Inside Pediatrics Spring 2023

“When the kidneys aren’t working very well, the children are in a situation where they have to dramatically restrict their sodium intake, their potassium intake, their phosphorous intake and frequently have to restrict how much water they take in per day in order to maintain their health,” said Feig, the director of the Division of Pediatric Nephrology at Children’s and the University of Alabama at Birmingham (UAB).

The restrictions can make it difficult for a child to get enough calories and nutrients, and it leaves them with few options that taste good. But effectively managing their diet is vital; the margin for error is slim.

“Too much water or sodium can result in extremely high blood pressure, and poor control of calcium and phosphorous metabolism can irreversibly damage their bones and predispose them to early, severe cardiovascular disease,” Feig said. “Consequently, it’s critically important to get this under control.” For the patient and their family, the transition to the proper diet is tough, but the Food is Medicine program exists to help with that process. Nutritionists and renal dietitians teach the families about choosing the right foods and how they can cook them. Then they help them put together a shopping list. “It’s trying to help families learn to use unfamiliar ingredients that are safe for their children, trying to make meals that are on the diet and agree with the palates of young children,” Feig said.

But the diet can be very expensive. Leaders didn’t expect that when they started the program, but they’re addressing it by providing biweekly care packages filled with shopping list ingredients to families who qualify based on income and expenses.

To help cover these expenses, program leaders worked with the Children’s of Alabama Foundation to develop an annual culinary event featuring celebrity chefs from around the Southeast. The event raises money for the program, and several of the chefs have also volunteered some of their staff to help teach cooking classes with the dialysis unit. Both opportunities have been on hold since the pandemic began, but Feig hopes they will soon be possible again.

The Food is Medicine program has led to improvements for patients in both bone health and control of serum potassium. Feig says their quarterly quality-of-life scores also have increased.

“The importance of a holistic approach to the management of disease that includes diet, quality of life, as well as their medications and their high-tech procedures is really what is allowing us to be particularly successful in the management of these patients and helping them grow up to be healthy, active citizens, who can then go to college, go into the workforce and really be happy adults,” he said.

Daniel Feig, M.D., Ph.D., helped develop the Food is Medicine Program.

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