Book Review: The Vegetarian Diet for Kidney Disease

"Ecologically Grown Vegetables"
Photo by Elina Mark
(Courtesy of Wikimedia)

As I've written on this blog before, my wife Caryl (pronounced "Carol") and I are vegetarians.  She is also a diabetic, plus she has high blood pressure, and needs to watch her sodium and cholesterol.  Caryl had gotten her diabetes under control when the "other shoe" fell -- she now has first stage kidney disease.

The doctor recommended a low potassium diet and gave her a list of no-no foods -- all of which were things we vegetarians rely on: beans, potatoes, lentils, soy, oranges, avocados, tomatoes, squash, nuts, and a ton of other veggies.  Just imagine trying to be a vegetarian without using these basic foods.

A search online revealed kidney disease diets that were all heavily meat-oriented for protein sources -- not an option for us, both because of our commitment to vegetarianism and the fact that we keep kosher and live in a rural area where kosher meat is not easily available.  This was so disheartening to Caryl that she plunged into depression. What on earth COULD she eat?  Food just did not seem interesting or palatable anymore.

Then I found this book by registered dietitian Joan B. Hogan, who specializes in renal nutrition.  Not only does it deal with vegetarianism and kidney disease, it talks about combinations of diseases -- such as having both diabetes and kidney disease.  As Hogan explains, it used to be believed that vegetarianism and kidney health did not mix, and that animal proteins were superior to proteins obtained from plants, based on early studies of baby rats.  But this is now changing.  As Hogan says, "This theory is now history, for we are not rats."

 Hogan's approach to menu planning is much more sensible than the old flesh-centered renal diet.  Rather than outrightly forbidding various foods, she classifies them as high, medium, and low potassium.  Sort of a "Chinese menu" approach where you can choose one from list A, two from list B, and three from list C per day. So, for example, Caryl can have an orange (high) if she doesn't have a tomato (high) the same day. Or she could have half an orange at breakfast and a slice of tomato later in a sandwich. This allows for a whole lot more flexibility and variety in the menu. (The same goes for other nutrients, but since potassium is what brought us to this book, this review focuses primarily on that.)

And there are lots of charts for various foods to compare levels of protein, potassium, phosphorus, sodium, etc., as well as a useful chart on commercial meat substitutes. (Which is why you should buy the book version, NOT the kindle version, which renders the charts totally unreadable. Besides, having the book on the shelf right there next to your recipe books is more convenient.)

There is also a very useful list comparing various types of beans, where I learned that pinto beans have half the potassium of white beans -- so by changing the beans we use in a favorite soup, we could cut the potassium way down and still enjoy it in smaller portions.

One thing that the book does not have is more info on how cooking and other preparations affect various foods. There are recipes with stats for the complete recipe, but not for individual cooked ingredients. For example, she mentions "soaked potatoes" in a chart but does not say how long to soak them, or how soaking affects their potassium level. I assume she means soak them raw and pour off the water?

I do know that potassium is water-soluble, so when we cook potatoes (and a lot of other veggies) we no longer use the water they were cooked in for soups.  Ditto for beans, which we first soak overnight, then pour off that water and use fresh water for cooking.  I assume this lowers the potassium levels of the foods, but some statistical comparisons between raw and cooked vegetables would be very helpful. And how does sprouting lentils and mung beans (both high potassium but also soaked first and rinsed repeatedly as they grow) change their statistics?

I later discovered that a lot of this type of info can be found on the USDA Food Composition Database, where, for example, a search for "lentils" did find comparisons between raw, cooked, and sprouted.  This info, plus Hogan's book that pointed us in the right direction for figuring out how to balance a renal vegetarian diet, has made life a lot more bearable.  Caryl is no longer so depressed and we are now enjoying food again.  Plus her potassium was normal last blood test. I give it ten stars!

Kudos to "Hatchlings" for listening to me!

If you play the Hatchlings egg hunt game on Facebook, then you know that there are always tons of Christmas-themed eggs every year.  But up until this year there had only been two Hanukkah eggs -- and both of those were way back in 2009.

Hatchlings 2009
Hanukkah egg

OK, it's pretty normal for Jewish holidays to be ignored by the dominant culture.  But I have to admit that the ubiquitous Christmas commercialism gets pretty old when you are constantly bombarded from all directions with a holiday you don't even celebrate.  (My Christian friends tell me it gets old for them, too, but that's another story.)

If you have Jewish kids, "The Season" is the time of year when they feel most left out.  Frankly, so do we adults.  So anytime there is even a tiny little acknowledgment of a Jewish holiday in the mainstream world, we Jews pounce on it like a starving dog on a bone.

