Your choices

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After your transplant, it’s vital to maintain a healthy lifestyle to ensure your new organ is stable and to reduce the risk of developing diabetes, obesity and heart disease. Aim to include foods across the 5 food groups each day to incorporate important nutrients such as calcium and iron. For more information refer to the Australian Guide to Healthy Eating.

Allow yourself treats once in a while, but make sure you’re aware of the foods that you need to include in your diet and those you should limit. Ensure your daily food intake is low in saturated fats and sugars. Include plenty of fruits, vegetables and fibre in your meals. While you will have a wide choice of foods, choosing meals intelligently will keep your transplant safer.

Be aware that carbonated drinks like coke and lemonade (but not soda water) are heavy in sugar.

Click to download a PDF on healthy food options

Good fat vs bad fat

Reducing fat intake can help maintain a healthy weight, and limiting saturated fats will help manage cholesterol levels.

When cooking, choose plant-based or vegetable-based oils that contain mostly polyunsaturated fats and monounsaturated fats, such as olive and nut-based oils and spreads. Limit animal-based fats, which contain mostly saturated fats such as butter, cream, cooking margarine, coconut and palm oils.

Limit processed snacks and takeaway foods like biscuits, cakes, pastries, pies, processed meats and savoury snacks such as potato crisps, as these often contain high levels of saturated fats.

good-fats

Better Choice	Try to limit
Vegetable oil spreads like canola or olive oil based margarine in small amounts Bake, boil, grill or steam foods. Use an oil spray for frying	Saturated fats – butter, ghee, coconut oil Deep frying
Trim fat off meats and remove skin from chicken before cooking	Meats – limit fats in your meats
Reduced-fat milk, low-fat or diet yoghurts, reduced-fat cheese e.g. cottage cheese, ricotta, low-fat feta, reduced-fat cheddar	Full cream milk, yoghurts and cheese
Avocado, nuts, seeds, peanut and other nut paste spreads	Processed snacks – chips, crisps, chocolate, cakes and biscuits

See more information on fats here.

Salt intake

To manage blood pressure, choose no added salt or reduced-salt products, and check how much salt you’re adding to your cooking or at the table. Limit processed foods, fast food and restaurant food as they are high in added salt.

Note: Frozen prepared food with the Heart Foundation Tick and labels indicating low salt and fat content are safe to eat.

If you’re told to limit potassium in your diet, be very cautious about using salt substitutes because most contain some form of potassium. Check with your doctor or dietitian before using salt substitute.

salt

Better choice	Try to avoid/limit
Fresh garlic, fresh onion, garlic powder, onion powder, black pepper, lemon juice, low-sodium/salt-free seasoning blends, vinegar, fresh or dried herbs and spices.	Salt and salt seasonings: table salt, seasoning salt, chicken salt, meat tenderiser, stock cubes, flavour enhancers.
Unsalted popcorn, pretzels, tortilla or corn chips, Vita-Weat, water crackers. Homemade or low-sodium sauces and salad dressings; vinegar; dry mustard.	High-sodium sauces like barbecue sauce, gravy mixes, soy sauce, teriyaki sauce, oyster sauce. Salted snacks: crackers, potato chips, corn chips, pretzels, tortilla chips, nuts, popcorn.
Fresh beef, veal, pork, poultry, fish, eggs. Low-salt deli meats e.g. turkey, roast beef, chicken. Freshly-cooked meat, fish, chicken, vegetables, rice, pasta, couscous, plain noodles and other grains.	Cured foods: ham, bacon, pickles, pickle relish. Luncheon meats: hot dogs, cold cuts, deli meats, pastrami, sausage, corned beef.
Natural cheeses like cottage cheese, ricotta, cream cheese, mascarpone and mozzarella. Homemade or low-sodium soups or casseroles made with vegetables; fresh meat; rice, pasta; canned food without added salt. Source: National Kidney Foundation	Processed foods: some cheeses like string cheese and haloumi, canned soups. Convenience foods: meat pies, sausage rolls, pizzas, chicken nuggets, macaroni & cheese, instant noodles, fast foods.

