Journal of Renal Nutrition
Volume 17, Issue 2 , Pages 157-159, March 2007

High-Octane (Flaxseed Oil) Protein Power Shakes for Patients on Dialysis

  • Danielle J. Monahan, MS, RD

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    • Corresponding Author InformationSubmitted by Danielle J. Monahan, MS, RD, 2432 Drexel Street, Vienna, VA 22180-6902.

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This Patient Information Forum may be photocopied for the purpose of distribution to patients only, but not for any other purposes, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale. Professional review and adaptation before patient use is encouraged.

 

“Let thy food be thy medicine and thy medicine be thy food.” Hippocrates, Father of Medicine, 5th Century BC.

MALNUTRITION AND inflammation are bad for the immune system, muscles, and heart.1

Here are some simple homemade shake recipes that should reduce these problems. Each ingredient has been carefully selected for its general health benefit, taste availability, and cost. All would also be acceptable for a person with diabetes.

The basic ingredients are plain yogurt (only ½ cup); cold-pressed, organic flaxseed oil; xylitol (a sweetener) or stevia; allowed fresh or frozen fruit; whey protein powder (preferably with the added amino acid glutamine); and spices. These ingredients can be purchased from a variety of sources, such as grocery and health food stores and various internet sites (e.g., www.google.com).

First, the health benefits of each ingredient will be reviewed, and then the basic shake recipe will follow. A blender will be needed.

1.Yogurt: Yogurt is milk that has been fermented with live active cultures. These fermented cultures are called probiotics. These cultures break down the milk sugar (lactose) so that even most people with lactose intolerance can consume some yogurt.Use plain nonfat yogurt if you need to limit calories but still need the protein. Otherwise, regular yogurt will be fine. Use organic yogurt because it is made without artificial flavors, sweeteners, preservatives, antibiotics, toxic pesticides, or fertilizers. Also, look for the words “live and active cultures” to make sure the product contains live cultures at the time of consumption. Four brands that come to mind are Stonyfield Farm, Brown COW, Dannon, and Nancy’s.

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Advantages of Using Probiotics 


Enhanced digestion and absorption of nutrients

Enhanced immunity

Reduced constipation

Reduced antibiotic-induced diarrhea


2.Flaxseed Oil: Flaxseed oil is made from pressing flaxseed and is one of the “good” fats. Flaxseed oil is the world’s richest source of linolenic acid and also rich in linoleic acid. Both of these are known as essential fatty acids or omega 3 and omega 6 oils. It is a great source of fats our bodies crave but cannot make on their own.Flaxseed oil has a golden yellow color with a slightly nutty flavor. You cannot cook with it because the oil is unstable in heat. However, it is a great salad oil or to use in these shake recipes!Buy only organic, cold-pressed flaxseed oil in dark glass or plastic bottles. That way you are assured you are not buying oil that has been made from seeds sprayed with toxic chemicals, nor have the health properties been destroyed by heat or light.2, 3, 4

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Benefits of Flaxseed Oil 


Enhanced joint comfort and flexibility

Help in reducing cholesterol and triglyceride levels

Decrease blood clotting tendency, which will decrease risk of heart attack or stroke

Normalize blood pressure

Promote blood glucose balance

Strengthen immune system

Increase fat burning

Boost energy and stamina

Maintain healthy skin, hair, and nails

Heighten mood and mental thinking

Ease menopause and premenstrual symptoms

Kill cancer cells in tissue culture without harming normal cells


3.Fresh or Frozen Fruit: Fruit provides fiber and antioxidants that can be helpful with decreasing constipation and inflammation in the body.There is a big link between inflammation and heart disease. The antioxidant and anti-inflammatory effects of fruit may be of tremendous benefit in reducing inflammation and heart disease.1 Fruit adds great flavor too!

4.Xylitol: Xylitol is a natural sweetener that tastes like sugar but has approximately 30% less calories. It occurs naturally in berries, fruit, vegetables, and birch. Xylitol dissolves quickly, mixes easily, and is heat stable, meaning you can use it in baking.Xylitol is considered a safe sweetener. It is slowly absorbed and metabolized, resulting in few insulin changes and therefore acceptable for a person with diabetes; however, it can cause diarrhea if more than 50 g (∼3 tablespoons) are taken at a time—because of this, use less, and gradually increase. The 1 tablespoon used in these shake recipes should not cause a problem.2, 3, 5, 6, 7

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Benefits of Xylitol 


Inhibits plaque and dental cavities

Retards demineralization of tooth enamel

Promotes remineralization of tooth enamel

Reduces infections in the mouth

Relieves dry mouth


5.Stevia: Stevia is a natural sweet herb from South America. It is estimated to be 150 to 400 times sweeter than sugar, so a little goes a long way. It has virtually no calories; therefore, people with diabetes can use it. Stevia can be found as a white powder or a liquid concentrate at most health food stores.The most important thing to remember is not to use too much because it can result in excessive sweetness and an aftertaste. Stevia is delicious in almost any recipe using fruit or dairy products but is hard to substitute for baking because it lacks sugar’s abilities to add texture, enhance the browning process, and feed the fermentation of yeast.

