You may be thinking, “a dietitian is saying fast foods are okay for CKD, that’s crazy!” but hear me out. It’s common knowledge that frequent intake of fast food is not ideal for overall wellness. Fast food is notorious for foods high in added fat and sodium and low in fiber and beneficial nutrients. But in our modern day fast-paced society, even health conscious people may need a quick bite to eat.
Those with kidney disease definitely need to limit frequency of fast food, but it’s not realistic to say one with CKD can never step foot in a fast food establishment ever again. In this blog, I will discuss some key nutrients to focus on when eating out with CKD and provide kidney friendly fast food choices. Keep in mind, your local restaurant may have different (and hopefully better) options!
Nutrients to consider when making fast food choices
There are some key nutrients to consider with chronic kidney disease: sodium, phosphorus, potassium and protein. I’ll go over each nutrient and strategies to keep your intake in check with each.
Sodium
A low sodium diet is recommended for CKD as it’s beneficial for blood pressure control. The majority of the menu items at fast food restaurants are high in sodium. You can check the restaurant’s website for nutrition facts to see your lower sodium options.
You can also use these tips and tricks to reduce the sodium content further:
1. This one is obvious – but don’t add additional salt!
2. Ask for your food to be prepared without added salt. Foods cannot be taken out of many food items, but this will ensure that whoever is preparing the food doesn’t add extra salt.
3. Ask for condiments and dressings on the side.
4. Try a grilled dish rather than fried.
Phosphorus
Excess phosphorus is not good for your bones, blood vessels and heart. Phosphorus is found naturally in virtually all foods, but there are also man-made forms of phosphorus, called phosphorus additives. These additives can double to triple the phosphorus content of a food!
Foods that are naturally high in phosphorus include animal proteins (beef, chicken, fish, etc), plant proteins (like beans, nuts, seeds) and dairy products. It’s very difficult to completely avoid phosphorus additives when eating fast food. By looking up the restaurants website, you may be able to locate the ingredient list of the menu items. Try to avoid food items with any ingredients containing “phos”.
Protein
Those with non-dialysis CKD should avoid excess animal protein intake as it is hard on the kidneys. There are typically little to no vegetarian/vegan options at a fast food restaurants. If opting for animal protein, I suggest avoiding “double” burgers or sandwiches with multiple types of proteins (like a chicken sandwich with bacon for example).
Potassium
Potassium is an important mineral and electrolyte the body needs to function properly. It is also beneficial for heart health. Potassium from plant foods isn’t harmful, potassium salts (and some potassium additives) however, are. Potassium salts should be avoided in most cases with CKD.
Keep in mind not all people with kidney disease needs to limit potassium. In many cases, upping the potassium intake is beneficial. Fruits and vegetables should be encouraged for those with CKD, and these options are typically lacking at fast food places. Whenever there is an option like a fruit and salad – this is a great addition to your fast food meal.
McDonald’s
Better Breakfast Choices
Fruit & Maple Oatmeal
I love recommending oatmeal for CKD, so no surprise the Fruit & Maple Oatmeal is on my list. This is the highest fiber item on the entire menu. This oatmeal is normally made with cream which contains phosphorus additives, so I recommend requesting just water in your oatmeal.
Nutrition breakdown (without cream): calories 300, total fat: 3 g, saturated fat: 0.5 g, carbohydrates: 63 g, fiber: 4 g, protein: 6 g, potassium: 320 mg, sodium: 140 mg
Egg McMuffin
The English muffin is much lower in sodium than the biscuit, although both choices do have phosphorus additives. I would recommend getting without the Canadian bacon to reduce the sodium, phosphorus and animal protein. The Canadian bacon has phosphorus additives, the cheese, surprisingly, does not.
Nutrition breakdown (without Canadian bacon): calories 290, total fat: 13 g, saturated fat: 6 g, carbohydrates: 29 g, fiber: 2 g, protein: 14 g, potassium: 160 mg, sodium: 550 mg
Better Lunch/Dinner Choices
Chicken Nuggets
The four piece chicken nuggets is not the heartiest of choices, but is the lowest sodium chicken option. The chicken nuggets do contain phosphorus additives (as do all of their chicken meals) which is why you would ideally want to avoid a large portion of them.
Nutrition breakdown: calories 170, total fat: 10 g, saturated fat: 1.5 g, carbohydrates: 10 g, fiber: 0 g, protein: 9 g, potassium: 140 mg, sodium: 330 mg
Filet o’Fish
This sandwich is one of the lower sodium choices on the menu. I would get it without cheese, again, to reduce the sodium some more. There are no phosphorus additives in this option.