Sugar intake

An increase in blood sugar (glucose) levels is often a side effect of immunosuppressant drugs. This can lead to post-transplant type 2 diabetes. Getting type 2 diabetes after a transplant is especially risky as it makes organ rejection and dangerous infections more likely.

High amounts of sugars and carbohydrates in your diet can raise blood sugar levels and cause weight gain.

If you were diabetic prior to your transplant and already taking medication for this, you may find that your management plan will change. In this case, it’s best to consult your endocrinologist, diabetes educator or Accredited Practicing Dietitian to help you work through these changes. You can manage your health, body and control sugar intake through a healthy diet.

To help control blood glucose levels

Have regularly-spaced meals, do not skip meals. Eating strategically will give you the power to maximise your energy levels. It will also allow you to manage your weight and keep your transplant safe
Eat foods that are high in fibre and preferably low glycaemic index (GI). Examples of low GI foods include traditional rolled oats, dense wholegrain breads, lentils and legumes, sweet potato, milk, yoghurt, pasta and most types of fresh fruit
Some types of carbohydrate can cause higher blood glucose. The best combination is to eat moderate amounts of high fibre, low GI carbohydrates
Avoid eating large quantities of foods rich with added sugars such as soft drinks, fruit juice, biscuits, cakes, lollies and chocolates

Healthy options	Food that could increase your blood sugar level
Low-fat spreads, sliced banana, low-fat cream cheese . Choose tins of fruit in juice or water rather than syrup.	Added sugars: powdered sugar, brown sugar, white sugar. Syrups & sweeteners (granulated sugar), pancake syrups, fructose, honey, high fructose corn syrup, molasses.
Oatmeal or wholegrain cereals topped with fruit, but not those coated with sugar or honey.	Breakfast cereals: many common breakfast cereals are packed with sugars that might start your day with a bounce but lead to trouble down the line.
Fruits, low-sugar options. Water or unsweetened fruit juice. Dilute fruit juice further to reduce the sugar level.	Energy and meal-replacement bars may have some nutritional value but are high in calories. The high sugar content causes a sugar rush and then crash, leaving you unsatisfied and hungry.
Oat flour, whole wheat flour, rye flour, brown rice flour.	White flour products cause an almost instant rise in sugars – e.g. bread, cakes, pasta, pies from white flour.
Vegetable oil spreads like canola or olive oil-based margarine in small amounts. Bake, boil, grill, steam foods. Use an oil spray for frying.	Deep-fried starches like French fries and doughnuts. An average doughnut contains about 200-300 calories, mostly from sugar.
Try halving the sugar you use in your recipes. It works for most things except jam, meringues and ice-cream. Swap cakes or biscuits for a piece of fruit.	Cookies, cakes, candies and jellies are full of sugar and trans fats.
If you like soft drinks, try diluting your drink with sparkling water. If you take sugar in hot drinks or add sugar to your breakfast cereal, gradually reduce the amount until you can cut it out altogether, or try using a natural honey.	Soft drinks and cordials. A can of soda/carbonated drink (not soda water) contains up to 15 teaspoons of sugar (150 empty calories which is easily absorbable), and will cause your blood sugar levels to spike.

Glycaemic Index (GI) – Lower the better

Transplant recipients keen on controlling their weight and sugar levels should stick to foods with a low GI rating. GI indicates how quickly a food raises blood sugar levels and ranges between 0 – 100. Glucose is rated at 100, and the closer a food is to a 100 rate, the more it affects blood sugar levels.

Foods with a low GI (55 or less), like vegetables, have less impact on blood sugar levels and deposition of fat compared to foods like white bread, pasta and potatoes which have a high index (70 or higher).

Sugars and white flours have very high GI index and can raise blood sugar levels quickly.

