Low-bacteria diet - this is how it works!

The transplant has been completed and many dietary restrictions have finally been lifted. As a rule, you no longer have to eat a diet low in phosphates and potassium, and the restrictions on the amount you drink are a thing of the past. At some point, a feeling of normality sets in for many people. To make sure your new kidney lasts as long as possible, we still want to give you a few tips and tricks to help you.

Low-bacteria diet - what is it?

Your body is exposed to many germs and pathogens on a daily basis, and yet you don't get sick every day. To ensure this, your defense system (=immune system) performs great work every day. However, there is also a risk that your new kidney will be exposed as a foreign body by your immune system, attacked and rejected. To prevent this from happening, immunosuppressants come into play after a transplant. These are drugs that partially suppress your immune system and thus ensure that your kidney disappears from its radar.

This, of course, is vital for the survival of your new kidney. At the same time, your immune system is now not as sensitive to germs or pathogens that enter your body. This tends to make you more susceptible to infections. In order to relieve your body, it makes sense in principle to keep the intake of germs through food under control as much as possible. This principle is also known as a low-bacteria diet. Low-bacteria diet refers to both the selection and the preparation of food.

Which foods are suitable for me?

Let's go through what to look for in various foods, meal by meal. Let's start with breakfast. Do you like to eat cereal with fruit and yogurt or milk in the morning? Then you can continue to do that, of course. Just make sure that you wash your fruit thoroughly or even better - peel it. With dairy products you should make sure that they are not raw milk products. You can easily check by looking for the words "made from raw milk" on the packaging. If it doesn't say anything, it's typically not raw milk. You can make a super granola out of oatmeal and puffed quinoa. You should be a bit more careful with nuts and dried fruits in your muesli. If they've been shelled and packaged for any length of time, they may contain mold spores.

On to lunch! Maybe you have a nice beef steak or fried tofu with potatoes and vegetables every now and then. This is also no problem with your new kidney. All raw products such as meat, fish, tofu and eggs should be cooked thoroughly. Nothing stands in the way of well-done salmon and beef steak. On the other hand, you should keep your hands off sushi, tartar or rare steak. You should also not consume raw eggs in large quantities. They are hidden in dishes such as chocolate mousse, sabayon, soft ice cream and mayonnaise. Mayonnaise, by the way, is also available as a vegan version - and therefore also without eggs. If you didn't know, you wouldn't even taste the difference.

And now for dinner. Perhaps a good snack with sausage and cheese and a fresh salad is often on the menu. Nothing stands in the way of that either. Just make sure that you buy your bread fresh from the bakery and avoid bread with nuts. Pre-sliced and packaged bread tends to be more susceptible to mold, so use caution here. With sausage, it's important that you buy it fresh - preferably packaged in an airtight container, and pay attention to the expiration date. With cheese, it's only relevant that it's not raw milk products, such as Brie or Camembert. Now for the salad. You should avoid salad from the fresh produce counter - because who knows how long it's been lying around there and how many fingers have been on it. But homemade usually tastes best anyway. With washed peppers, tomatoes and cucumbers, the salad can be spiced up wonderfully. And if you're in the mood for a sweet note, you can also add an apple.

Overall, you can see that you have significantly fewer dietary restrictions after transplant compared to a time on dialysis. There are a few things to keep in mind, but you won't starve. Quite the opposite - especially compared to the menu during your time on dialysis, you now have a much greater choice.

For a better overview, here is a summary of the most important information in the following table:

Which preparation methods are suitable for me?

While reading this text, you have probably already noticed that the type of preparation also plays a decisive role in the low-germ diet.

Have you ever traveled to a country with lower hygiene standards than ours? To make sure you don't catch a food infection there, the saying goes:

"Wash it, cook it, peel it or forget it". Generally speaking, the same principle applies to the low-bacteria diet. Now, let's take a look at what that means exactly together.

For all foods that you can eat raw - such as fruits and vegetables - it is important that you wash them thoroughly beforehand. Even better, of course, are varieties that are peeled, such as oranges. At this point, an important note: grapefruit, pomelo, star fruit and pomegranate can negatively influence the degradation of your medication and must therefore not be consumed. As you can see, there are few things that are "forbidden" after a transplant. However, you should really keep your hands off these foods.

Of course, it is even better if you cook your food. The heat kills germs during cooking. This also applies to browning, of course. This principle is especially important for meat, fish and eggs. You should always make sure that the food is completely cooked through.

If it is not possible to cook meat, fish or eggs, it is better not to eat them. This also applies to finished products containing raw meat, fish or eggs. But you can't really think of any - except for the eggs in mayonnaise or chocolate mousse. And that's where you're welcome to take inspiration from vegan cuisine. There's an insanely delicious avocado chocolate mousse. Granted, it sounds crazy, but it's incredibly good!

