THE FIRST FROZEN MEAL was developed in 1945 for consumption on military and commercial airplanes.1 In 1954, when Swanson's frozen meals hit the market, the “TV Dinner” became an icon of American culture. At that time, the frozen meal consisted of a three-compartment tray containing meat, potatoes, and vegetables. Now the frozen-foods aisle at the supermarket is packed with an ever-growing selection of frozen meals marketed to a diverse consumer population. During a stroll through the freezer section, you may come across ethnic cuisines such as Thai, Indian, and Italian, and specialty diet meals catering, for example, to vegetarians or low-carb dieters.
Nephrology dietitians work with a diverse population of patients with chronic kidney disease (CKD), many of whom may benefit nutritionally from the convenience of frozen meals. Patients who are trying to juggle a dialysis regimen, plus a work schedule and family life, may not find the time to prepare home-cooked meals. In addition, frozen meals are often appropriate for those who are physically unable to cook safely at home. Some patients may have difficulty preparing meals for a range of reasons, including weakness, inability to stand, poor eyesight or blindness, and illness. Frozen meals provide these patients with an option for quick and easy dining at home. It was reported that older individuals have a higher acceptance of frozen meals.2
Which frozen meals are can be recommended for CKD patients? Frozen meals can be very high in sodium, potassium, and phosphorus, rendering many of them unsuitable for our patients. Unfortunately, food labels on frozen meals do not always contain the necessary information to educate patients about which frozen meals constitute a better choice. Although disclosure of sodium content is mandatory on the nutrition facts label, obtaining potassium and phosphorus content can pose a challenge, because food companies are not required to report this information, and therefore many of them do not.
Upon searching food-company websites and calling the companies directly to obtain this additional pertinent nutrition information for the frozen meals listed in Table1, some companies were able to provide the potassium and phosphorus content. See Table 2 for the contact information for frozen meal manufacturers.Any nutrient level that was unable to be found is listed as “not available” (NA). This does not imply that the level is insignificant, but that the information is not being made available to consumers. It is the role of nutrition and nephrology professionals to advocate for the disclosure of complete nutrition information of food products so that CKD patients may be appropriately educated.
Table 1.
Nutrition Information for Frozen Meals
Manufacturer
Product Name
Calories
Protein (g)
Fat (g)
Trans Fat (g)
Potassium (mg)
Phosphorus
Sodium (mg)
Fiber (g)
Amy's
Asian Noodle Stir Fry
290
9
7
0
410
210
630
4
Amy's
Black Bean Enchilada Meal
330
9
8
0
250
110
740
9
Amy's
Thai Stir Fry
310
8
11
0
340
140
420
5
Amy's
Brown Rice and Vegetable Bowl
260
9
9
0
520
240
550
5
Amy's
Light in Sodium Vegetable Lasagna
290
15
8
0
449
NA
340
4
Amy's
Light in Sodium Veggie Loaf
290
9
8
0
628
NA
340
7
Amy's
Macaroni and Soy Cheeze
370
16
15
0
140
NA
500
4
Healthy Choice
Sweet and Sour Chicken
430
16
9
0
500
NA
600
5
Healthy Choice
Beef Stroganoff
340
20
9
0
630
NA
490
5
Healthy Choice
Chicken Broccoli Alfredo
300
17
5
0
430
NA
430
8
Healthy Choice
Country Herb Chicken
240
15
5
0
610
NA
600
5
Healthy Choice
Lemon Pepper Fish
310
13
4.5
0
450
NA
440
5
Healthy Choice
Grilled White Meat Chicken
