Is Pineapple Good for Kidney Disease?

Is Pineapple Good for Kidney Disease?

It seems everyone is asking me, “Can I have pineapple with kidney disease?”. 

And for good reason! 

For one, pineapple is delicious! It’s been a favorite fruit of mine since I first discovered fresh pineapple in college. I ended up burning my tongue from the enzyme and acid content because I ate the entire pineapple in one sitting! Oops!

But you’re asking if it’s okay to eat pineapple when you have kidney disease because you know some food may not fit into your goal for better kidney health.

Although there are a few considerations when choosing the type and amount of pineapple to eat when you have kidney disease, I’m here to tell you that pineapple is full of beneficial nutrients that can fit into your kidney diet!

As a Registered Dietitian and renal nutrition expert, I’ll walk you through why you may benefit from adding pineapple to your kidney diet and how to figure out if pineapple is okay for you to eat with your kidney disease.

Nutritional Considerations for Kidney Disease:

Eating for kidney disease can be difficult at times because of the tough restrictions you have to follow in order to preserve your kidney health. Knowing what to look for and why can help you feel more at ease in making confident decisions for your health.

Some of the most important nutrients to consider in pineapple for kidney disease are:

  1. Sodium
  2. Potassium
  3. Protein & Potential Renal Acid Load
  4. Carbohydrate & Fiber
  5. Phosphorus

To simplify the topics below, we will first consider these nutrients in 1 cup of cubed fresh pineapple. We will then compare any differences in these nutrients depending on the preparation method for the pineapple.

The good news? Pineapple, in the right portion, is a winner for all of these considerations. Unless your doctor or dietitian has a specific concern about you eating pineapple, you should enjoy eating it!

Now I’ll get into the nitty gritty of kidney nutrition and how pineapple is a good fit. 

Sodium 

Goal: as low as possible.

When you have kidney disease, sodium is an important nutrient to consider because you can get more than the recommended amount very easily. Fortunately, pineapple has a very minimal amount of sodium (<2 milligrams) (1).

Pineapple: A win!

Potassium 

Goal: Varies (some people need to monitor).

Sometimes you have to monitor how much potassium comes from your food when you have kidney disease. 

Pineapple is considered a low-potassium food because it only has 180 milligrams (mg) of potassium in 1 cup of fresh pineapple (1). Some versions may have more potassium or added potassium. Continue reading for the nutrition breakdown of different types of pineapple.

Check with your renal dietitian or healthcare team to determine if this applies to you. If you don’t have a renal dietitian, you can work with me or find another renal dietitian to work with here.

Pineapple: another win!

Protein & Potential Renal Acid Load (PRAL)

Goal: negative value

You’ve probably been given the recommendation to follow a lower protein diet and for good reason. Eating less protein is the best way to protect your kidney health and improve overall health outcomes when you have kidney disease. Pineapple is naturally low in protein (<1 gram) so this makes it a kidney-friendly choice (1, 2).

In case you haven’t heard of PRAL yet, it’s the value given to food to say whether it produces more of an alkaline or acidic environment during metabolism. The goal with PRAL is to eat foods that provide a more alkaline environment. 

The more negative the PRAL value, the more alkaline the food is as it’s broken down (metabolized) in your body. The more positive the PRAL value, the more acidic the food is as it’s broken down in your body.

Pineapple also has a PRAL value of -2.3 so it will help you reach your goal of having a negative overall PRAL value in your daily intake of food (1, 3).

Pineapple: winning!

Carbohydrates & Fiber 

Goal: Varies (just count it!)

I usually recommend keeping your carbohydrate (carb) intake consistent throughout the day to keep your blood sugars more stable (even if you don’t have diabetes!). 

This means having about the same amount of carbs with each meal. The recommended amount of carbs per meal can vary from 30-90 grams. 

One cup of fresh pineapple provides around 22 grams of total carbohydrate so you would just include this as part of your meal or snack. Read more about nourished kidney snacks here!

Pineapple also provides 2 grams of fiber which contributes to your goal of 25-38 grams of fiber per day (1).

Pineapple: still winning!

Phosphorus

Goal: no added phosphates!

Phosphorus is another important nutrient to consider when you have kidney disease. Sometimes it is recommended to avoid natural phosphorus. Pineapple is naturally low in phosphorus so that’s a bonus! 

I always recommend avoiding added phosphorus (phosphates) when you have kidney disease, which can be found in anything packaged. This will ensure you protect your bones from becoming weak and your skin and heart from hardening. 

