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DietforPatientswithHypokalemicPeriodicParalysis

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DietforPatientswithHypokalemicPeriodicParalysis
LastupdatedSunday,July17th,2011
DesignedbytheNationalInstitutesofHealth
ThisinformationisbasedonadietdesignedattheNationalInstitutesofHealthinthe1960sforayoungman
withHypokalemicPeriodicParalysis(HypoKPP).AccordingtotheNIHphysiciansanddieticianMaryR.
Emerson,plusmanyothermedicalauthorities,thosewithHypoKPPshouldfollowadietwhichishighin
protein,lowincarbohydrate,andlowinsodium.
DrawingonmytrainingasanutritioninstructorIhaveadaptedthedietMs.Emersonplannedtobettermeet
today'spatient,takingintoaccountcurrentknowledgeofbothHypoKPPandnutrition,andthechangesinfood
cultureovertheyears.Inadditionthisarticlebeginswithinformationwhichexplainstherationalebehindthe
diettothosewhomaybelearninghowtomanageHypoKPP.
WhatisBloodSugarandWhereDoesItComeFrom?
Bloodsugar,alsoknownasbloodglucose,
isthebodysfuel.Itfeedsthebrain,nervous
system,musclesandothertissues.The
bodymakesglucosefromthecarbohydrates
weeat,butalsofromproteinsandfats.We
wouldnotbeabletofunctionwithout
glucose.
Asfoodisdigesteditisconvertedto
glucosewhichisreleasedintotheblood.
Someglucoseisstoredintheliver,as
insuranceagainstlowbloodsugar.
Maintainingastablebloodglucoselevelis
importanttoeveryone'shealthand
performance,butitisabsolutelyessentialtothosewithHypokalemicPeriodicParalysis.
TheGoaloftheHypoKPPDietIstoKeepYourBloodSugarStable
HowBloodSugarLevelAffectsMuscleStrength
Aftereating,bloodsugarrises.Thepancreasproducesahormonecalledinsulinwhichallowsglucosetomove
intothetissues,includingthemuscles.Thehigherthebloodsugarrisesthemoreinsulinisproduced,themore
glucosemovesintothemuscles,andthefasteritmoves.Aseachmoleculeofglucoseentersthemuscleit
takesanionofpotassium(K+)withit,loweringtheamountofpotassiuminthebloodserum.Asserum
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potassiumdropsthemusclesbecomeweak.
Sodium(Na+)intensifiesthiseffectby
speedingupthemovementofglucoseand
K+intomuscleviatheNa+K+pump.It
takesanionofNa+tomoveamoleculeof
glucoseintothecell.Whenamoleculeof
glucoseandanionofNa+attachtothe
bindingsitesoftheNa+K+pumptheyare
immediatelytransportedintothecell.
Lowbloodsugarisalsocommon
triggerforepisodes.
Whenyougofortoolongwithouteating
bloodsugardrops.Ifitdropstoolowthe
liverreleasesstoredglucoseintotheblood,
aneffectwhichcouldbecomparedto
drinkingsyrup.
Thisreleaseofglucosespursareleaseof
insulin,andthemovementofthestored
glucoseandpotassiumintothemusclecan
beenoughtocauseweaknessinmany
patients.Forthisreasonit'sbesttosnack
betweenmealsandkeepyourbloodsugar
fromdropping.
Onthiswebpageyouwillfind:
Foodstoomitfromthedietfoodshighin
carbohydrateandsalt.
Foodstobeusedinlimitedamountshigher
incarbohydrate,butnecessarytoa
balanceddiet.
Foodsthatmaybeusedasdesired.Thesearehighinprotein
Vegetableswhichcontaincarbohydrate,insmallamounts.Thesevegetablesarenecessaryinthedietto
furnishminerals,vitamins,andfiber.
Whatdoes"Carbohydrate"Mean?
Carbohydratesareorganiccompoundsfoundinlivingtissues.Theycontainhydrogenandoxygen,plusstarch,
sugarsandcellulose(fiber).TherearethreesimplecarbohydratesGlucoseFructoseandLactose.Glucose
istheonlyformthebrainandmusclecanuseasfuel.FructoseandLactosemustbedigestedandbroken
downintoglucosebeforetheycanbeused,sotheyraisebloodsugarmoreslowlythanglucose.
WhatFoodsHaveCarbohydratesinThem?
Glucoseisfoundingrainsandvegetables.Fructoseisfoundinfruit.Lactoseisfoundinmilkandmilk
products.
OnfoodlabelscarbohydratesaretheingredientsendinginthelettersOSE,includingbutnotlimitedto:
Glucose,sucrose,fructose,dextroseandmaltose.
HypoKPPDietPrinciples
