegetables under running water with a clean vegetable brush (use the brush only on firm-skinned produce).

Separate:

  • Keep produce and other grocery items separate from raw items such as eggs, poultry, beef, pork, and fish.
  • Prepare produce first and separately from raw items to prevent and avoid cross-contamination.  Cross-contamination occurs when a pathogenic bacteria is introduced to an otherwise safe item that does not contain that pathogen.
  • Use one cutting board and one knife for produce, and another cutting board and another knife for raw items.
  • Never place cooked food back on the plate that held them when they were raw.
  • Make sure your appliances are clean.
  • Place raw uncooked items in containers or on plates on the bottom shelf to prevent dripping and contaminating other food items.
  • To ensure items are cooked thoroughly, see the table below.  
  • Remember to thaw them safely first — NEVER on the counter or in the sink.  Items should be thawed either in the refrigerator, in sealed packages in water on the counter (changing the water every 30 minutes), or in the microwave on the defrost setting.  Cook everything immediately after thawing.

Cook:

  • Cook all items to the appropriate safe temperature to ensure that all harmful pathogens (bacteria) are killed.  Use a thermometer for accuracy (see chart below).
  • When reheating food, be sure to reheat it to its required temperature listed above.  A digital thermometer is the best way to ensure that all cooked foods are at the appropriate temperature.
  • Remember, with ANY food, if in doubt, throw it out!  It’s not worth the risk.

Chill / Storage:

  • Keep cold foods cold and chill food properly to slow the growth of harmful pathogens.  The refrigerator should be between 0-4 degrees Celsius. The danger zone for bacterial growth is between 4-60 degrees Celsius.  Be sure your fridge temperature is between 0 and 4 degrees Celsius (32-40 degrees F) and that your freezer is at least -18 degrees Celsius ( 0 degrees F).
  • Items should be chilled within 2 hours of being cooked and / or served.  This is where the most common occurrence of foodborne illnesses occur; when items are not chilled and stored quickly after serving.
  • When making large amounts of food such as a large pot of chili, divide the food into smaller containers to ensure proper chilling.  The container should be no more than 2 inches deep. A deeper container takes longer to chill, which may result in foodborne illness.

By remembering the four core food safety principles, using a digital thermometer, and following temperature guidelines, you can be reassured that your food is safe and healthy.  This will help you be as safe and as healthy as possible to empower you to continue to manage your chronic kidney disease.

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.

If you think you may have a medical emergency, call your doctor or local emergency service immediately. KidneyChef does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the website. KidneyChef does not guarantee the accuracy of information on the Website and reliance on any information provided by KidneyChef is solely at your own risk.

References

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1600-6143.2009.02916.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159107/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298063/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555333/

https://www.mdpi.com/1660-4601/12/8/10117

www.canfightbac.org

www.hc-sc.gc.ca

https://www.niddk.nih.gov/health-information/digestive-diseases/foodborne-illnesses

www.who.org

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