Frozen Meals

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	480-664-8729
	President's Choice	1 President's Choice Circle, Second Floor NW Brampton, Ontario L6Y 5S5, Canada	888-495-5111

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.