As a fresh fruit, pineapple doesn’t have any added phosphates to it. Double bonus!

Pineapple: home run win!

Put it all together: pineapple is a safe choice for people with kidney disease!

Even better, pineapple has some extra benefits that make it helpful to support your health, including your kidney health. Let’s explore those benefits now!

Beneficial Nutrients of Pineapple for Kidney Disease:

What’s the final verdict? Pineapple is a rock star as a functional food for kidney disease!

The top 3 nutrients it delivers are:

  • Vitamin C
  • Manganese
  • Bromelain 

Vitamin C (ascorbic acid)

Pineapple is an excellent source of vitamin C. One cup of cubed pineapple gives you 131% of your daily recommended amount (1)! 

Vitamin C is an essential nutrient and necessary when you have kidney disease! It’s not a nutrient that our bodies can make on their own. It has to come from the food we eat!

Low vitamin C levels are associated with kidney disease (4). This could be the result of increased oxidative stress that happens naturally with kidney disease. Vitamin C is an antioxidant that helps reduce oxidative stress in your body. 

Acting as an antioxidant is the biggest role vitamin C plays in kidney disease. 

Kidney disease increases your risk for cardiovascular disease (5) and vitamin C has been shown to decrease the risk of cardiovascular disease and incidence of stroke, along with reducing blood pressure (6).

Kidney disease also increases your risk for anemia (7). Vitamin C helps your body to absorb iron from your food, which means you’re less likely to develop anemia (8).

In kidney disease, it’s generally recommended to avoid vitamin C in supplements. Why? because too much vitamin C in your body at one time will turn into oxalates that can cause damage to your kidneys. 

Having said that, everyone is different. There are a few exceptions when it may be appropriate to have vitamin C in your supplement. Vitamin C can help increase the absorption of iron in your gut. So if you are iron deficient, your healthcare provider may recommend an iron supplement with vitamin C. 

Please consult with your health care provider/renal dietitian before you start taking any supplements with vitamin C.

I almost always recommend eating foods rich in vitamin C for protecting your kidney health.  Pineapple definitely fits the bill for this recommendation!

Manganese

Pineapple is also an excellent source of manganese, providing 85% of your daily needs in just 1 cup (1)!

Manganese also functions as an antioxidant, reducing oxidative stress associated with kidney disease. In addition, it plays an important role in regulating blood sugars and cholesterol.

The research surrounding manganese is in its teenage years. I.e., it’s all over the place. 

One research study shows lower manganese levels in people with diabetes and kidney disease (9). While another shows increased levels of manganese in people with kidney disease (10). And then another one shows higher manganese levels are associated with decreased rates of anemia in kidney disease (11). 

Manganese toxicity from food is unlikely, even with kidney disease, unless you also have liver disease or problems with bile excretion (12).

The takeaway here is that manganese definitely has a role in protecting your health from kidney disease and eating pineapple is a great way to get the recommended amount in your diet.

Bromelain 

Pineapple contains an enzyme called bromelain that helps your body to digest your food better  (13).  

Bromelain protects the balance of your gut flora, too! Since chronic kidney disease can alter your gut flora, eating pineapple can help you restore a better balance and then better gut health improves your health outcomes with kidney disease. (14)

Bromelain also has anticoagulant properties meaning it can prevent clot formation (13). You may want to discuss this property with your healthcare provider if you take anticoagulants and are consuming large amounts of pineapple or using a supplement containing bromelain. 

Lastly, kidney disease is associated with chronic inflammation and bromelain has been shown to decrease inflammation (13).

Copper

Pineapple is also a significant source of copper. One serving contains 20% of your daily recommended amount (1). 

Eating adequate amounts of copper is needed for red blood cell production and preventing anemia. Copper also functions as an antioxidant and is needed for energy production. (15)

When you have kidney disease you are at increased risk for anemia so eating pineapple can be one way to increase your daily intake of copper (7). 

B Vitamins

Pineapple is a great source of several B vitamins, including thiamine (B1), folate (B9), and pyridoxine (B6) (1). These B vitamins play a crucial role in energy metabolism. They help to release the energy from the food you eat so that your body can use it. Folate and pyridoxine also help prevent anemia (16).

Now that you know pineapple is good for kidney disease, let’s compare the different ways pineapple can be prepared and purchased!

Types of pineapple:

You can enjoy fresh, frozen, canned, and even dried pineapple. Which is best?

Fresh

You can buy fresh pineapple in the produce section of the grocery store. Nothing compares to fresh pineapple, in my opinion. It has the strongest and sweetest flavor. It also seems to be the most thirst-quenching. Please buy fresh pineapple!

