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.

中文翻译：

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减钠肉类和家禽产品含有大量来自食品添加剂的钾

背景 消费者越来越容易获得低钠包装食品；然而，尚不清楚它们是否适合包含在低钾饮食中。对于因慢性肾病导致肾钾排泄受损的个体以及服用某些干扰肾素-血管紧张素醛固酮轴的药物的个体，考虑到发生高钾血症和致命性心律失常的风险，限制饮食钾的需要很重要。目的 本研究的主要目的是确定减少包装肉类和家禽产品 (MPP) 中钠含量对食品添加剂中钾和磷含量的影响。设计 这是一项横断面研究，比较了化学分析的 MPP（n=38，n=19 原始，n=19 钠还原），根据市场份额销售额，从加拿大排名前三的杂货连锁店中选出。选择所有包装标签包含钠含量降低声明的 MPP 及其非钠含量减少的包装 MPP 对应物进行分析。根据分析共同体协会官方方法 992.15 和 984.27 对钠还原 MPP 和非钠还原（原始）MPP 对应物的蛋白质、钠、磷和钾含量进行化学分析，并使用配对 t 检验进行比较. 使用 McNemar 检验比较各组之间出现在产品标签成分表上的磷和钾添加剂的频率。结果 钠减少的 MPP (n=19) 含有比非钠减少的对应物 (n=19) 多 44% 的钾 (mg/100 g)（平均差异 [95% CI）：184 [90-279]；P=0.001）。钠还原 MPP 的钾含量变化很大，范围从 210 到 1,500 毫克/100 克。在 63% 的减钠产品和 26% 的非减钠产品的成分表中发现含钾添加剂 (P=0.02)。钠减少的 MPP 所含的钠 (mg/100 g) 比非钠减少的对应物少 38%（平均差异 [95% CI]：486 [334-638]；P<0.001）。磷和蛋白质的含量以及磷添加剂出现在产品标签成分表上的频率在两组之间没有显着差异。结论 钾添加剂经常被添加到钠减少的 MPP 中，其数量显着增加了由慢性肾病和某些药物引起的肾脏处理钾受损患者的钾负荷。应劝告需要限钾的患者对降钠 MPP 的钾含量保持谨慎，并鼓励他们相应地选择食物。