Lifestyle changes

Diet

Some people we spoke to said that their diet was already healthy, so they hadn’t needed to make any changes. Others said that they had changed their diet, for example by reducing the amount of salt, fat or sugar they ate.

Jackie couldn’t recall anyone ever advising her to reduce her salt intake because of her kidney problem, but she did it herself as part of efforts to maintain a healthy lifestyle.

Age at interview 59

Gender Female

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Justine says she improved her diet after learning that she had high blood pressure. Eric’s had improved since retiring because he no longer ate fry-ups in his workplace canteen. Laura eats a largely vegetarian, home-cooked, organic diet. She had declined an offer of medicines to lower the levels of cholesterols in her blood, preferring to do this by dietary means. By contrast James eats whatever he likes but takes medicine to control his cholesterol.

Royston Y cut down on cheese after being advised by a nurse that his cholesterol level was raised. He was also given written information about healthy eating and is careful to stick to this.

Age at interview 82

Gender Male

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Changing one’s diet can be very hard, particularly for people with other health problems that limit what they can eat, such as diabetes, or gastrointestinal conditions such as diverticulitis, hiatus hernia, colitis or Crohn’s disease. Fortunately, almost all health conditions can be helped by eating a healthy balanced diet that is low in salt, fat and sugar and includes lots of fruit and vegetables. Some foods must be avoided when taking certain medicines. For instance Simon had to avoid grapefruit, cranberry and foods rich in vitamin K (such as green vegetables) because they reduce the effectiveness of warfarin. Grapefruit can also interact with some types of blood pressure lowering medicines, and with statins used to control cholesterol.

Anne recalls a GP suggesting she should not eat too much fruit and vegetables because of her colitis. She describes her daily diet, which is also limited by diabetes.

Age at interview 71

Gender Female

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Lesley found that certain foods or drinks gave her symptoms that she attributed to her kidney condition but could also have been caused by other things; she had found it helpful to follow dietary advice aimed at people with more advanced kidney disease. Symptoms don’t usually occur until kidney performance reaches stage 4 or 5; Jim B had adopted a special kidney diet when his condition reached stage 5.

Some people had been advised or had read that they should keep their fluid intake up. While drinking a healthy amount of fluid will prevent dehydration, it is not known whether drinking a larger volume of fluid than normal can slow down the progression of kidney disease.

A GP considered David’s diet to be healthy but advised him to keep his fluid intake up. This was easy for David as he frequently went to the tap for a cup of water anyway.

Age at interview 78

Gender Male

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Other factors affecting how easy it was to change dietary habits included having to cook food for other people or if arthritic pain or poor mobility limited the amount of time they could stand up to cook meals. Elizabeth pointed out that living alone meant there was less incentive to cook proper meals. Simon was just getting over a cold and said he wanted to eat more healthily but that, ‘when you’re feeling like absolute rubbish you want to eat rubbish’.

Betty likes cooking for herself but doesn’t do it much these days because of pain from a back problem when she stands for any length of time.

Age at interview 89

Gender Female

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Since Elizabeth has been widowed she hasn’t bothered to cook elaborate meals for herself but has a roast dinner at her daughter’s house on Sundays.

Age at interview 74

Gender Female

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Some said they would like more advice and information about how they could change their diet to help their kidneys. Others had seen a dietitian, usually for conditions such as diabetes, or had received dietary advice at cardiac rehabilitation classes.

When Gordon attended rehabilitation sessions after a heart operation, as well as doing exercises he was advised on how to eat healthily to protect his heart.

Age at interview 72

Gender Male

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Weight loss

Some of the people we spoke to wanted to lose weight but found it very difficult. Donald said he had failed to lose weight despite changing his diet because of his diabetes. Flo said she was too old to bother at age 70.

A nurse told Betty that she is overweight, but as she is relatively inactive because of mobility problems and already eats healthy food in small quantities, Betty doesn’t know what else she can do.

Age at interview 89

Gender Female

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Donald has diabetes and receives dietary advice from a dietitian but has not lost weight. He often eats out because he lives alone and finds it tempting to snack to keep his blood sugar level up.

Age at interview 60

Gender Male

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Many of those who had lost weight had done so by attending slimming classes such as Slimming World or Weight Watchers. After attending classes Justine found she lost weight not just by cutting out certain foods but also by eating more vegetables. Not everyone who had lost weight managed to keep it off. People who are taking diuretic medicines (water tablets) may find their weight changes according to how much fluid they are retaining at any particular time.

Margaret had been given vouchers from the NHS towards slimming classes and said she now felt healthier as a result of losing weight.

Age at interview 72

Gender Female

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Physical activity

Some people we spoke to considered themselves reasonably fit or said they were on their feet all day so didn’t feel they needed to increase their levels of physical activity. Health or mobility problems limited other people’s ability to be active, but most tried to do some level of activity. Walking was popular although Ian said his Chronic Obstructive Pulmonary Disease limited the distance he could walk on cold days. Other forms of activity included gym exercises, gardening, golf, cycling and swimming.

Flo has multiple health problems and finds that the exercise advice offered to her by health professionals is often unrealistic for her circumstances.

Age at interview 70

Gender Female

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Barbara cannot walk as much as she used to but does walk every day when taking her grandchildren to school and back or to the shops.

Age at interview 69

Gender Female

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Following an operation on her spine, Jackie Z has had exercise on prescription from her GP, which she gets at her local gym, in addition to regular physiotherapy at hospital.

Age at interview 70

Gender Female

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Smoking

Among the people we spoke to were those who had never smoked, those who had smoked in the past and successfully quit or were trying to quit (either with professional help or going it alone), those who had cut down or were trying to do so, as well as current smokers.

Russell gave up smoking 22 years ago after finding the smell of a friend’s cigarette revolting when he was recovering from the flu.

Age at interview 84

Gender Male

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Liban stopped smoking about 12 years ago immediately after learning that he had diabetes.

Age at interview 73

Gender Male

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Mike was referred for professional help to quit smoking. For four months he sucked a nicotine lozenge whenever he craved a cigarette. He hasn’t smoked since.

Age at interview 36

Gender Male

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Roy had declined professional help in his efforts to cut down. He found it difficult to cut down as his wife still smoked. John X had been advised to quit smoking and reduce his alcohol consumption. He found it too difficult to do both at the same time, but has succeeded in cutting down the number of cigarettes he smokes. Lesley enjoyed smoking and had not tried to quit because she was afraid to fail in her attempts.

Elizabeth is trying to cut down from 20 cigarettes a day to 10. She feels that health professionals have little patience or sympathy with smokers.

Age at interview 74

Gender Female

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Alcohol reduction

The people we spoke to drank different amounts. Liban drank no alcohol at all because of religious reasons, Margaret didn’t drink because she didn’t enjoy it, Peter and Bernard had given it up for health reasons. Others drank alcohol only occasionally, or regularly but within recommended limits (current guidance is no more than 14 units a week for both men and women – NHS Choices 2016). Some drank more than this and were worried about the effects on their health.

Eric said he had reduced his consumption since retiring from work; Simon cut down because too much alcohol can interfere with the warfarin he now takes for his heart condition. Laura believes she drinks too much but is surprised that her GP has not advised her to cut down because of her kidney condition.

John X sought help with reducing his alcohol consumption after learning he had a liver problem. He rarely drinks nowadays.

Age at interview 66

Gender Male

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For detailed healthy lifestyle advice see the NHS Choices website.

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