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AllpatientswithHypoKPPshoulddrinkanadequateamountoffluideveryday,toavoidkidneystones.Water
istheverybestdrink,withgreenteaaclosesecond.Coffeeseemstoprovokesymptomsinsomepatients,
andeasetheminothers.Buttwocupsofcoffeeadayisthehealthylimitforanyone.
Unsaltedbutterandunsaturatedsaladoilsmaybeusedifneededforcalories.Mostpeopleneedtoavoid
extracalories,socautionisadvisedwiththeuseoffats.
Thefreeuseofsugaristobeavoided.SugarsubstitutesEqual,SplendaandSteviamaybeusedasdesired,
thoughsomepatientsreportthatthesestillprovokesomeglucoselikeeffects.
Thedietshouldbelowinsodium,nomorethanthreefourthsofatsptotaldaily.Lookforthesodiumcontenton
labels.Foodsthathavelessthan140mgor5%oftheDailyValue[DV]ofsodiumarelowinsalt.
Freshorplainfrozenvegetables(thosefrozenwithoutaddedsauces)andlimitedamountsofwholegrainsmay
beused.
CannedvegetablesarealmostalwaystoohighinsodiumforregularinclusionintheHypoKPPdiet.Foods
whichareonthe"Listtoomit"(below)becauseofhighsodiumcontentshouldnotbeused.
Thedietshouldalsobehighinpotassium.Bananas,orangejuice,milk,andpotatoesareallhighinpotassium.
However,thesefoodsmustbeeatenonlyinlimitedamountsbecauseoftheirhighercarbohydratecontent.
GetYourProtein!
Proteinisyourfriend,eatplentyeveryday!Eachmealandsnackshouldincludeapalmsizedportionof
proteinwhichisasthickasadeckofcards.
Thebestproteinsourcesare:leanmeats,fish,poultrywithouttheskin,eggs,lowsaltcheeseandcottage
cheese,tofu&awidevarietyofbeans.Musclemeatisalsohighinpotassiumwhichhelpsmeettheneedfor
potassium.
Forhealthreasons,chooselowfatcookingoptions,i.e.broil,grillorpoachratherthanfrying.Proteinfoods
makegoodsnackswhenyouarehungry.
Proteinswhichcanbeeatenfreely
Leanbeef,Bison,Chicken,Turkey,Duck,Lamb,Veal,Pork(leancuts),Freshfish,Eggs,Unsaltedcottage
cheese,lowsaltcheese.Soybeansastofu,temphorboiledgreen(edamame),roastedunsaltedpeanuts,
"Natural"styleunsalted,nosugaraddedpeanutbutter,unsaltednuts.
OtherUnlimitedFoods
FreshcoconutAvocadoLemonandlimejuiceVegetablesfromthe"A"list(foundbelow)Dietgelatin
VinegarTeaSpices,butnotpackagedsauceswhicharehighinsodium.
FruitExchangeList
Eatthreeitemsdailyfromthislistthecarbcontentofeachitembelowisabout10grams.
1smallappleorcunsweetenedapplesauce2freshapricotsbanana1cstrawberries,blackberries,or
raspberries2/3cupblueberriescantaloupe10largefreshcherriesgrapefruitorcgrapefruitjuice12
grapescgrapejuice2kiwi1nectarine1smallorangecorangejuice1medpeach1smallpearc
freshorunsweetenedcannedpineappleor1/3cpineapplejuice2mediumplums2driedprunes1large
tangerine1cupwatermelon.
AListVegetables
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Eatgenerousportionsof:
AsparagusBeansproutsBroccoliBrusselssproutsCabbageBokChoiCauliflowerCeleryCollards
CucumberEggplantGreenbeansGreenonionsNewredpotatoesKaleLeeksMushroomsOkraOnion
DaikonradishPeapodsPeppers(allvarieties)RadishesRutabagaSoybeansSpinachSummersquash
SwisschardTomatoVegetablejuicecocktailZucchini.
BListVegetables
Eatonlysmall(c.)portions:
BakingpotatoesCarrotsPeasPumpkinBeetsTurnipsSweetpotatoWintersquashParsnip.
BreadExchangeList
Eatthreeitemsdailyfromthislistinonlytheamountspecified.Eachitemlistedhasabout15gramsofcarbs.
1sliceofwholegrainbread1smallwholegrainhamburgerbun1biscuitor1roll1smallpieceofcornbread
2grahamcrackers1smallbrownpotatocupcookedbrownriceorwholegrainpasta(noodles,spaghetti,
macaroni)cupmashedpotatoescupcornorlimabeanscupcookeddriedpeas(split,crowder,
blackeye,etc.)cupparsnipscupsweetpotatoes.
GrainsofWisdom
Choosewholegrains,refininggrainremovesvitamins,
mineralsandothernutrientsincluding78%ofitsfiber.
Whitebreadcontainsahighlevelofglucosewhich
raisesbloodsugarquickly.Wholegrainbreadhasthe
sameamountofglucose,butthefibercontentslowsthe
riseofbreadsugar.Smallportionsofwholegrain
productsareOK,largeonesarenot.