Some useful links

To read more about GI visit the – Glycemic Index Foundation

Find low GI products

Find low GI foods

Low GI sample recipes

How to make low GI foods

The Heart Foundation BMI Calculator

So, how much sugar is in some everyday food and drinks?

10 teaspoons of sugar

375ml can of Cola

8 teaspoons of sugar

2 rows of Milk Chocolate

16 teaspoons of sugar

600ml bottle of Cola

4 teaspoons of sugar

2 Chocolate Biscuits

15 teaspoons of sugar

600ml bottle of Lemonade

3 teaspoons of sugar

1 scoop of Ice Cream

13 teaspoons of sugar

500ml can of Energy Drink

9 teaspoons of sugar

600ml bottle of Sports Drink

1 teaspoon of sugar

2 small Lollies

Source Diabetes SA

Alcohol

Alcohol in moderation (one standard drink per day) is usually acceptable, but you need to discuss this with your dietitian and transplant nurse. Know your limits and work with them.

Regularly drinking alcohol above the maximum recommended amounts can cause weight gain and raise blood pressure. This can be dangerous for your new organ.

What is a standard drink?

A standard drink contains approximately 10 gms of pure alcohol. Adapted from the NSW government alcohol fact sheet, each of these is one standard drink:

Recommended limits for alcohol intake

Type of organ transplanted	Male	Female
Kidney, Pancreas, Islet	2 standard drinks per day	1 standard drink per day
Heart, Lung	2 standard drinks per day	2 standard drinks per day
Liver	Alcohol should be avoided for the first year after your liver transplant under any circumstances. Moderate alcohol consumption may damage the new liver. You may have an alcoholic beverage to celebrate special occasions. Remember to limit your intake to one to two glasses of wine or champagne, or one to two glasses of beer. People whose liver disease was caused by alcohol should never drink alcohol again.

Meal ideas

	GOOD CHOICES
BREAKFAST	Wholegrain cereal with reduced-fat milk Multigrain bread/toast/English muffin Margarine e.g. canola or olive Cooked breakfast: tomato, mushrooms, spinach, baked beans, corn kernels, egg or omelette Fruit
LUNCH	Sandwiches, rolls, wraps or crackers made with multigrain breads Use margarine or avocado as a spread on bread (if needed) Filling: salads, reduced-fat cheese, low-fat cream cheese, low-fat ham, turkey, chicken, tuna, salmon, eggs Salads Soups Fruit Low-fat yoghurt
DINNER	Vegetable-based soups Lean meats, skinless chicken, fish, eggs, baked beans, lentils, tofu 1 small boiled potato/1 cup cooked rice/1 cup cooked pasta/2 slices of multigrain bread and Vegetables or salad with all meals Fruit Low-fat custard or yoghurt

Table compiled by Sheridan Collins, Dietitian, Nutrition & Dietetics, The Children’s Hospital at Westmead. Check out Transplant Australia’s transplant-friendly recipes.

For information on serve sizes and healthy eating tips check out Eat for Health.

Acknowledgements

Transplant Australia gratefully acknowledges the valuable contribution of the following experts in reviewing this material:

Arian Chong

Senior Renal Dietitian
Royal Prince Alfred Hospital

Carissa Maroney

Dietitian
Cardiothoracic Medicine, Surgery & Intensive Care, Heart & Lung Transplant, Cardiology
St Vincent’s Hospital

Helen Vidot

Specialist Dietitian
Liver Disease & Transplantation
Royal Prince Alfred Hospital

Katie Marks

Dietitian
Nutrition & Dietetics
The Children’s Hospital at Westmead

Sheridan Collins

Dietitian
Nutrition & Dietetics
The Children’s Hospital at Westmead

Good fat vs bad fat

Better Choice

Try to limit

Vegetable oil spreads like canola or olive oil based margarine in small amounts

Bake, boil, grill or steam foods. Use an oil spray for frying

Saturated fats – butter, ghee, coconut oil

Deep frying

Trim fat off meats and remove skin from chicken before cooking

Meats – limit fats in your meats

Reduced-fat milk, low-fat or diet yoghurts, reduced-fat cheese e.g. cottage cheese, ricotta, low-fat feta, reduced-fat cheddar

