5 Tips for Dining Out with IGA Nephropathy

Introduction

Eating out with family and friends can be very stressful when you are following a diet for your health. Your IgAN and kidney function status may mean you have many restrictions or only one or two. This article will help you decide what goes best on your plate when eating out. 

Your Personal Needs

IgAN affects people’s kidneys to differing degrees and changes over time, meaning that what one person can order at a restaurant is not necessarily recommended for someone else with IgAN. Focus on what matters most to you in your diet before you order.     

Sodium

Most people with IgAN have been told to follow a low-sodium diet. The largest contributor to sodium/salt in the US Diet is from eating out and packaged goods (1). You can easily have more sodium in one meal at a restaurant than you should have in a whole day. 

Here are some quick tips on how to limit salt in your meal:

• Ask for dressings, sauces, and dips on the side. Then, add only the amount you need to season your food. 
• Skip the bread. Bread and butter can have a lot of additional salt.
• Ask for no additional salt to be added to your foods.
• Choose a side of fruit, steamed veggies, or salad. 

Protein

Depending on your age or kidney function status, you may have been told by your doctor to eat more or less protein at your meals. Typically, restaurant portions are more food than we should eat at one sitting. When it comes to meat, typical restaurant portions can be 2-3 times what you need at one meal. Consider choosing salads that contain protein as a way to right-size the portion you need, or cut your meat in half and bring home as leftovers. 

Gluten

Many people with IgAN choose to avoid gluten because of the association between gluten-free diets and IgA Nephropathy. This association is not completely understood at this time, and research continues in this area (3, 4). This can be hard when eating out or ordering for yourself. 

Consider asking your waiter/waitress the following questions (4):

• Do you have a gluten-free menu?
• What items can be made gluten-free?

General Considerations would be:

• Ask for foods without sauces or dressings (these foods may contain flour/gluten)
• Ask if grilled items are marinated with items that may also contain gluten, such as soy sauce. 
• Ask if soups are gluten-free, as they can be thickened with flour.

Other Needs

Many times, there may be additional foods that you avoid due to taste preference or health. Remember to take these into consideration as you want to enjoy your meal and stay safely within your general health needs. 

Plan Ahead

Many times, you know where you will be eating out before you eat. Looking at the menu online ahead of time can make your decision easier at the restaurant. This also allows you to spend time enjoying the people you are with and not on what to eat. Many chain restaurants have their nutrition information posted on their website. This is a great way to actually see how much sodium, protein, etc., is in the meal. This information is a great guide and a way to reduce stress during ordering. 

At the Restaurant

Once at the restaurant, focus on having fun and not on what to eat. As mentioned above, skipping bread, taking home leftovers, and asking for sides of salads or fruits can help maintain your health and taste as the meal’s focus.  

Ordering Out from a Menu

Ordering food online for delivery has become a common way to get food. Although you may not be sitting down at a restaurant, ordering from a delivery service is still considered eating out. You want to follow the tips mentioned in this article because you may be eating more than you realize. The plus to ordering from a menu is that you have plenty of time to choose your options and many times you can see your order history. Once you have found a dish that meets your health needs and taste you can simply re-order. 

Enjoy Yourself

Eating out is supposed to be a way to enjoy friends and family, reduce cooking burden or simply to feed yourself quickly. Regardless of the reason to eat out you should enjoy yourself. If you are going out for a celebration, remember that the reason you are eating out and understand that one meal is not going to ruin your kidneys. Food is just one piece of the puzzle when it comes to your health.  

Conclusion

Eating out can be a very stressful situation with IgAN. Taking into consideration your personal health needs, planning ahead and enjoying yourself can make eating out less stressful and more enjoyable. If you or a loved one is looking for more information on healthy options at home check out our recipes on igan.org. 

References:

1. About Sodium and Health. Center for Disease Control.  https://www.cdc.gov/salt/about/index.html
2. Beginners Guide to a Low Sodium Diet. https://www.cukebook.org/guides/diet/low-sodium-diet/
3. https://www.kidney-international.org/article/S2157-1716(15)32171-7/fulltext
4. Patel J, Kalantar-Zadeh K, Betz M, Joshi S. A Low-Protein, Plant-Dominant Gluten-Free Diet for Immunoglobulin A Nephropathy and Focal Segmental Glomerulosclerosis. Adv Kidney Dis Health. 2023 Nov;30(6):517-522. doi: 10.1053/j.akdh.2023.09.001. PMID: 38453268.
5. Dining and Social Eating. Celiac Disease Foundation. https://celiac.org/gluten-free-living/dining-and-social-eating/#:~:text=It%20is%20best%20to%20choose,batter%20to%20make%20them%20fluffier.