HigherCarbohydrateFoodstoEatDaily
1qtofskimmilk(8oz.glass=12gramscarbsx4=48g
carbs)
3itemsdailyfromthebreadexchangelist.(about45g.carbstotal)
3itemsdailyfromfruitexchangelist.(about30g.carbs)
1servingfromlistof"B"vegetables(510g.carbs)

HotPotatoes
Weallcheatonourdietssometimes.Theimpactofhighcarbohydratefoodscanbeslowedbyaddingfat.Add
butter&sourcreamtobakedpotato.ChooseFrenchfriesratherthanboiledpotato.Choosefullfaticecream
ratherthansherbetoricemilk.Thincrustpizzaisbetterthanthickcrust.Putbutterormargarineonbread.
HowMuchPotassiumperDay?
3,5004,000mgdailyisrecommendedfornormalpeople.Thedietsofhuntergatherersincludeabout7,000
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8,000mgdaily,soincreasedintakeishealthy,butdiscussyourpotassiumintakewithyourdoctorifyouareon
aK+sparingdiuretic!
FindK+in:
DairyProducts:MilkYogurt
Fruit:ApricotsAvocadoCantaloupeNectarinesPrunesApplesGrapefruitOrangesPeaches
StrawberriesMelons
Vegetables:CarrotsCeleryBeetsDarkleafygreensBroccoliSpinachTomatoZucchini
Proteins:ChickenFreshfishTurkeyBeefLambFreshPorkNuts.
Foodstoavoidduetohighsodiumcontent
BaconHamPotatochipsPretzelsSausageSeasonedsaltFrankfurtersSoyasauceLunchmeats
SauerkrautCornedbeefSaltednutsPicklesOlivesFetacheeseRollmopsBouilloncubesSalted
CrackersSaltedpopcornPizzaFrenchonionsoupmixDelisaladsandsoupscannedvegetablesregular
cannedsoupspackagedfoodslikeHamburgerHelperandSidedishes.
Foodstoavoidduetohighcarbohydratecontent
SugarSyrupHoneyJamJellySweetrollsDoughnutsIcecream(excepttosubstitute)CandyJello
CookiesCreamofWheatRegularsoftdrinksPuddingsCakePastriesGritsMinuteRiceInstantoatmeal
SweetenedorsugarcoatedcerealsFrozenorcannedfruitwithsugaradded.
Occasionally,ifdesired,1doughnutOR1/2cupoficecreammaybesubstitutedfor1itemon"bread
exchangelist".
MenuPlanning
TheHypoKPPdietisaveryhealthyone.Lowinunhealthysaturatedfats,sodiumandjunkfoods,itishighin
fresh,healthfulfruits,vegetablesandproteinsources.Knowyourself.Youareuniqueandyourdietmustmeet
yourneeds,notaformula.Somepeoplerequiremoresodium,somerequiremorecalories.Individualsvaryin
theirtoleranceforcarbohydrates,butthegeneralruleisthatadietlowinsodiumandcarbsresultsinmore
strengthandfewerattacks.
MealPlanning
Menusareeasytoplan.Eachmealandsnackshouldcontainaservingofproteinequaltothesizeofyour
palmandasthickasadeckofcards.
Mealsshouldalsoinclude:
1ormoreAlistvegetables.
1Blistveggie,
Aservingofmilk.
Duringthedayyoualsoneed:
Threebreadexchanges
Threefruitexchanges.
Choosehealthforyourselfandyourwholefamilywithagooddiet!
Sothedailymenuisbuiltlikethis.
Breakfast:protein+fruitexchange+milk.
Midmorningsnack:protein+fruitexchange.
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Lunch:protein,13Alistveggies+1Blistveggie+milk+breadexchange.
Midafternoonsnack:protein+breadexchange.
Dinner:protein,13Alistveggies+1Blistveggie+milk+breadexchange.
Eveningsnack:protein+Alistveggie.
BreakfastIdeas
BreakfastOne
grapefruit(fruitexchange)
1servingbranbuds(breadexchange)
Scrambledegg(s)
8ozofmilk
Sweetener
BreakfastTwo
4ozorangejuice(fruitexchange)
Scrambledegg(s)withmushroomsandparsley
1slicewholewheattoastwithbutter
8ouncesofmilk
BreakfastThree
Poachedegg(s)
1slicewholewheattoastwithbutter
8ozofmilk
Morethancerealandeggs!
