Why is a low-phosphorus diet useful in managing kidney disease? What foods contain phosphorus?

Answer From Rachael Majorowicz, R.D.N., L.D.

Phosphorus is a mineral that's found naturally in many foods and also added to many processed foods. When you eat foods that have phosphorus in them, most of the phosphorus goes into your blood. Healthy kidneys remove extra phosphorus from the blood.

If your kidneys don't work well, you can develop a high phosphorus level in your blood, putting you at greater risk of heart disease, weak bones, joint pain and even death.

If you need to limit phosphorus

Your phosphorus needs depend on your kidney function. If you have early-stage kidney disease or you're on dialysis, you may need to limit phosphorus. Nearly every food contains some phosphorus, so this can be hard to do.

The best way to limit phosphorus in your diet is to limit foods highest in phosphorus, including:

  • Fast foods, foods sold at gas stations, and other packaged and convenience foods
  • Processed cheeses, such as American cheese and cheese spreads
  • Fresh or frozen meats that have added flavor or fluids to keep them moist
  • Cola and pepper-type sodas, many flavored waters, bottled teas, energy or sports drinks, many powdered drink mixes, beer, and wine

The table below gives examples of foods lower in phosphorus that you can substitute for foods higher in phosphorus. 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.

Higher phosphorus foods Lower phosphorus foods
Fast foods, convenience foods, restaurant meals and gas station foods Homemade meals or snacks made from fresh ingredients
Milk, pudding, yogurt, soy milk, nondairy creamers and enriched milks Unenriched almond or rice milk
Processed cheeses and cheese spreads A small amount of Brie or Swiss cheese
Fat-free cream cheese or fat-free sour cream Regular or low-fat cream cheese or sour cream
Ice cream or frozen yogurt Sherbet, sorbet or frozen fruit pops
Quick breads, biscuits, cornbread, muffins, pancakes or waffles Fresh dinner rolls, bread, bagels or English muffins
Processed meats, such as bacon, bologna, chicken nuggets, ham and hot dogs, and meat, poultry or seafood with "phos" in the ingredients Lean beef, eggs, lamb, wild game, or "all natural" poultry, seafood or other fish without "phos" in the ingredients
Chocolate or caramel, including chocolate drinks and candy bars Jelly beans, hard candy, fruit snacks or gumdrops (in moderation)
Colas and pepper-type sodas, some flavored waters, bottled teas, energy or sports drinks, beer, wine, and some drink mixes (any with "phos" in the ingredients) Lemon-lime soda, ginger ale, root beer, plain water and some drink mixes (any without "phos" in the ingredients); fresh-brewed coffee (made from beans) or brewed tea (made from tea bags)

Check food labels carefully

Manufacturers may add phosphorus when processing foods to thicken them, improve taste, prevent discoloration or preserve them. Check food labels to see whether any ingredients contain "phos" in the term. When trying to limit phosphorus, look for foods that don't list "phos" among the ingredients.

Examples of phosphorus food additives include:

  • Calcium phosphate
  • Disodium phosphate
  • Phosphoric acid
  • Monopotassium phosphate
  • Sodium acid pyrophosphate
  • Sodium tripolyphosphate

Fast foods, convenience foods, and processed meats and cheeses contain potentially large amounts of phosphorus.

Seek professional help

For help creating a meal plan that meets your needs, work with 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.

With

Rachael Majorowicz, R.D.N., L.D.

Oct. 31, 2018 See more Expert Answers

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