Nutrition breakdown (without cheese): calories 370, total fat: 17 g, saturated fat: 2.5 g, carbohydrates: 38 g, fiber: 1 g, protein: 16 g, potassium: 280 mg, sodium: 480 mg
Hamburger
The hamburger is the lowest sodium sandwich on McDonald’s menu. The beef patty also contains no phosphorus additives, unlike the chicken patties. This is also the sandwich with the lowest amount of animal protein.
Nutrition breakdown: calories 250, total fat: 9 g, saturated fat: 3.5 g, carbohydrates: 31 g, fiber: 1 g, protein: 12 g, potassium: 200 mg, sodium: 510 mg
Better Sides
Apple slices
If you want something safe to go along with your meal – apple slices are the clear winner. The portion is small, but know what you are getting with this choice.
Nutrition breakdown: calories 15, total fat: 0 g, saturated fat: 0 g, carbohydrates: 4 g, fiber: 0 g, protein: 0 g, potassium: 35 mg, sodium: 0 mg
Fries
It’s hard to skip the fries when getting fast food! If you choose to have fries, I recommend getting the kids size and asking for the fries to be unsalted. They will cook up a fresh batch for you. The fries do contain lots of other ingredients besides potatoes!
For your information here are the ingredients of McDonald’s French fries as stated on their website: Potatoes, Vegetable Oil (canola Oil, Corn Oil, Soybean Oil, Hydrogenated Soybean Oil, Natural Beef Flavor [wheat And Milk Derivatives]*), Dextrose, Sodium Acid Pyrophosphate (maintain Color), Salt. *natural Beef Flavor Contains Hydrolyzed Wheat And Hydrolyzed Milk As Starting Ingredients. (As you can see there are phosphorus additives in the fries.)
Nutrition breakdown: calories 110, total fat: 5 g, saturated fat: 0.5 g, carbohydrates: 15 g, fiber: 1 g, protein: 0 g, potassium: 230 mg, sodium: 90 mg
Burger King
Note: Burger King does not have potassium content listed in the nutrition facts they provide. They also do not have ingredients listed.
Better Breakfast Options
French Toast Sticks
This is the lowest sodium option on the breakfast menu by far. The 3 piece has 220 mg sodium, the 5 piece has 400 mg sodium. This is also a low protein option. I’m unable to confirm if this item contains any phosphorus additives, but it very well may.
Nutrition breakdown (3 pieces, without syrup): calories 230, total fat: 10 g, saturated fat: 2 g, carbohydrates: 32 g, fiber: 2 g, protein: 6 g, potassium n/a, sodium: 220 mg
Better Lunch/Dinner Options
Hamburger
A plain old hamburger is going to be your lowest sodium option. It’s not a huge burger, so also not crazy high in animal protein.
Nutrition breakdown: calories 250, total fat: 10 g, saturated fat: 4 g, carbohydrates: 29 g, fiber: 1 g, protein: 13 g, potassium n/a, sodium: 560 mg
Impossible Patty (made as a hamburger)
Burger King does have a plant-based meat alternative, the Impossible Burger. You can request this in place of the beef patty when ordering a regular hamburger. This isn’t an options on their menu.
The Impossible burger sandwiches on their menu are very high in sodium (the Impossible Whopper is over 1,300 mg sodium, the Impossible King sandwich is 2,000 mg sodium)!
The exact Impossible patty Burger King uses is not known, but per the Impossible website their regular patties contain 370 mg sodium, 19 g protein, 670 mg potassium and 15% DV for phosphorus (188 mg). The patty they use may or may not contain phosphorus/potassium additives (again, unsure of the exact patty used). This may be a higher sodium option but it’s a good choice for those wishing to eat plant-based.
Nutrition breakdown: unknown
4 Piece Chicken Nuggets
Again, four nuggets are not the most filling of options, but it is the lowest in sodium. It’s also going to be lower in protein compared to the sandwiches. I’m suspecting phosphorus additives are in this item as many breaded products do contain it, but I’m unable to confirm due to ingredients not being available.
Nutrition breakdown: calories 193, total fat: 12g, saturated fat: 2 g, carbohydrates: 11g, fiber: 1 g, protein: 9 g, potassium n/a, sodium: 495 mg
Chicken Jr.
The Chicken Jr is the lowest sodium chicken sandwich on the menu. This sandwich uses a smaller chicken patty so it is also lower in protein compared to the other sandwich offerings. It’s unclear if the product uses any phosphorus or potassium additives.
