By Nikki Sclafani, MS, RD, LD

Why Are Food Labels So Important? 

Food labels allow you to make educated decisions about the foods you choose for you and your family. They also help you to compare different products found in supermarkets. As a dialysis patient, reading and understanding food labels can assist you in making the right food choices for your special diet needs. Today, food labels offer more complete and accurate nutrition information than ever before. Labels on a package of food are a lot like the table of contents in a book. The label gives information about the food inside and what nutrients you will get from that food. Nutrients are substances found in food that are necessary for maintaining good health. Nutrients include protein, fats, carbohydrates, vitamins and minerals. Phosphorus and potassium are nutrients that dialysis patients must regulate. Too much potassium can weaken heart muscle or can even cause a heart attack. Too much phosphorus can lead to muscle weakness and painful bones and joints. Over time, high phosphorus levels can cause irreversible damage to your heart, lungs, skin, joints and muscles. Lab tests should be taken each month to determine your current levels of phosphorus and potassium. You can find out what your levels are by asking your dietitian. 

Who Monitors the Information on Food Labels?

The Food and Drug Administration (FDA), United States Department of Agriculture (USDA) and The Federal Trade Commission (FTC) regulate food labels. Nutrition labeling is required for almost all foods. However, some foods do not require labels, such as some bakery and deli items or foods made for immediate consumption. The USDA has a Web site, found at www.nal.usda.gov/fnic/foodcomp/, which provides the nutrient values for many foods. 

What are Daily Values?

Daily Values tell you whether the food has a lot or a little of a nutrient. Daily Values for someone consuming a 2,000 and 2,500-calorie diet are listed at the bottom of the food label. Daily Values represent the recommended needs of the "typical" consumer and not always appropriate for kidney patients. 

How are Nutrients Measured?

Most nutrients are measured in grams, also written as g. Some nutrients are measured in milligrams, written as mg. There are one thousand milligrams in a gram. Other information is given in percentages, written as %. 

What Are The Parts Of the Food Label?

Serving Sizes - The serving size refers to the average amount or portion size that a person eats at one time. A number of different measurement methods including cups, ounces or grams can list the serving size. Remember that the nutritional information given on the label is based on one serving of the food. Therefore, if the serving size is one cup and you eat two cups, then you will need to double the numbers on the label.

Servings Per Container - Provides you with the number of servings a package of food contains. Many foods contain more than one serving per container. If you eat a whole package or container of food that has three servings, then you must multiply all numbers by three. 

Amount Per Serving - Refers to the number of nutrients and calories for each serving of food. These nutrients include the following: total calories, calories from fat, total fat, saturated fat, cholesterol, sodium, total carbohydrate and protein. Food labels may also list additional nutrients such as potassium and phosphorus.

Percent Daily Values - The Percent Daily Values section provides the percentage of total nutrients for one serving. The Percent Daily Values are based on a 2,000-calorie diet. The Percent Daily Value for phosphorus for a 2,000-calorie diet is 1,000 mg. This may be too much phosphorus for some dialysis patients to consume. However, if you know that 1,000 mg is 100% of the Daily Value, than you can determine that 100 mg is 10% of the Daily Value, 200 mg is 20%, 300 mg is 30% and so on. Ask your dietitian how many milligrams (mg) of phosphorus are right for you. You will notice that there are no Percent Daily Values for cholesterol or sodium. Too much cholesterol can contribute to an increased risk of heart disease. This is true for a dialysis patient and the general population. The American Heart Association (AHA) recommends that adults should have less than 300 mg of cholesterol in their diet each day. Too much sodium can contribute to high blood pressure. Most dialysis patients have experienced this at one time or another. Sodium makes your body hold fluid, which results in high blood pressure, swollen hands and feet, shortness of breath and rapid weight gain. Sodium can also make you thirsty. 

Ingredient List - Lists the ingredients in order from greatest to least. Some foods may list phosphorus as an ingredient even though it is not listed elsewhere in the food label. If it is one of the top ingredients listed on the Ingredient List, the product may contain too much phosphorus for you. Remember that the first place to start when you look at the food label is the serving size and the number of servings in the package.

Nikki Sclafani, MS, RD, LD is the Clinical Support Specialist for Bone Care International. Ms. Sclafani has worked in the nephrology field for three years.

The information contained herein is intended for educational purposes only. It is not intended and should not be construed as the delivery of medical care. Persons requiring diagnosis or treatment, or those with specific questions, are urged to contact their local healthcare provider for appropriate care.

This article originally appeared in the July 2003 issue of aakpRENALIFE, Vol. 19, No. 1.

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