240
22
5
0
540
NA
600
4
Healthy Choice
Roast Turkey Breast
200
14
3.5
0
NA
NA
600
5
Kashi
Chicken Pasta Pomodoro
280
19
6
0
510
NA
470
6
Kashi
Black Bean Mango
340
8
8
0
430
NA
430
7
Kashi
Lemon Rosemary Chicken
330
17
9
0
360
NA
640
5
Kashi
Lime Cilantro Shrimp
250
12
8
0
300
NA
690
6
Kashi
Southwest Style Chicken
240
16
5
0
540
NA
680
6
Lean Cuisine
Alfredo Pasta With Chicken and Broccoli
250
17
6
0
375
NA
650
3
Lean Cuisine
Café Classics Chicken Marsala
140
14
4
0
200
NA
520
3
Lean Cuisine
Café Classics Chicken Teriyaki
250
15
2
0
590
NA
690
3
Lean Cuisine
Café Classics Grilled Chicken Caesar
240
18
7
0
350
NA
690
3
Lean Cuisine
Café Classics Bow Tie Pasta and Chicken
230
16
4.5
0
590
NA
660
3
Lean Cuisine
Café Classics Three Cheese Chicken
210
21
10
0
550
NA
500
3
Lean Cuisine
Café Classics Tortilla Crusted Fish
330
16
9
0
280
NA
540
3
Lean Cuisine
Café Classics Chicken a l'Orange
260
18
3
0
490
NA
580
2
Lean Cuisine
Spa Cuisine Butternut Squash Ravioli
350
13
9
0
310
NA
660
6
Lean Cuisine
Spa Cuisine Hunan Stir Fry With Beef
270
15
7
0
660
NA
610
2
Lean Cuisine
Spa Cuisine Lemon Chicken
300
15
5
0
320
NA
570
3
Lean Cuisine
Spa Cuisine Chicken Mediterranean
240
19
4
0
560
NA
590
6
Organic Bistro
Chicken Citron
430
34
17
0
620
210
370
6
Organic Bistro
Ginger Chicken
360
34
14
0
330
150
400
7
Organic Bistro
Sockeye Salmon Cake
600
34
36
0
690
310
350
8
Organic Bistro
Savory Turkey
480
39
17
0
630
200
320
7
Organic Bistro
Pasta Puttanesca
320
11
6
0
640
100
380
8
Organic Bistro
Spiced Chicken Morocco
340
22
10
0
210
70
270
7
Organic Bistro
Jamaican Jerk Shrimp Cake
320
18
7
0
430
180
105
6
President's Choice
Chicken Szechwan
200
17
4
0
320
NA
440
4
President's Choice
Chicken Tikka Masala
290
19
3.5
0
290
NA
430
3
President's Choice
Rotini With Chicken Pesto
370
24
8
0
530
NA
670
6
President's Choice
World's Best Seasoned Meatless Chicken
150
24
3
0
600
NA
530
1
President's Choice
Ginger-Glazed Salmon
300
17
4
0
450
NA
570
5
President's Choice
Thai Noodles With Coconut Chicken
288
14
8.5
NA
415
NA
660
2.8
NA, not available.
Table 2.
Frozen-Food Manufacturers' Contact Information
Manufacturer
Address
Telephone
Amy's Kitchen, Inc.
PO Box 449, Petaluma, CA 94953
707-578-7270
ConAgra Foods (Healthy Choice)
PO Box 3768, Omaha, NE 68103
877-266-2472
Kashi Company
PO Box 8557, La Jolla, CA 92038
877-747-2467
Nestle USA (Lean Cuisine)
PO Box 2178, Wilkes Barre, PA 18703
800-225-2270
Organic Bistro
4300 N. Miller Rd., Suite 242 Scottsdale, AZ 85251
The National Kidney Foundation recommends that CKD patients choose frozen meals with sodium under 20% and total fat less than 15%3 (see Table 1 for a list of frozen meals that may fall within the parameters of your patients' dietary requirements).
The meals listed in Table 1 have less than 700 mg of potassium, and nearly all contain less than 700 mg of sodium. Although phosphorus levels were unavailable for the majority of meals, those listed fall between 100 and 240 mg. The one exception is Organic Bistro's Sockeye Salmon Cakes (310 mg). Because this meal is extremely high in both calories and protein, it would be expected to contain more phosphorus. The calorie and protein content of the meals varied widely, from 140 to 600 calories, and 3 to 36 g of protein. The fiber content of frozen meals is relatively low, ranging from 1 to 9 mg. Each meal is equal to one serving size. The frozen meals listed are available in many supermarkets. The growing market for home-delivered meals, including the food company Alleready Foods, which tailors meals for patients on dialysis, is beyond the scope of this article.