Arti Sharma Parpia1, Mary L'Abbé2, Marc Goldstein3, Joanne Arcand4, Bernadene Magnuson5, Pauline B Darling6. 1. Department of Nutritional Sciences, University of Toronto and the Comprehensive Care Program, St Michael's Hospital, Toronto, Ontario, Canada. 2. Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 3. Diabetes Comprehensive Care Program, St Michael's Hospital, Toronto and Faculty of Medicine, University of Toronto, Toronto Ontario. 4. Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada. 5. Health Science Consultants, Inc., Mississauga, Ontario, Canada. 6. School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario. Electronic address: pdarling@uottawa.ca.
Abstract
OBJECTIVE: Patients with chronic kidney disease (CKD) are advised to limit their dietary intake of phosphorus and potassium as hyperphosphatemia and hyperkalemia are both associated with an increased risk of mortality. There is uncertainty concerning the actual content of these minerals in the Canadian food supply, as phosphorus and potassium are increasingly being used as food additives. This study aimed to determine the impact of food additives on the chemically analyzed content of phosphorus, potassium, sodium, and protein in commonly consumed meat, poultry, and fish products (MPFs). DESIGN: Foods representing commonly consumed MPF identified by a food frequency questionnaire in dialysis patients were purchased from three major grocery store chains in Canada. MPF with and without phosphorus and potassium additives listed on their ingredient list (n = 76) as well as reference MPF that was additive free (n = 15) were chemically analyzed for phosphorus, potassium, sodium, and protein content according to Association of Analytical Community official methods. RESULTS: Phosphorus, potassium, and sodium additives were present on the ingredient list in 37%, 9%, and 72% of MPF, respectively. Among MPF categories that contained a phosphorus additive, phosphorus content was significantly (P < .05) higher in MPF with phosphorus additives versus MPF without phosphorus additives and MPF reference foods (median [min, max]): (270 [140, 500] mg/100 g) versus (200 [130, 510] mg/100 g) versus (210 [100, 260] mg/100 g), respectively. Among MPF categories containing a potassium additive, foods listing a potassium additive had significantly more (P < .05) potassium than foods that did not list potassium additives and reference foods (900 [750, 1100] mg/100 g) versus (325 [260, 470] mg/100 g) versus (420 [270, 450] mg/100 g). CONCLUSIONS: The use of additives in packaged MPF products as indicated by the ingredient list can significantly contribute to the dietary phosphorus and potassium loads in patients with CKD. Patients with CKD should be educated to avoid MPF foods listing phosphorus and/or potassium additives on the ingredient list, which may lead to improved dietary adherence.
OBJECTIVE:Patients with chronic kidney disease (CKD) are advised to limit their dietary intake of phosphorus and potassium as hyperphosphatemia and hyperkalemia are both associated with an increased risk of mortality. There is uncertainty concerning the actual content of these minerals in the Canadian food supply, as phosphorus and potassium are increasingly being used as food additives. This study aimed to determine the impact of food additives on the chemically analyzed content of phosphorus, potassium, sodium, and protein in commonly consumed meat, poultry, and fish products (MPFs). DESIGN: Foods representing commonly consumed MPF identified by a food frequency questionnaire in dialysis patients were purchased from three major grocery store chains in Canada. MPF with and without phosphorus and potassium additives listed on their ingredient list (n = 76) as well as reference MPF that was additive free (n = 15) were chemically analyzed for phosphorus, potassium, sodium, and protein content according to Association of Analytical Community official methods. RESULTS:Phosphorus, potassium, and sodium additives were present on the ingredient list in 37%, 9%, and 72% of MPF, respectively. Among MPF categories that contained a phosphorus additive, phosphorus content was significantly (P < .05) higher in MPF with phosphorus additives versus MPF without phosphorus additives and MPF reference foods (median [min, max]): (270 [140, 500] mg/100 g) versus (200 [130, 510] mg/100 g) versus (210 [100, 260] mg/100 g), respectively. Among MPF categories containing a potassium additive, foods listing a potassium additive had significantly more (P < .05) potassium than foods that did not list potassium additives and reference foods (900 [750, 1100] mg/100 g) versus (325 [260, 470] mg/100 g) versus (420 [270, 450] mg/100 g). CONCLUSIONS: The use of additives in packaged MPF products as indicated by the ingredient list can significantly contribute to the dietary phosphorus and potassium loads in patients with CKD. Patients with CKD should be educated to avoid MPF foods listing phosphorus and/or potassium additives on the ingredient list, which may lead to improved dietary adherence.
Authors: Amelie Bernier-Jean; Germaine Wong; Valeria Saglimbene; Marinella Ruospo; Suetonia C Palmer; Patrizia Natale; Vanessa Garcia-Larsen; David W Johnson; Marcello Tonelli; Jörgen Hegbrant; Jonathan C Craig; Armando Teixeira-Pinto; Giovanni F M Strippoli Journal: Clin J Am Soc Nephrol Date: 2021-12-01 Impact factor: 8.237
Authors: Chi N Duong; Oladimeji J Akinlawon; Joseph Gung; Sabrina E Noel; Sherman Bigornia; Kaylea Flanagan; Shirin Pourafshar; Pao-Hwa Lin; Clemontina A Davenport; Jane Pendergast; Julia J Scialla; Katherine L Tucker Journal: Am J Clin Nutr Date: 2022-08-04 Impact factor: 8.472