Low Protein Diet

Description

Protein contains 16% nitrogen which the body eliminates in the urine as urea. In cases where liver or kidney function is impaired, ammonia or toxic nitrogen metabolites may build up in the blood. These toxins contribute to kidney disease and may produce behavioral changes such as delusions, psychosis and hallucinations.

The Low Protein Diet is designed to reduce these nitrogen metabolites and ammonia in individuals with toxic bowel, liver disease or kidney failure. In order to achieve these objectives, dietary protein must be limited to 0.6 gram/kg (2.2 lbs.) of body weight or about 40-50 grams per day.

The Low Protein Diet is useful for the management of liver and chronic kidney diseases. For optimal results protein-rich foods should be consumed throughout the day rather than at one meal.

The Low Protein Diet is deficient in protein and can result in muscle wasting. This is a consequence of muscle protein being broken down to provide amino acid to the body for daily use. This diet may also be low in iron, calcium, thiamine (Vitamin B-1), riboflavin (Vitamin B-2) and niacin (Vitamin B-3) and so a nutritional supplement may be necessary to prevent deficiency.

Sample Menu

Menu for One Day

Breakfast
1 orange
1/2 tbls margarine or butter
1 egg or egg substitute
1/2 c whole milk - fresh
1/2 c rice or creamed cereal
Hot, noncaloric beverage
1 slice toasted whole wheat bread
1 tbls sugar - granulated (opt)

Lunch
1 apple
1 oz sliced turkey breast
1/2 c gelatin dessert
1/2 c steamed broccoli
1 c grape juice
1 slice whole wheat bread
Hot, noncaloric beverage
1/2 tbls margarine or butter
1 tbls sugar - granulated (opt)

Mid-Afternoon Snack
6 salt-free soda crackers
1-2 tbls jelly
1/2 tbls margarine or butter
1/2 c apple juice

Dinner
1/2 c tomato juice
1 slice whole wheat bread
1 oz beef liver
1 baked potato
1/3 c sherbet
1 tsp margarine or butter
4 apricot halves
1/2 cup steamed spinach
1/2 tbls margarine or butter
Hot, noncaloric beverage

Evening Snack
1 banana

Total Calories For The Day: 1,850 (optional fat and sugar included)

Nutrient Content:

Calories:	1850	Fat:	32%
Protein:	8%	Cholesterol:	380mg
Carbohydrate:	60%	Fiber:	15g

Food Exchange List

Bread and Cereal Exchange List: 6 or more servings/day

Recommended

Gelatin	Popcorn
Potato	Sweet potato
Baked goods made with low protein flour or wheat starch

Avoid

Green peas	Lentil
Beans (dried)	High protein baked goods and cereals

Fat Exchange List: unlimited

Recommended
All

Avoid
None

Fruit Exchange List: 3 or more servings/day

Recommended
Fresh, frozen, canned, or dried fruits, both whole and juice

Avoid
None

Meat and Meat Substitute Exchange List: 3 servings/day

Recommended
All meat may be coated with flour or wheat starch and fried to increase caloric content

Avoid
None

Milk Exchange List: 1/2 serving/day

Recommended
Cream, or whole milk - fresh to increase calories

Avoid
Skim milk, or milk - 2% fat

Vegetable Exchange List: 2 per day

Recommended
Fresh, frozen, or canned vegetables, both whole and juice

Avoid
None

Note: Include six to eight cups of fluids, such as water, per day.

References

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Gallice, P. & A. Crevat. A Compound From Uremic Plasma and Normal Urine. Clinical Chemistry, 31 (1985).

Walser, M. 1983. Nutrition in renal failure. Ann Rev In Nutri, 3.

Walser, M., H.D. Mullan, et. al. 1984. Modifications in protein: Nutritional aspects of renal failure. In Nutritional Management. M.

Walser, A. L. Imbembo, S. Margolis, and G. A. Elfert, eds. W.B. Saunders Co., Philadelphia.

Wills, M. Uremic Toxins and Their Effect on Intermediary Metabolism. Clinical Chemistry, 31 (1985).

Williams, A.J. & J. Walls. Protein Restriction in Chronic Renal Failure. Lancet, January 12, 1985.