Abstract
Background
Sodium-reduced packaged food products are increasingly available to consumers; however,
it is not clear whether they are suitable for inclusion in a potassium-reduced diet.
For individuals with impaired renal potassium excretion caused by chronic kidney disease
and for those taking certain medications that interfere with the rennin-angiotensin
aldosterone axis, the need to limit dietary potassium is important in view of the
risk for development of hyperkalemia and fatal cardiac arrhythmias.
Objective
The primary objective of this study was to determine the impact of the reduction of
sodium in packaged meat and poultry products (MPPs) on the content of potassium and
phosphorus from food additives.
Design
This was a cross-sectional study comparing chemically analyzed MPPs (n=38, n=19 original,
n=19 sodium-reduced), selected from the top three grocery chains in Canada, based
on market share sales. All MPPs with a package label containing a reduced sodium content
claim together with their non-sodium-reduced packaged MPP counterparts were selected
for analysis. The protein, sodium, phosphorus, and potassium contents of sodium-reduced
MPPs and the non-sodium-reduced (original) MPP counterparts were chemically analyzed
according to the Association of Analytical Communities official methods 992.15 and
984.27 and compared by using a paired t test. The frequency of phosphorus and potassium additives appearing on the product
labels' ingredient lists were compared between groups by using McNemar’s test.
Results
Sodium-reduced MPPs (n=19) contained 44% more potassium (mg/100 g) than their non-sodium-reduced
counterparts (n=19) (mean difference [95% CI): 184 [90-279]; P=0.001). The potassium content of sodium-reduced MPPs varied widely and ranged from
210 to 1,500 mg/100 g. Potassium-containing additives were found on the ingredient
list in 63% of the sodium-reduced products and 26% of the non–sodium-reduced products
(P=0.02). Sodium-reduced MPPs contained 38% less sodium (mg/100 g) than their non–sodium-reduced
counterparts (mean difference [95% CI]: 486 [334-638]; P<0.001). The amounts of phosphorus and protein, as well as the frequency of phosphorus
additives appearing on the product label ingredient list, did not significantly differ
between the two groups.
Conclusions
Potassium additives are frequently added to sodium-reduced MPPs in amounts that significantly
contribute to the potassium load for patients with impaired renal handling of potassium
caused by chronic kidney disease and certain medications. Patients requiring potassium
restriction should be counseled to be cautious regarding the potassium content of
sodium-reduced MPPs and encouraged to make food choices accordingly.
Keywords
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Biography
A. S. Parpia is a hemodialysis dietitian, Diabetes Comprehensive Care Program, St Michael’s Hospital, Toronto, Ontario, Canada.
Biography
M. B. Goldstein is an emeritus professor, University of Toronto, and the medical director of hemodialysis, St Michael’s Hospital, Toronto, Ontario, Canada.
Biography
J. Arcand is an assistant professor, Faculty of Health Sciences, University of Ontario Institute of Technology, Toronto, Ontario, Canada.
Biography
F. Cho is a technical manager, Scientific Services, Maxxam Analytics, Mississauga, Ontario, Canada.
Biography
M. R. L’Abbé is the chair, Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Biography
P. B. Darling is an assistant professor, School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Article info
Publication history
Published online: January 06, 2018
Accepted:
October 30,
2017
Received:
May 24,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST F. Cho is an employee at Maxxam Analytics and has no financial interest in this research. No potential conflict of interest was reported by the other authors. The food products were chosen by the principal investigators at the University of Ottawa and Toronto.
FUNDING/SUPPORT Funding for this research was provided by a research grant from the Canadian Foundation of Dietetic Research.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
