Frozen Meals

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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

NA, not available.

Table 2. Frozen-Food Manufacturers' Contact Information

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.

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References 

1. The Library of Congress: Who “invented” the TV dinner? 11 September 2008. Available at: http://www.loc.gov/rr/scitech/mysteries/tvdinner.html
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2. Gregoire MB, Nyland N, Morcos S. Use of frozen meals by and food preferences of various age groups of adults. J Nutr Elder. 1993;13:23–37
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3. National Kidney Foundation: Treating kidney disease and eating healthy. 11 September 2008. Available at: http://www.kidney.org/patients/plu/plu_nutr/nutr_2.cfm
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