Well, this year Hatchlings threw us more than a bone -- we got a whole week of meals.  Eight beautiful Hanukkah eggs.  You see, I got to thinking that maybe the reason we had never had a Hanukkah series might be because the Hatchlings design team didn't know what the symbols of Hanukkah are.  Hatchlings eggs tend to be in series of eight, and Hanukkah has eight days.  So a while back, I suggested these possibilities:  Judah Maccabee, menorah, latkes (potato pancakes), sufganiot (Israeli donuts), gelt (coins), presents, bottle of olive oil, Star of David.  Well, they took my suggestion -- and now we have those eight things in a Hanukkah egg series (the menorah on this page is number 8.)  Which just goes to show, it's better to step forward with a solution rather than sit back and grumble about a problem.

So my New Year's resolution is this:  I'm going to look for more ways to facilitate inclusiveness in this increasingly divisive world.  Sometimes you get left out, not from prejudice, but from sheer ignorance.  Fortunately, ignorance is curable with education.   Not to mention activism.   (Now let me see... we've never had any Passover Hatchlings eggs, and Passover also has eight days... so what would be eight good symbols to use for  a Passover series?  For that matter, Kwanzaa also has eight days...)

Wishing everyone a happy, prosperous New Year 2013!

No end of the world today

According to an old Mayan prophecy, the world was supposed to end at 5:11 AM today.  (In my time zone at least.)  Well, it's 12:00 noon and I'm still here.   Not that I really expected the world to end.  But this does give me an opportunity to answer some common questions about Judaism and "the End Times."

First of all, we need to clarify that the word olam in Hebrew can mean either "world" in the sense of the physical planet, or "eternity." The best modern translation is probably something like "space-time continuum."   (I have always wondered if this fact had any influence on Einstein's ability to imagine a point at infinity where space and time converge.  He wasn't a religious Jew, but culturally he must have heard the word olam.  Did the Hebrew language help facilitate the "thought experiment" that led to the Theory of Relativity?  Interesting question...)

In Greek, however, there are two separate words for these two ideas:  kosmos for the physical world, and aeon for a period of time or age.   So already we have a major difference between Jewish thought and Greco-Roman thought when it comes to talking about "the end times."  During the period when Christianity split off from Judaism, it was common in both groups to try and calculate the End of the World.  But were the early Christians talking about the end of the physical kosmos, or the end of an age?

Jesus and his disciples were speaking Aramaic, a derivative of Hebrew, so most likely they were using olam.  But the Gospels are written in Greek, not Hebrew, and, as far as I know, Greek does not have a single word that includes both time and space.  So the Christian authors had to choose between kosmos and aeon.  I'm no expert in this, but I do know that Judaism has tended to lean toward the "end of an age" rather than a literal destruction of the planet.

In fact, there is a famous quote in Avot de Rabbi Nathan (a classical Jewish commentary) that says, "If you are planting a tree and you hear the messiah has come, first finish planting your tree, then go to meet him."  In other words, don't drop everything just because you hear rumors about the end of the world.

By and large, modern Judaism discourages calculating a specific date for "the end times."  Why?  Because setting a specific date tends to become a form of escapism.  If you think the world is ending soon, and that a deity is going to appear and miraculously solve all your problems, then why bother to do anything to improve the world?  Many, many times I have been told by Christians that there is no point in trying to make peace in the Middle East, because there will always be "wars and rumors of wars" until Jesus returns.  Somehow, this seems defeatist and, frankly, rather callous.  In contrast, Jews are commanded to actively "seek peace and pursue it " (Psalm 34:14).

Jesus appearing in the clouds
from the Macklin Bible 1798

In Greek drama, there is a concept called deus ex machina, literally "god from a machine."  At the end of a play, an actor playing a god would be lowered on a rope (the machine) to "descend" and straighten out everything in the story.  We also see a form of this in the Book of Job, where, after Job and his friends debate the question of "why bad things happen to good people," God speaks to Job and answers the question on a cosmic scale.  (In fact, some scholars believe that the author of Job might have been a Greek convert to Judaism.  The book certainly follows the format of a Greek play.)  In Christian imagery, Jesus will descend from heaven on a cloud when he returns and sets the world right.  And in modern New Age circles, the "gods" are extraterrestrials who will descend in UFOs.

The problem with deus ex machina is that it doesn't work very well in real life.  If we sit around waiting for a messiah to fix everything for us, then nothing ever gets fixed.  This is why Jews are not "waiting for" the messiah.  Rather, we are working to bring the messianic age, to beat swords into plowshares as promised by Isaiah.  Each mitzvah we do brings us one step closer.  Some Jews do believe there will be an actual person who is the messiah, others see "bringing messiah" as a process.  But most of us would agree that it is not enough to just sit around and wait for a deus ex machina to appear and solve all our problems.   We are each responsible to help make the world a better place to live in.

(If you are still worried about a literal end of the world, check out this page on the NASA website.  NASA received so many inquiries about this "event," they actually posted a Q and A!)