Nutrition breakdown: calories 453, total fat: 30 g, saturated fat: 5 g, carbohydrates: 34 g, fiber: 2 g, protein: 12 g, potassium n/a, sodium: 691 mg
Better Sides
Applesauce
It’s clear that applesauce is a good choice for a side as this is the only fruit or vegetable option on the menu (in my area at least)!
Nutrition breakdown: calories 50, total fat: 0 g, saturated fat: 0 g, carbohydrates: 13 g, fiber: 1 g, protein: 0 g, potassium n/a, sodium: 0 mg
Fries
Go for the smallest size available for fries (which is medium). Again, you can request them to be made without added salt. The ingredients of the fries aren’t posted, but I’m wondering if they have phosphorus additives like the ones from McDonalds!
Nutrition breakdown: calories 370, total fat: 16 g, saturated fat: 2 g, carbohydrates: 54 g, fiber: 4 g, protein: 5 g, potassium n/a, sodium: 270 mg
Wendy’s
Better Breakfast Options
Oatmeal Bar
The Oatmeal Bar is a safe breakfast option that provides some fiber. It is low in sodium and contains no phosphorus or potassium additives.
Nutrition breakdown: calories 280, total fat: 10 g, saturated fat: 4 g, carbohydrates: 45 g, fiber: 4 g, protein: 3 g, potassium 94 mg, sodium: 230 mg
Better Lunch/Dinner Options
Apple Pecan Salad
Wendy’s is the only fast food chain on this list that still offers salads. As this is the menu item that offers the most vegetables, it’s going to be on my list even though it may not be the lowest in sodium.
This salad normally comes with chicken, but I would recommend getting without which will reduce the amount of sodium, phosphorus (the chicken has phosphorus additives and also is a source of natural phosphorus) and will reduce the animal protein of the meal. The dressing that comes with the salad is the lowest sodium of all their salad dressings.
Note: Wendy’s does not have a nutrition calculator, so I’m unable to calculate the nutrition facts without the chicken – but all nutrients would be lower (besides carbs and fiber which would stay the same).
Nutrition breakdown (salad with chicken): calories 450, total fat: 25 g, saturated fat: 11 g, carbohydrates: 28 g, fiber: 5 g, protein: 23 g, potassium 705 mg, sodium: 1230 mg
Nutrition breakdown of salad dressing: calories 90, total fat: 3 g, saturated fat: 0 g, carbohydrates: 16 g, fiber: 0 g, protein: 0 g, potassium 94 mg, sodium: 190 mg
Jr. Hamburger
Again, the hamburger at Wendy’s is also one of the lower sodium menu items. The bun does contain phosphorus additives but the beef does not.
Nutrition breakdown: calories 250, total fat: 11 g, saturated fat: 4 g, carbohydrates: 25 g, fiber: 1 g, protein: 13 g, potassium 188 mg, sodium: 420 mg
4 Piece Chicken Nuggets
Small size nuggets win for lowest sodium chicken item. All the chicken products at Wendy’s do contain phosphorus additives, but at least with the nuggets you’ll be avoiding the phosphorus additives that come along with the bread. This is also going to be less animal protein than a full sandwich.
Nutrition breakdown: calories 180, total fat: 12 g, saturated fat: 2.5 g, carbohydrates: 9 g, fiber: 0 g, protein: 10 g, potassium 188 mg, sodium: 380 mg
Better Sides
Apple Bites
This is a no brainer!
Nutrition breakdown: calories 35, total fat: 0 g, saturated fat: 0 g, carbohydrates: 8 g, fiber: 1 g, protein: 0 g, potassium 94 mg, sodium: 0 mg
Baked Potato
If you are a potato person, I would skip the fries (which contain phosphorus additives) and opt for the simple baked potato. You can even get it with sour cream and chives which will not add much in terms of sodium and protein. Another option to spice up the potato would be butter and black pepper.
Nutrition breakdown (plain potato): calories 270, total fat: 0 g, saturated fat: 0 g, carbohydrates: 61 g, fiber: 7 g, protein: 7 g, potassium 1,645 mg, sodium: 40 mg
Conclusion
Although we know fast food is not the ideal choice for someone with CKD, it’s okay to eat from time to time. By knowing what menu choices are better for kidney disease, you can be confident you won’t be derailing your kidney diet in one meal. It’ really our day to day eating habits that make the biggest impact on our kidney and overall health!
If you would like help figuring out what foods you can eat with chronic kidney disease, let’s work together!