6.Whey Protein: Whey is a normal byproduct of cheese making: It is the liquid left when the solids in milk come together and are pressed into solid form. Whey protein is free of fat and lactose (milk sugar) and therefore can be used in people with lactose intolerance. It is also relatively low in potassium, phosphorus, and sodium.8, 9

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Benefits of Whey Protein 


Boosts the immune system

Helps bone strength

Helps heal wounds

Builds muscle

Improves overall wellness


7.L-Glutamine Powder: Glutamine is the most abundant non-essential amino acid in the body. It is found in large quantities in skeletal muscle and blood.During times of extreme need, as with intense exercise, illness, and surgery, more glutamine is required than the body can make. It is during these times that it may be necessary to supplement because the body cannot make enough to meet demands. Many whey protein powders contain added glutamine; therefore, try to choose them.2, 3

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Benefits of Glutamine 


Stimulates muscle protein synthesis and repair

Helps the immune system

Is a fuel (food) for the cells of the gut lining


8.Spices and Flavoring Extracts: Spices add flavor and many have antioxidant, anti-inflammatory, and anti-nausea properties (e.g., ginger). Cinnamon has even been shown to help regulate blood glucose.3 You can experiment with other spices such as nutmeg and cloves. Flavoring extracts such vanilla also add “spice.” Just let your taste and imagination be your guide. Have some fun!Next is the basic High-Octane Power Shake Recipe. Different fruits, such as pineapple, apple, blueberry, raspberry, strawberry, blackberry, and cherry (please get an okay from your dietitian), spices, flavoring extracts, and sweeteners can be substituted depending on your desire.10, 11

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High-Octane Power Shake Recipe 


½ cup fresh or frozen fruit (pineapple, apple, berries; remember to check with your dietitian)

½ cup plain whole yogurt (or plain nonfat yogurt if lower calories are needed)

1 scoop unflavored whey protein (∼20 g), preferably with added glutamine powder

1 tablespoon organic, unrefined, cold-pressed flaxseed oil

1 tablespoon xylitol (1/8 teaspoon stevia if lower calories are needed)

Spices and/or vanilla extract: suggest 1/4 teaspoon ground spice or 1 teaspoon grated fresh spice and/or ½ teaspoon vanilla extract; experiment. The berry fruits may need no added spices or extracts

4 to 5 ice cubes

In a blender, add each ingredient. Blend for approximately 1 to 2 minutes or until well blended. Makes about 12 ounces. Remember to measure the liquid and take your phosphate binder!

Each shake made with whole yogurt and xylitol averaged about 370 calories, 19 g protein, 175 g phosphorus, 375 g potassium, and 3 g dietary fiber. If fat-free yogurt and stevia are substituted for the whole-fat yogurt and xylitol sweetener, the calorie content is reduced to 295; the other nutrients remain approximately the same.

The main difference in the shakes would be in the potassium content of the different fruits. They range from a low of 335 g of potassium for the blueberries to a high of 430 g of potassium for the strawberries. Again, check with your dietitian if these fruits are allowed for you.

Although the potassium and phosphorus content may seem high, they are comparable to commercial protein/calorie formulas available on the market. Again, remember to count the liquid and take your phosphate binder. Enjoy!

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References 

  1. Nadeau DA. Seminar “Vibrant Colors, Vibrant Health.”. Washington DC: National Kidney Foundation; 2005;Spring Clinical Meeting
  2. Firshein R. The Nutraceutica Revolution. New York, NY: Penguin Putnam Inc; 1998;
  3. Balch PA, Balch JF. Prescription for Nutritional Healing. Third Edition. Avery, New York: NY; 2000;
  4. Trenev N. Probiotics: Nature’s Internal Healers. Avery, New York: NY; 1998;
  5. Bralley JA, Lord RS. In: Laboratory Evaluations in Molecular Medicine: Nutrients, Toxicants, and Cell Regulators. Norcross, GA: The Institute for Advances in Molecular Medicine; 2005;p. 131–171
  6. Fischer WL. How to Fight Cancer and Win. Baltimore, MD: Agora Health Books; 2000;
  7. Joiner-Bey H. The Healing Power of Flax. Topanga, CA: Freedom Press; 2004;
  8. Dean W, Shao Y, South J. Vitamin Research Products. Carson City: NV; 2005;
  9. Wikipedia: The Free Encyclopedia: Xylitol. Available at: http://en.wikipedia.org/wiki/Xylitol. Accessed January 30, 2007.
  10. Shabert J, Ehrlich N. The Ultimate Nutrient Glutamine: The Essential, Nonessential Amino Acid. Garden City Park, NY: Avery; 1994;
  11. Scipione A. In: “Glutamine,” Life Extension. 2006;p. 87–90January

PII: S1051-2276(06)00299-8

doi:10.1053/j.jrn.2006.12.011

Refers to erratum:

Journal of Renal Nutrition
Volume 17, Issue 2 , Pages 157-159, March 2007