What should I look out for in drinks?

During dialysis, many beverages tend to be omitted due to the high phosphate and potassium content as well as the fluid restriction. As a rule, you no longer have to pay as much attention to this after the transplant. However, it is clear that drinks such as cola and beer should still be enjoyed in moderation. However, nothing stands in the way of the occasional consumption of soft drinks for the time being.

To take the strain off your new kidney, just make sure that you store open beverage bottles in the refrigerator and ideally consume them within 24 hours. Drinks with stale carbon dioxide no longer taste so good anyway.

If you make tea or coffee, use boiling water and drink it fresh. In the case of tea, it is best to take the tea bag out after about 3 minutes and not let it steep in the water forever. This will also prevent the bag from becoming soggy and the tea from floating around loose in your cup. If you get thirsty for a hot drink on the road, it's best to go to a cafe and have it freshly made. It usually tastes much better than tea, coffee or cocoa from a vending machine.

If you are more of a water drinker, it is best to take your own bottle with you, which you refill and clean daily. With tap water, make sure you let it run for a while before using it for drinking. This way you can be sure it's fresh and extra tasty. When traveling and on the road, buy packaged water bottles on the go.

What should I look out for when shopping?

Now you've already seen that a low-bacteria diet can be easily integrated into your everyday life with a few tips and tricks. How can you also make sure that you keep control over potential germ sources when you go shopping?

It's best to go shopping more than once a week. That way, you'll always have fresh ingredients and you can be sure that they're not past their sell-by date. Of course, you can stock up on foods like pasta or canned goods that have a long shelf life anyway. When you clean out your groceries, make sure you put the new products in the back of the pantry shelf. That way, you'll make sure the "older" ones get used first.

Otherwise, you can continue to be inspired by the food offer in the supermarket. You can be superficial and choose the fruits and vegetables that look the best and have no dents. Also look at packaged products, that the packaging is intact. Often, foods that are sorted further back on the shelf are a good choice. With eggs, make sure there are no cracks in the shell. After all, there is nothing more annoying than scrambled eggs in the shopping bag.

For fresh produce, such as bread, go to your favorite bakery for a chat and skip the self-service counter. You don't know how many fingers have had it in their hands. And besides, fresh bread from the bakery usually tastes better anyway.

And last but not least, here's a tip for buying frozen goods. It's best to take a cool bag with you and, if you like, a few cold packs. This way you can make sure that the so-called cold chain is not interrupted. And then off into the freezer at home or use directly!

What is the best way to prepare my food?

You already know that you can usually eat anything that is properly heated without hesitation. We would now like to give you a few useful tips for hygiene in the kitchen and when cooking.

Washing your hands before cooking and eating is nothing new. This applies to all people, and rightly so. If you haven't done this routinely before, it's high time to get into the habit of this etiquette as self-protection. Washing hands is also recommended after contact with raw foods such as fish, meat and eggs. This is because you can prevent possible germs from being transferred to other foods.

If you want to be very precise, it is recommended to use a separate cutting board for products such as raw fish and meat. Preferably one made of glass, in which the germs cannot settle in the first place and which can be cleaned in the dishwasher. To remind yourself of this, you can get a colorful cutting board for these foods, for example. Then there will be no confusion here.

Otherwise, you should make sure that you wipe down the surfaces of your kitchen regularly and also wash out your bread basket and refrigerator with vinegar solution every now and then. This way, you don't give mold spores a chance to grow in the first place. But the fact that a kitchen should be as mold-free as possible is probably nothing new to you either.

If you also change your dishcloths and dishwashing cloths every day or every 2-3 days and wash them at 60 °C, you'll be well on your way to a clean kitchen.

What's the best way to store food?

Are you also happy when you have something left over for the next day at dinner and you don't have to cook again for lunch? Or do you like to cook ahead?

Then this changes absolutely nothing for you. Keep packing the remaining portions in an airtight container. You can either keep it in the refrigerator for 2 to 3 days and use it within that time. Or you freeze your meal - also packed airtight. Tupperware containers are suitable for both.

If you want to defrost your frozen meals, it is best to put them in the refrigerator - even if it takes a little longer. You can then dispose of the excess "thaw water" as a precaution before reheating the food. Of course, you can speed things up by throwing your meal directly into the pan or pot and heating it up there.

Generally speaking, the same goes for you as well as others: What no longer smells good or looks "bad" goes. No one wants to spoil their stomach - with or without a new kidney. For you, the additional motto is: Expired food should no longer be consumed.

And now we have reached the end. Give yourself a little time to adjust and enjoy the newfound freedom: You can generally drink (water) as much as you want, and you often don't have to worry about the amount of potassium and phosphate in your food as much as you did before. Of course, continue to pay attention to a healthy and balanced diet. Bon appetit!