From the Welcome Desk at DPC – April: Making Recipe Substitutions

By Stephen C., Policy Assistant

Granny Smith APples

This week, I want to talk about dietary substitution. When someone gets diagnosed with kidney failure, it doesn’t mean it’s time to throw out all of those old recipes. There are plenty of ways to make any recipe renal friendly.

When my father was first diagnosed, we tried to find kidney friendly recipes online and bought kidney friendly cookbooks. We stuck with it for a while, but eventually we found it to be easier to just adapt our old recipes to fit the renal diet. In fact, this is something I still do quite a bit. Whenever we plan event menus for our patients, I am in charge of making sure our catering is renal friendly. I work with caterers to make substitutions and ensure our patients have something they can eat.

Substitution isn’t just a part of cooking for renal patients. I went vegetarian for my New Year’s resolution, so substitution is very much a part of my cooking regimen as well. I also try to avoid dairy, so I’ve become pretty adept at making egg replacers, opting for almond milk instead of cow’s milk, and liberally applying soy products instead of meat.

So this week, I’m going to try and walk you through the process of substitution by taking a random recipe from Epicurious.com and make it kidney friendly. Since it is now spring, I’ll do a fresh salad. Here’s the original recipe:

Roasted Baby Beets and Arugula Salad with Lemon Gorgonzola Vinaigrette
1/4 cup fresh lemon juice – 4 mg phosphorous, 75 mg potassium
1 tablespoon red wine vinegar – 1 mg phosphorous, 6 mg potassium
1/2 cup plus 1/3 cup extra-virgin olive oil – 0 mg phosphorous, 1 mg potassium
1/2 cup crumbled Gorgonzola cheese (about 4 ounces) – 261 mg phosphorous, 173 mg potassium
2 cups roughly torn bite-size pieces French bread – 68 mg phosphorous, 72 mg potassium
1/4 cup assorted chopped fresh herbs (such as parsley, basil, and rosemary) – N/A
1 garlic clove, minced – 5 mg phosphorous, 12 mg potassium
24 baby beets, trimmed, scrubbed – 396 mg phosphorous, 3192 mg potassium
8 ounces baby arugula (about 12 cups) – 156 mg phosphorous, 1107 mg potassium

Amount per serving: 148 mg phosphorous, 773 mg potassium

So right from the start, we’ve got a problem. Beets are not kidney friendly. In fact, most vegetables that grow in the ground (potatoes, carrots, turnips, parsnips) are not kidney friendly. So now let’s try and think of an alternative. What flavors are beets bringing to this dish? In this case, the beets are balancing out the zest of the arugula with sweetness. Where else can we find that? I brainstormed alternatives and looked them up here. In this case, I decided on apples. For good measure, let’s add caramelized onions as well. Those sweet caramelized onions and apples will really take the edge off the bitter greens and pair really well with the gorgonzola.

Next, lemon juice and arugula can both be problematic, but if you follow the serving directions on the recipe, you should be fine. Gorgonzola is also a little high in phosphorous and sodium. It’s ok to use it, but let’s limit it to a quarter cup instead of a half cup. If you’re a transplant patient, don’t forget that you should be avoiding moldy cheeses altogether.

So let’s look at that recipe again with our substitutions:

Roasted Baby Beets and Arugula Salad with Lemon Gorgonzola Vinaigrette
1/4 cup fresh lemon juice – 4 mg phosphorous, 75 mg potassium
1 tablespoon red wine vinegar – 1 mg phosphorous, 6 mg potassium
1/2 cup plus 1/3 cup extra-virgin olive oil – 1 mg phosphorous, 6 mg potassium
1/4 cup crumbled Gorgonzola cheese (about 4 ounces) – 130 mg phosphorous, 86 mg potassium
2 cups roughly torn bite-size pieces French bread – 68 mg phosphorous, 72 mg potassium
1/4 cup assorted chopped fresh herbs (such as parsley, basil, and rosemary) – N/A
1 garlic clove, minced – 5 mg phosphorous, 12 mg potassium
4 cups chopped apples – 55 mg phosphorous, 535 mg potassium
1 onion, minced – 25 mg phosphorous, 113 mg potassium
8 ounces baby arugula (about 12 cups) – 156 mg phosphorous, 1107 mg potassium

74 mg phosphorous, 335 mg potassium

Wow! With a couple simple changes, we cut out over half the potassium. Here’s the rest of that recipe with the substitutions made.

Place lemon juice and vinegar in small bowl. Gradually whisk in 1/2 cup oil. Stir in cheese. Season with salt and pepper. (Dressing can be made 1 day ahead. Cover and chill.)

Heat remaining 1/3 cup oil in medium ovenproof skillet over medium heat. Add bread pieces; toss to coat. Add herbs and garlic; toss to coat. Sauté until bread is crisp, about 4 minutes. Using slotted spoon, transfer croutons to plate in single layer. Cool.

Caramelize onions in the same pan to soak up only leftover herbs and crumbs. Cook over medium heat for a half hour or more or until dark brown in color. Reduce the heat as needed to avoid burning. This can also be done ahead of time to allow time for

Toss arugula with 1/2 cup dressing in large wide bowl. Season to taste with salt and pepper. Top with apples and caramelized onions and serve.

I haven’t actually tried this recipe, but let me know how it turns out!

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