The American Association of Kidney Patients (AAKP) and the Academy of Nutrition and Dietetics are among the organizations strongly against a proposed FDA rule change. The change being considered would amend the FDA “standard of identity” regulations that specify salt (sodium chloride) as a required or optional ingredient. The proposed rule would give manufacturers the flexibility to use salt substitutes in standardized foods. Such substitutes include potassium-based ingredients.
“If finalized, the proposed rule would support efforts to reduce sodium content in standardized foods and may help to improve consumer dietary patterns by reducing sodium consumption,” according to the FDA’s summary.
AAKP and the Academy of Nutrition and Dietetics signed onto an August 8 letter to the FDA to voice their concern and opposition. “Many people with CKD, including those with kidney failure, cannot properly excrete potassium,” the letter notes. “When a high amount of potassium is consumed, including through the consumption of artificially added potassium (e.g., salt substitutes) it accumulates in the person’s body. This elevated level of potassium, medically known as hyperkalemia, can cause cardiac arrhythmias and sudden cardiac death. Immediate medical attention is required should a person recognize the signs hyperkalemia. Given the very high estimates of those who are unaware they have compromised kidney function and the clinical consequences of hyperkalemia, adding ‘hidden potassium’ in the form of potassium chloride substitutes to the American diet is a risk that should not be taken.”
AAKP and the Academy did applaud the FDA for working to reduce sodium intake among people in the United States. “As we all know, packaged and prepared foods are the greatest source of both apparent and hidden sodium in the American diet,” according to the letter. “Excessive sodium intake contributes to the high rates of hypertension and chronic kidney disease (CKD) currently seen in the U.S. – and at alarmingly younger ages.”
The letter added, “While we support efforts to increase Americans’ intake of potassium for overall health, adding potassium chloride to lower sodium in foods may further inhibit our CKD patient population from increasing fruit and vegetable intake.”
The organizations strongly recommended that the FDA require clear labeling of added potassium to support high-risk populations making safe food choices.