Why is a low-phosphorus diet useful in managing kidney disease? What foods contain phosphorus?
Calcium and phosphorus, which are minerals, help build strong bones. Healthy kidneys help regulate the level of phosphorus in your blood by removing extra phosphorus. If your kidneys aren’t working properly, eventually you may have high phosphorus levels in your blood (hyperphosphatemia). A high phosphorus level increases your risk of bone disease and heart disease.
How much phosphorus is too much?
Your phosphorus needs may vary, depending on your kidney function. For adults with kidney disease, generally 800 to 1,000 milligrams (mg) of phosphorus a day is the limit. Many healthy adults eat almost double this amount.
Whether you have early-stage kidney disease or you’re on dialysis, you’ll likely be advised to limit your phosphorus intake. Nearly every food contains some phosphorus. A registered dietitian can help you choose foods that are lower in phosphorus.
Choose low-phosphorus foods
The best way to limit phosphorus in your diet is to limit foods highest in phosphorus, including:
• Fast food, convenience foods and processed foods, which may be full of phosphorus additives
• Beverages that contain phosphorus (look for the letters “phos” in the ingredient list)
Below is a partial listing of foods lower in phosphorus to help you identify substitutes for higher phosphorus foods. Although a food or drink may be low in phosphorus, you still need to watch portion sizes and limit the number of servings you eat or drink each day.
1-Instead of these higher phosphorus foods
2- Choose these lower phosphorus foods:
1-Milk, pudding, yogurt, soy milk, nondairy creamers and enriched rice milk
2-Unenriched rice milk
1-Processed cheeses and cheese spreads
2-A small amount of Brie or Swiss cheese
1-Hard cheeses, ricotta or cottage cheese, fat-free cream cheese
2-Regular or low-fat cream cheese
1-Ice cream or frozen yogurt
2-Sherbet, sorbet or frozen fruit pops
1-Soups made with higher phosphorus ingredients (milk, dried peas, beans, lentils)
2-Soups made with lower phosphorus ingredients (broth- or water-based with other lower phosphorus ingredients)
1-Whole grains, including whole-grain breads, crackers, cereal, rice and pasta
2-White bread, crackers, cereals, rice and pasta
1-Quick breads, biscuits, cornbread, muffins, pancakes or waffles
2-White dinner rolls, bread, bagels or English muffins
1-Dried peas (split, black-eyed), beans (black, garbanzo, lima, kidney, navy, pinto) or lentils
2-Green peas, green beans or wax beans
1-Processed meats, such as bologna, ham and hot dogs, and meat, poultry or seafood with “phos” in the ingredients
2-All-natural lean beef, pork, lamb, poultry, seafood or other fish without “phos” in the ingredients
1-Organ meats, walleye, pollock or sardines
2-All-natural lean beef, pork, lamb, poultry, seafood or other fish without “phos” in the ingredients
1-Nuts and seeds
2-Popcorn or pretzels
1-Peanut butter and other nut butters
2-Jam, jelly or honey
1-Chocolate, including chocolate drinks
2-Jelly beans, hard candy, fruit snacks or gumdrops
Colas and pepper-type sodas, some flavored waters, bottled teas, some drink mixes (any with “phos” in the ingredients)
Lemon-lime soda, ginger ale, root beer, plain water or some drink mixes (any without “phos” in the ingredients)
Check food labels carefully
Dozens of additives contain phosphorus. Look for any ingredient that contains “phos” in the term. Here are some examples:
• Calcium phosphate
• Disodium phosphate
• Phosphoric acid
• Monopotassium phosphate
• Sodium acid pyrophosphate
• Sodium tripolyphosphate
Manufacturers may add phosphorus when processing foods to thicken them, improve taste, prevent discoloration or preserve them. Check the ingredients on food labels to see if phosphorus has been added. If so, try to choose a similar food item that doesn’t have such additives or where “phos” is listed near the end of the ingredients.
Food manufacturers aren’t required to list the amount of phosphorus on food labels. Be aware that fast foods and convenience foods have potentially large amounts of phosphorus.
Seek professional help
For help creating a meal plan that meets your needs, consult a registered dietitian. A dietitian can make sure that you get enough nutrition while following your doctor’s medical recommendations.
Because it’s difficult to lower phosphorus in your diet, your doctor may recommend a phosphate binder medication to help control the amount of phosphorus your body absorbs from foods.
References
1. Chronic kidney disease evidence-based nutrition practice guidelines. Rockville, Md.: Agency for Healthcare Research and Quality. http://guidelines.gov/content.aspx?id=23924. Accessed Aug. 26, 2015.
2. Taal MW, et al. Chronic kidney disease-mineral bone disorder. In: Brenner & Rector’s The Kidney. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Aug. 27, 2015.
3. Phosphorus and your CKD diet. National Kidney Foundation. http://www.kidney.org/atoz/content/phosphorus.cfm. Accessed Aug. 26, 2015.
4. USDA National Nutrient Database for Standard Reference, Release 27. U.S. Department of Agriculture, Agriculture Research Service. http://ndb.nal.usda.gov. Accessed Aug. 27, 2015.
5. Tips for people with chronic kidney disease — Food label reading (fact sheet). National Kidney Disease Education Program. http://nkdep.nih.gov/resources/nutrition-food-label.shtml. Accessed Sept. 1, 2015.
6. What we eat in America, NHANES 2011-2012. U.S. Department of Agriculture. http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/1112/Table_1_NIN_GEN_11.pdf. Accessed Sept. 1, 2015.
7. Nutrition and chronic kidney disease (Stages 1-4): Are you getting what you need? National Kidney Foundation. http://www.kidney.org/atoz/pdf/NutriKidFail_Stage1-4.pdf. Accessed Sept. 1, 2015.
8. Berkoben M, et al. Treatment of hyperphosphatemia in chronic kidney disease. http://www.uptodate.com/home. Accessed Sept. 1, 2015.
9. Barbara Woodward Lips Patient Education Center. Making good phosphorus food choices. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
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