Youcaneatanythingforbreakfast.Lowsodiumcottagecheesewithfruitisanicechoiceinthesummer.A
minutesteakisgreatforbreakfast,withasmallservingofhashbrowns,andaservingofberriesand/oran"A"
Listveggie.Howaboutatunamelt,or"sloppyJoe"(seerecipebelow)onwholewheattoast?
ProteinSmoothie
ProteinSmoothiesareeasilymadeinyourownkitchen.Therearetwoversionstothisrecipe,thetofu/soyone
andthedairy/milkone.Chooseyourpreference.Themethodisthesame.
One375gram(12oz)boxof'silken'(Japanesestyle)tofu.Putitintheblenderwith4cupssoymilk.Soyis
greatforthisbecauseithasaverylowglycemicindex.(Alternatelyuse1cups2%cottagecheeseand4
cupsskimmilk.)
Blendtillsmooth.Addabanana&1cupunsweetenedberries(orafreshnectarineandpeachcutintopieces).
Add1tspvitaminCpowderortwocrushed1000mgvitaminCtablets.Addmilkasyoublend.Youmayalso
add2Tbs.saffloweroilforessentialomegafattyacids.
ofacupisaserving.Thismakesanexcellentbreakfastwithapieceoffruit.Acupservingcanalsobe
usedasamidmealandbedtimesnack.
Snackingisgood!
Midmorning,midafternoon&beforebed,asnackwillkeepbloodsugarstable.Typicalsnacksmightbe:
cupProteinshake,
23oz(50100g)unsaltednutsbanana,
CubesofSwisscheeseandanappleorpear,
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Boiledeggandcelery/carrotstickswithranchdressingdip,
Celerystickswithpeanutbutterorcreamcheesefilling,milk,
Cubedchicken,cherrytomatoes&ranchdip,
Tea,edamame(babysoybeans),
2grahamcrackers,banana,milk.
LunchSuggestions
Hamburgerpatty,smallwholewheatburgerbunwithmustardorcatsup,largeservinglettuceandtomato,onion
sliceavocadowithvinegarandoildressing,banana,8oz(240ml)ofmilk.
Saladofcoldturkeyorchickencarrots,cucumber,redkidneybeans,greenpepper,onlettuceormixed
greens,onionsandsaladdressing.
Fish,poultryorleanredmeat,Swisscheese,1slicewholewheatbread,acupofbroccoli,fruitexchange.
Ricewrapsfilledwithbeansprouts,chicken,cashews,gratedginger,sliveredvegetables,spicydipping
sauce.
Ringingthedinnerbell!
Trythesesuggestions:
Bakedchickenbreast,1/4cupherbedrice,peaswithbutter,coleslawdressing:1tspmayo,1tspvinegar&
tspSplenda,8ozmilk,strawberries.
Steak,smallbakedpotato&sourcream,carrots,celerystickswithcreamcheese,8ozofmilk.
Chili,madewithleanbeef,onions,tomatoes,&pintobeans,servedwithasaladandbreadexchange.
Gingerlimemarinatedchickenbreast,broiledorgrilled,cottagecheesestuffedtomatoes,steamedbroccoli,
1breadexchange
SloppyJoe
1lb(500g)extraleangroundbeef
1oniondiced
1/4cupketchup
1/2cupwater
2Tbsvinegar
2TbsSplenda
2tspmustard
2tspgarlicpowder
Browngroundbeefwithchoppedonionanddrain.
Addremainingingredients,stirandletsimmerfor1520min.
Serveonbunsorbread.
Lessonswe'velearned
Makedietarychangesoverweeks,ratherthandays.Changeonethingatatime,soyoucantrackwhatis
helpingandwhatmaynotberightforyou.Trynewfoods&recipes,andtrynottothinkofitasdenialeating.
Youcanstillhaveanythingyoulike,inadaptedquantities.Foodstoleratedbyothersmaybeatriggerforyou.
Usecommonsense.

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Tags:
Diet[1]

Section:
Doctor[2]
Patient[3]

Classification:
AndersenTawil[4]
Hypokalemic[5]
Thyrotoxic[6]

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[3]http://hkpp.org/taxonomy/term/9
[4]http://hkpp.org/taxonomy/term/17
[5]http://hkpp.org/taxonomy/term/14
[6]http://hkpp.org/taxonomy/term/13

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