Frozen

You can also buy frozen pineapple chunks in the, you guessed it, frozen section of the grocery store. It’s minimally processed so you most likely won’t have to worry about preservatives like sugar, salt, phosphates, or potassium additives. Always check the label though!

Canned

I grew up on canned pineapple and I think this is why I never liked pineapple. Yuck! (Sorry Mom!) It comes in a variety of preparations. You can get crushed, cubed, tidbits, or sliced pineapple. I find it a little more sour than fresh and frozen pineapple. 

Canned pineapple is preserved in juice or syrup so you’ll get higher amounts of carbohydrate, sugar, and added sugar when comparing the same volume (serving size) to fresh or frozen pineapple. 

It is also higher in oxalates, which you may need to consider if you have kidney stones.

Juice

Pineapple can be juiced just like oranges and apples. Pineapple juice is delicious but, again, it will be higher in carb and sugar content. It will also have less fiber so it will raise blood sugars faster than the whole fruit. 

Dried 

You can buy dehydrated pineapple chunks, slices, or tidbits. Dehydrating fruit shrinks and concentrates the nutrients in it so you have to be careful with portions when munching on all dried fruits. Volume for volume, dried pineapple will be higher in carbs, sugar, potassium, oxalates, and fiber. 

You’re more likely to run into preservatives when you buy dried pineapple, too. Sugar may have also been added to it in the preservation. Potassium additives are also commonly found in dried fruits so be sure to check the label of the brand you choose to make sure it doesn’t have potassium added to it. 

One cup nutrient comparisons of 1 cup of pineapple relevant to kidney disease. It compares fresh, frozen, canned (in juice), and dried types of pineapple. It shows potassium, carbohydrate, total sugar, fiber, vitamin C, manganese, copper, and oxalate content in each type, ultimately showing fresh or frozen pineapple is the best choice when considering kidney disease.

How to enjoy pineapple with kidney disease:

As you’ve already found out, I’m a super fan of fresh pineapple! Pineapple can be a little tricky to cut so I’ve included this video tutorial for how to tell when it’s ripe and how to cut it!


Pineapple Video by Candace Mooney

You can eat pineapple by itself as a snack, sprinkle coconut shavings on top with some coconut yogurt, or layer with other ingredients in a parfait.

You can grill pineapple chunks with bell peppers and onions on kebabs. You can also grill pineapple slices to caramelize them for a sweet treat. 

You can pair it with rice in a stir fry or make some sticky rice with pineapple for dessert. 

You can make a sweet vinaigrette salad dressing with the juice or top a quinoa bowl with pineapple chunks. 

You can also use frozen pineapple in smoothies to make them more of a frozen treat! You may also want to add some dried tidbits to your trail mix. The options are endless with pineapple! 

Special Considerations:

Diabetes 

When you have diabetes with kidney disease, it’s important to consider how much carbohydrate your meals contain. You’ll need to count how many carbs are in your pineapple towards your end goal for that specific meal. 

Review the table above with the nutrition comparisons of the different types of pineapple. The more fiber and less sugar in the source, the slower your blood sugar will rise and fall. This will help you reach your goal of well-controlled blood sugars to protect your kidney health.

Kidney Stones 

A plus side to pineapple for people with a history of kidney stones is that it contains citrate. Citrate can bind urinary calcium and calcium oxalate to reduce the formation of kidney stones. (17)

As mentioned above, canned pineapple and dried pineapple contain more oxalates than fresh or frozen pineapple. You may need to consider oxalate content if you have a history of kidney stones. 

But you may not need to decrease oxalate content. Instead, pair high oxalate foods with food that is higher in calcium. This will help bind the oxalate so it’s not absorbed in your gut but rather excreted in your stool. (18)

The best way to know how to eat to protect yourself from developing kidney stones is to get a 24-hour urine test ordered by your doctor and review it with a qualified dietitian.

Summary:

Pineapple is good for kidney disease!

It is naturally low in sodium, potassium, protein and PRAL, and phosphorus making it a great choice for kidney disease.

It does have carbohydrates and sugar that you need to consider when making a balanced meal.

Pineapple supports your health with kidney disease by being an excellent source of vitamin C, manganese, and bromelain. It also provides a notable amount of copper, thiamine, pyridoxine, and folate.

The way it is prepared makes a difference in its nutrition profile. Fresh pineapple would be the best choice, followed by frozen, and then tied in last would be canned and dried. 

Now go out there and enjoy your pineapple! 

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