Full cream milk, yoghurts and cheese

Avocado, nuts, seeds, peanut and other nut paste spreads

Processed snacks – chips, crisps, chocolate, cakes and biscuits

Salt intake

Better choice

Try to avoid/limit

Fresh garlic, fresh onion, garlic powder, onion powder, black pepper, lemon juice, low-sodium/salt-free seasoning blends, vinegar, fresh or dried herbs and spices.

Salt and salt seasonings: table salt, seasoning salt, chicken salt, meat tenderiser, stock cubes, flavour enhancers.

Unsalted popcorn, pretzels, tortilla or corn chips, Vita-Weat, water crackers. Homemade or low-sodium sauces and salad dressings; vinegar; dry mustard.

High-sodium sauces like barbecue sauce, gravy mixes, soy sauce, teriyaki sauce, oyster sauce. Salted snacks: crackers, potato chips, corn chips, pretzels, tortilla chips, nuts, popcorn.

Fresh beef, veal, pork, poultry, fish, eggs. Low-salt deli meats e.g. turkey, roast beef, chicken.

Freshly-cooked meat, fish, chicken, vegetables, rice, pasta, couscous, plain noodles and other grains.

Cured foods: ham, bacon, pickles, pickle relish.

Luncheon meats: hot dogs, cold cuts, deli meats, pastrami, sausage, corned beef.

Natural cheeses like cottage cheese, ricotta, cream cheese, mascarpone and mozzarella.

Homemade or low-sodium soups or casseroles made with vegetables; fresh meat; rice, pasta; canned food without added salt.

Source: National Kidney Foundation

Processed foods: some cheeses like string cheese and haloumi, canned soups.

Convenience foods: meat pies, sausage rolls, pizzas, chicken nuggets, macaroni & cheese, instant noodles, fast foods.

Sugar intake

To help control blood glucose levels

Healthy options

Food that could increase your blood sugar level

Low-fat spreads, sliced banana, low-fat cream cheese . Choose tins of fruit in juice or water rather than syrup.

Added sugars: powdered sugar, brown sugar, white sugar. Syrups & sweeteners (granulated sugar), pancake syrups, fructose, honey, high fructose corn syrup, molasses.

Oatmeal or wholegrain cereals topped with fruit, but not those coated with sugar or honey.

Breakfast cereals: many common breakfast cereals are packed with sugars that might start your day with a bounce but lead to trouble down the line.

Fruits, low-sugar options.

Water or unsweetened fruit juice. Dilute fruit juice further to reduce the sugar level.

Energy and meal-replacement bars may have some nutritional value but are high in calories. The high sugar content causes a sugar rush and then crash, leaving you unsatisfied and hungry.

Oat flour, whole wheat flour, rye flour, brown rice flour.

White flour products cause an almost instant rise in sugars – e.g. bread, cakes, pasta, pies from white flour.

Vegetable oil spreads like canola or olive oil-based margarine in small amounts. Bake, boil, grill, steam foods. Use an oil spray for frying.

Deep-fried starches like French fries and doughnuts. An average doughnut contains about 200-300 calories, mostly from sugar.

Try halving the sugar you use in your recipes. It works for most things except jam, meringues and ice-cream. Swap cakes or biscuits for a piece of fruit.

Cookies, cakes, candies and jellies are full of sugar and trans fats.

If you like soft drinks, try diluting your drink with sparkling water.

If you take sugar in hot drinks or add sugar to your breakfast cereal, gradually reduce the amount until you can cut it out altogether, or try using a natural honey.

Soft drinks and cordials. A can of soda/carbonated drink (not soda water) contains up to 15 teaspoons of sugar (150 empty calories which is easily absorbable), and will cause your blood sugar levels to spike.