ARCHIVED Ask A Dietitian 2/21/13 - 2/7/14 Topic

Dietitian 04/23/13 replied to Roatf
Hi Roatf, the Food Score has a specific use - to compare like items based on limited food label information. It is definitely not a good tool to compare all foods. For instance, olive oil doesn't get a high rating simply due to the fact it is an oil and is made up largely of fat calories. So, Food Score is not meant to assess all foods against each other.

However, if you want to compare frozen entrees or breakfast cereals, it does pretty well.

Here is more information about Food Score: http://www.mynetdiary.com/food-score.html

Thanks for your thoughtful questions and summary.

Best,
Kathy Isacks, MPS, RD, CDE

Nancyp0913 04/25/13 replied to Dietitian
Hi, Kathy! I wonder if you have any suggestions on best to use mynetdiary with kidney disease? According to my last eGFRs, I am at Stage 3. Although I have not officially been diagnosed, I decided to be proactive until such a time my doc is concerned enough for neph and renal dietician referrals. So...I'm doing the best I can on my own. Any ideas? Thanks!

Dietitian 04/25/13
Hi Everyone - I will be answering posts on Friday!
Best,
Kathy Isacks, MPS, RD, CDE

Dietitian 04/26/13 replied to Nancyp0913
Chronic Kidney Diseasse (CKD): Hi Nancyp0913, the eGFR can be affected by hydration so I wouldn't assume you are in Stage 3 CKD based upon that one single test.

CKD
Smoking cessation
Blood pressure control (very important for kidney health and preservation)
Get blood cholesterol/lipoprotein levels within a healthy range
Control blood glucose if applicable
Lose weight if overweight
Regular physical activity
Watch sodium and saturated/trans fats intake (CKD as it progresses has a very high morbidity/mortality from heart disease)

At this point in time, without any true confirmation of CKD stage, I would definitely NOT limit any particular nutrients and certainly not fluids!

If you are later diagnosed with CKD after all, then I would insist upon a referral to a renal dietitian SOONER not later, and have him/her define nutrient guidelines for you (typically calories, fluids, protein, sodium, phosphorus, and potassium - but it depends upon your labs). At that point, upgrade to a Maximum membership if you don't already have one so you can track the nutrients recommended. Please note that food labels are not required to list most nutrients so you might have to edit or add foods to add those values otherwise your food logs will UNDERestimate your true mineral totals. This is especially true for potassium and phosphorus.

Let me know how it goes.

Best,
Kathy Isacks, MPS, RD, CDE

Nancyp0913 04/26/13 replied to Dietitian
Thanks, Kathy. That one eGfr just alerted me to the problem. My labs (4) have had me under 60/stage 3 for the last two years, and before that I was a low stage 2 for awhile! Before the health screening, I had no idea and investigated my labs after that. So it would be wise to get referred to a neph now?? It concerns me that my current doc doesn't seem concerned. Maybe it's time for a new doc!! Re the apps... I am able to monitor phosphorus, potassium, protein, and sodium on the pro versions for iPhone and iPad, now. What more will Max get me? Thanks, again!!

Isitdinnertime? 04/27/13 replied to Nancyp0913
Just posted this separately, before finding your thread: I've broken my leg (tib/fib), not weight bearing, and I'm trying to eat the healthiest possible diet (plus supplements) to keep me slim but optimally nourished. I'm vegetarian (ovo/lacto). Any nutritional advice gratefully received. R

Dietitian 04/29/13 replied to Nancyp0913
Hi Nancyp0913 - If you are able to customize goals and track those nutrients with the Pro app without the Max membership, then great - you have what you need now.

In terms of care - your primary care provider is likely following specific labs and if they are within a certain range, you might still be appropriate to be followed by him/her. But these are questions to ask your doctor - if and when you should get referred to a nephrologist (and renal RD). CKD can have a very slow progression, especially in otherwise healthy individuals. Best to discuss with your doctor since they know your medical history.

Now, having said all of that, some organizations do support referral to a nephrologist given CKD Stage 3 and pre-existing conditions.

Here's a link from DaVita (sorry, don't mean to promote their business but they do have a good description of Stage 3): http://www.davita.com/kidney-disease/overview/stages-of-kidney-disease/stage-3-of-chronic-kidney-disease/e/4749

Best,
Kathy Isacks, MPS, RD, CDE

Dietitian 04/29/13 replied to Isitdinnertime?
Healing from any physical trauma requires following the recommended therapies (rest, ice, elevation or whatever your doctor has told you to do for whatever time period) and if/when physical therapy exercises prescribed, following those as well.

If you had multiple fractures with large bones, then healing would also require more calories, protein, and a host of essential vitamins & minerals. But it sounds like it was just your tibia/fibula - so it is not likely that your nutritional needs have increased above and beyond what is required for weight maintenance.

Having said that, I would be careful if you are trying to lose weight, not to go too low in calories or protein while you are trying to recover from your fractures. Sounds like you are already taking nutritional supplements - just sure to include calcium and vitamin D in the mix.

You might find my article on protein helpful: http://www.mynetdiary.com/protein-foods-in-diet.html

Being lacto-ovo vegetarian, I would be surprised if your diet is too low in protein, unless you are restricting your calories intake a lot. I would be happy to view your intake online if you would like. You can allow viewing by going on the web and changing your Information Sharing settings in your Community Profile.

Best,
Kathy Isacks, MPS, RD, CDE

Nancyp0913 04/29/13 replied to Dietitian
Thanks, Kathy!!

Lmartin28 04/30/13 replied to Dietitian
Hi Kathy,
I am Hypoglycemic and breakfast seems to be a huge struggle for me. Most breakfast foods are sugary or contains dairy (I am lactose intolerant). What can I eat to help maintain a health diet?

Thanks

ARCHIVED Ask A Dietitian 2/21/13 - 2/7/14