Chef Brings Fun & Flavor to Kitchens of Dialysis Patients

Celebrity chef Aaron McCargo, Jr. has spent much of the past two years working with Fresenius Medical Care North America (FMCNA) dietitians to develop healthy, flavorful recipes for people on dialysis. Cooking can be challenging for dialysis patients, who have to strictly limit their intake of fluids, as well as many popular foods that are high in potassium, phosphorus and sodium. But Chef McCargo - known for his "Big Daddy's House" cooking show on the Food Network—is eager to share the message that "even if you are on dialysis, food doesn't have to be boring."

How do you come up with dialysis-friendly recipes, and how much of a role do Fresenius Medical Care's dietitians play?

I try to talk with patients when I visit dialysis clinics and listen to their requests. Like when we were in New Orleans and I got an education on shrimp and how cheap they are in the Gulf. Or another time during a cooking demo when one guy said, "You know what? I haven't had a Buffalo wing in forever. I really want a Buffalo wing." This is how I build my suggestion box.

When I'm working on a new recipe idea I really count on Robin Russell, an FMCNA renal dietitian who is my main contact. She works with a team of dietitians to analyze the nutrition data and makes sure it really works for the patients. They're the professionals, and I rely on them. I never want anyone to mistake me for a dietitian, because that's not my forte. I am a chef. I am a creator— that's what I know how to do.

Many common foods— including tomatoes, cheese, milk, bread, nuts, beans and oranges— can be harmful to dialysis patients. Has it been hard to learn to cook without them?

It was tough in the beginning. I started out thinking that I would just use a lot of vegetables, cut out the saturated fat and the salt and add a lot of flavoring. But I quickly realized I had a lot to learn, and that there was a lot more that the dietitians, and the patients, could help me with. Since then, it feels like I've had a crash course on dialysis and the renal diet.

The biggest challenge turned out to be using less liquid. That was a shell-shocker. It took away my ability to create nice brothy soups and liquidy sauces to coat the pot the way I'd like to. Cooking without salt was probably a close runner-up. I've learned, though, that you can still have great food without all of the salt and without using so much liquid.

So how do you avoid salt, and all those other restricted foods while still preparing dishes that are flavorful and exciting?

Instead of salt, I tell folks to add flavor by using fresh herbs, dry spices and, in limited quantities, lemon and lime juices. They taste great and have a lot less sodium than many store-bought seasonings. The zests (made by scraping off the colorful, outer skin of citrus fruits) are another nice way to enhance the essence of the lemon or lime. I also try to use different oils and vinegars such as rice wine, balsamic vinegar, cider, and sherry, and low-sodium cheese and foods that are high in protein and low in saturated fat, such as lean meats, poultry and fish.

What do you say to people who don't believe dialysis-friendly dishes can really taste good?

I just ask them to "let me make you a believer." My crunchy lemon herbed chicken recipe, for example, doesn't have salt and doesn't have a lot of fat, but it's delicious. Then there's the chicken tacos, the spicy lime turkey burgers, the jumbo shrimp scampi and the pasta asparagus carbonara— these are some of my favorite recipes that I've developed with FMCNA. Once people taste those, they realize, "Wow, these recipes really taste good."

What kitchen tools do you recommend?

Keep it simple! Stop buying all the fancy gadgets. The recipes I create just call for these same basic utensils:

a zester

a whisk

a pair of tongs

a spatula and spoon of some sort

a cutting board and a knife

some bowls

frying pan and some pots

In March, during National Kidney Month, you visited several cities to promote your newest batch of dialysis-friendly recipes. Can you share a few highlights from that trip?

National Kidney Month was the perfect time to spread awareness about getting tested for chronic kidney disease (CKD) and about how to eat healthily for those people receiving dialysis. I had a great time visiting Knoxville, Cleveland, San Antonio and Austin— all cities where there is a high incidence of CKD. I had the opportunity to demo some of my favorite recipes, such as Sauce-less BBQ Baby Back Ribs and Berry and Peach Parfait.

You were recently tested for chronic kidney disease (CKD). Why?

I didn't have a lot of personal experience with kidney disease and dialysis before FMCNA partnered with me to create fun and flavorful recipes for dialysis patients. I do have friends who are on dialysis, but I never really got into the details beyond hearing them say they can't eat this and can't eat that. And then my eyes were really just opened wide once I started dealing with it firsthand, talking with the dietitians and the patients, learning what the dietary restrictions are.

I learned that as an African American, my risk of developing chronic kidney disease is higher than average. So earlier this year, I asked my doctor for a CKD test as part of my regular checkup. It only took a couple of minutes to draw a little bit of blood, and the next day I found out my kidneys are in good shape. That took a lot of stress away, and I would encourage others to get tested as well.

Have you changed your own diet and lifestyle since partnering with FMCNA?

I'm a lot more conscious about what I eat, and I'm trying to cut back on salt. But that isn't something that you change overnight. I still like to go out for a cheese steak with extra cheese, extra hot peppers and onions. But as with anything, I try to do it in moderation.

Does it concern you that African Americans are at higher risk for diabetes and kidney disease?

It does concern me. But I also look at the history of our diet and the type of foods we may have been raised on. Some of us have gotten used to starting our days with home fries, bacon, eggs with tons of cheese, cheesy grits, sausage gravy and biscuits— and that's just the breakfast menu! Then we get to lunch and, if you are in the South, it's a basket of fried chicken, cornbread and some ribs. For others, it's just too easy to grab some takeout food as a quick fix for the munchies. Not all African Americans dine this way, but for those who do, it's dangerous, and it's hard to kick the habit.

Some of us are becoming more moderate, more conscious of what we're eating. But we're still sometimes oblivious to how to change. I feel proud and blessed to be an advocate and to be able to share the little bit of knowledge that I have. I try to tell people, "Hey, if you're not on dialysis yet, this is the deal, this is the down low and this what can help you. Eat better now, and practice a regular workout routine. This can prevent you from being in that situation."

What message would you like to get out there about kidney disease and dialysis?

There needs to be more awareness about kidney disease, and we also need to raise awareness about the importance of diet. Too often we go straight to talking about diabetes and high blood pressure and we stop. We don't always tell people that if we don't prevent diabetes, here's where you may wind up. You may someday need a new kidney and need to go on dialysis. We need to open up people's eyes to CKD just like we've done with breast cancer, heart disease or AIDs. I mean, we're talking about 26 million Americans with CKD, and more at risk.

Chef McCargo's Tips for Changing Food from Bland to Bold: Five Spices to Use Instead of Salt

Chili powder* — tastes great in chili or taco meat flavoring. Also try adding it to rubs.

Smoked paprika — adds a deep brown color to breadcrumb casserole toppings, barbecue rubs or to seasoning blends for sautéing or searing proteins. Also adds a great smoky flavor to marinades.

Lemon zest — adds a lively taste to breadcrumbs, breaded chicken tenders and fish sticks or to renal-friendly vegetables like eggplant or string beans. Also great in dressings and marinades, or mixed with dry spices and used as a rub for broiled or baked seafood.

Dried oregano — enhances the flavor of scampi sauces and combines well with lemon zest. Gives steamed vegetables or tossed salads a fresh, earthy taste and aroma. Or add it to fajita seasonings, along with chili powder, cumin, cayenne and lemon zest.

Italian seasoning* — a blend of thyme, oregano and basil is great for finishing off sauces such as stroganoff or gravies. Works well on baked, grilled or sautéed proteins with lemon zest and little oil. Or add it to lemon zest, juice and olive oil to make dressings or marinade.

*Check to be sure you are using a salt-free product.