Your Guide to the New Food Label

In 1994, the Food and Drug Administration (FDA) introduced a new food label. The Nutrition Facts Label helps us understand the nutrients that each food adds to our diet. All items on the label can be trusted as true information about the product to be eaten. This fact sheet will help you “label read” to meet your needs on a special diet. New labels have percent daily values listed for a set group of nutrients. These values are based on the FDA recommended 2000 calorie diet. Using percent daily values can help you choose foods that are within your special diet needs. The Nutrition Facts Table lists the items that are required by law to be listed on food products. Food labels can help you see which foods are best choices for your diet. All ingredients are listed in order by weight, with the item of the most weight listed first. If an ingredient is listed at the end, a very small amount was used in the product. Look at the list of Ingredients to Avoid for help in reading the labels. Ask your dietitian to help you look at labels to best meet your needs.

Serving Sizes

The serving size listed tells what a single portion of a food is. The rest of the information on the label tells information about the serving size listed. If larger or smaller amounts of the food are taken, use the information on the label to figure out the nutrients for the portion you are going to eat. Be aware that the serving sizes listed may not be the same as the exchanges on your diet plan. Talk with your dietitian about how to use serving sizes to meet your needs. See “Putting it All Together,” below, for portion sizes for CKD.

Calories

Calories tell the energy found in a serving of the food. If you are trying to lose weight, you may be looking for foods with less calories per serving. If you need to gain weight, look for foods with more calories per serving. Ask your dietitian what is best for you.

Fat and Cholesterol

Many people with CKD are on low fat and low cholesterol diets. Look at fat and cholesterol daily values to choose lower fat items, limit cholesterol and saturated fats. Look for foods with less than 10% daily value of saturated fat and less than 7% daily value of cholesterol. Choose lean or extra lean meats with just 7.5 - 15% daily value of total fat. If you need to gain weight, higher fat foods may be ok. Talk with your dietitian about your needs.

Sodium

Many people with CKD limit their use of sodium. In general look for foods that have no more than 6 to 10% of the daily value for sodium. Many low sodium products have added potassium. Look for potassium chloride in the ingredient list. If listed, be aware that the product will have high potassium content. Caution should be taken if you are on a potassium-restricted diet.

Carbohydrate, Sugars, and Fiber

If you have diabetes, this information is important for you. Choosing foods with less sugar and more fiber will help with your diabetes control. The total carbohydrate grams per serving will help you with carbohydrate counting and balancing your meals. Every 15 grams of carbohydrate equals one bread/starch portion for diabetic and for CKD diet. A good source of fiber will have at least 10% of the daily value, while a high fiber food will have at least 20% daily value.

Protein

Protein is very important for keeping you healthy. Use the label, looking at the grams of protein listed. Each 7 grams listed equals one ounce of protein, or one meat serving on a diet exchange system.

Label Protein	Meat Servings
7 grams	1
14 grams	2
21 grams	3

Ask your dietitian how much protein you need daily.

What about Potassium and Phosphorus?

Potassium and phosphorus may be listed as percent daily values, but it is not required. If potassium and phosphorus are not listed, it does not mean that they are not in that food. If percent daily values for potassium and phosphorus are listed, you can use them to help with your diet. Percentages for potassium and phosphorus are based on the Recommended Daily Allowances (RDA). The RDA is a guideline for the needs of healthy adults. Your needs are different when you have CKD.

In general:

Potassium Low	Medium	High	Very high
<100mg	101-200	201-300	>300
<3%	3-6%	6-9%	over 9%
Percentages based on daily value for US food labeling - potassium 3500mg

Phosphorus Low	Medium	High
<50mg	51-150mg	>150mg
<5%	5-15%	>15%
Percentages based on daily value for US food labeling - phosphorus of 1000mg

Ask your dietitian about your potassium and phosphorus needs. Some foods with higher levels may be on your plan if they are good sources of protein.

Pulling it All Together

Know the portion sizes for your diet plan:

Food Group	CKD Diet
Milk	4 oz or ½ cup
Milk Substitute	4oz or ½ cup
Pasta, rice, cereal	½ cup
Bread	1 slice
Hotdog or hamburger bun	½ bun
Meats, protein foods	1 oz
Vegetables, cooked	½ cup
Vegetables, fresh, raw	1 cup
Fruit, canned	½ cup
Fruit, fresh	1 small or ½ large
Juices	4 oz or ½ cup
Oils, margarine	1 teaspoon

Know your diet needs for Calories, Fats, Cholesterol, Carbohydrate, Protein, Potassium and Phosphorus. Ask your dietitian to help you. No single food will have all the nutrients at the levels you need. A balanced diet from a variety of foods will help you meet your needs.

In general look for items with:

Nutrient	Percent Daily Value
Total Fat	Under 20%
Saturated fats	Under 10%
Cholesterol	Under 7%
Fiber	Over 10%
Sodium	Under 6-10%
Potassium if listed	Under 6%
Phosphorus if listed	Under 5-15%

Look at certain foods and choose:

Food	Look for
Meats: lean and extra lean	Total fat 7.5 to 15%
Frozen meals	Sodium under 20%, Total fat under 15%
Margarine and Vegetable oils	Saturated fat under 10%
Deli meats	Total fat under 15%, Sodium under 20%
Vegetables	Sodium under 6%

Ingredients to Avoid

Banana, cheese, chocolate, cocoa, coconut, cream, dried fruit, dried peas and beans, lentils, melon, milk, molasses, nuts, orange, peanut butter, potassium chloride (KCl), potato, raisins, dark rye flour, frozen vegetables packed with sauce, spinach, tomato, wheat or oat bran, whole wheat.