You have been encouraged to reduce the phosphate in your diet to help manage your kidney condition. This booklet contains information about phosphate and how you can reduce the phosphate in your diet.
What is phosphate?
Phosphate is a mineral found in the body. It helps maintain healthy bones. Phosphate is also found in other tissues in the body and helps to keep the heart and blood vessels healthy. We get the phosphate we need each day from our diet.
What has phosphate got to do with the kidneys?
The kidneys help to control the level of phosphate in the body. When the kidneys are not working properly, the amount of phosphate in the body can build up and become too high. This can be seen from your blood test.
What happens if the blood phosphate level is too high?
If the blood phosphate level stays high, this can cause weak bones, painful joints and increase the risk of breaking bones. Phosphate can also mix with calcium in your body and cause blood vessels to harden. This increases your risk of heart disease.
What can I do to manage this?
Controlling your blood phosphate level can help to reduce these problems.
Your blood phosphate level can be controlled by:
- Reducing the phosphate in your diet
- Taking tablets called ‘phosphate binders’
- Completing each scheduled dialysis session
Which foods and drinks contain phosphate?
Controlling your blood phosphate level can help to reduce these problems. Your blood phosphate level can be controlled by:
- Reducing the phosphate in your diet.
- Taking tablets called ‘phosphate binders’.
- Completing each planned dialysis session.
Which foods and drinks contain phosphate?
Phosphate is found in many foods and some drinks. Meat, poultry, fish, eggs and dairy foods, including milk, yoghurt and cheese all contain phosphate. About half of the phosphate in these foods is taken up by the body.
Pulses (e.g. beans, lentils), cereals, nuts, seeds also contain phosphate. Less than half of the phosphate in these foods is taken up by the body.
Processed foods often have phosphate added to them. Phosphate is added to foods and drinks as an additive to improve theIr taste and texture and extend their shelf life. Most of this phosphate is taken up by the body.
Recommendation
It is recommended that you limit the phosphate that comes from phosphate additives.
How can I reduce the phosphate in my diet?
Reduce your intake of foods that contain phosphate additives, these can include:
- processed meats and poultry products e.g. some brands of ham, bacon, sausages, chicken coated in breadcrumbs, chicken and turkey slices
- processed fish products e.g. fish coated in batter or breadcrumbs
- processed cheese slices and spreads
- processed potato products e.g. waffles, croquettes
- instant pastas with sauce, instant noodles
- bakery products e.g. crumpets, scones
- dark carbonated (fizzy) drinks e.g. colas.
How will I know which foods contain phosphate additives?
Phosphate additives are listed as an ingredient on the food label. They are shown either by an E number or a chemical name. Try to limit foods and drinks that contain the phosphate additives shown in the table below:
Phosphate Food Additives
For example, these are the ingredients for an instant coffee latte drink:
Sugar, Skimmed Milk Powder, Glucose Syrup, Coconut Oil, Coffee, Lactose, Natural Flavourings, Salt, Acidity Regulator (E340), Stabilisers (E331, E452).
If the phosphate additive is listed by its chemical name, it may be easier to look for an ingredient that includes the letters ‘phos’, e.g. these are the ingredients for a honey roast ham:
Pork (96%), Honey (4%), Salt, Sugar, Stabilisers: Triphosphates; Antioxidant: Sodium Ascorbate; Preservative: Sodium Nitrite.
Back to topTips on reducing phosphate additives
- Prepare meals with fresh meat, poultry and fish, where possible.
- Choose the best quality meat within your budget.
- Check food labels regularly and swap to brands that do not contain phosphate additives, where possible.
- If using processed meats, try to serve with fresh potatoes, rice or pasta and fresh or frozen vegetables.
- Make your own sauces to serve with rice or pasta.
- Limit fast food takeaways to an occasional treat.
- Reduce your intake of foods naturally high in phosphate Phosphate is found in high amounts in dairy foods. Phosphate is also found in meat, poultry, fish, eggs and pulses. All these foods can still be eaten as they provide protein, vitamins and minerals. The renal dietitian will check the protein in your diet and advise you on eating the right amount.
Phosphate is found in large amounts in dairy foods. Phosphate is also found in meat, poultry, fish, eggs and pulses. These foods can still be eaten as they provide essential protein, vitamins and minerals. However the renal dietitian will check the protein in your diet to make sure you are eating the right amount.
The following food and drink alternatives can help you make choices to reduce your intake of foods naturally rich in phosphate. Try to choose mainly the foods that are lower in phosphate and limit high phosphate foods to only occasionally.
If you have any other dietary needs (e.g. diabetes, coeliac disease, following a weight reducing diet), it is important you continue with these diets.
Back to topDairy and non-dairy alternatives
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- If you need to use extra milk in a day, a milk substitute can be made with 2 parts double cream to 1 part water.
- Organic non-dairy drinks are lower in phosphate than cow’s milk. Check the label and try to avoid the non-dairy drinks that contain phosphate additives.
Choose from these lower phosphate foods
Limit these high phosphate foods
Meat, fish and protein alternatives
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- *Check the food label and try to choose meats and meat products without phosphate additives.
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- *Check the food label and try to choose brands without phosphate additives.
- Remove edible fish bones as they contain phosphate.
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- A portion of pulses can replace a portion of meat or fish as they are a good source of protein. Try to avoid eating pulses at the same meal with meat, poultry or fish.
- If you are vegetarian, continue having pulses as usual.
- Nuts are high in phosphate but are a good source of protein. If you wish to include them, please discuss with the dietitian.
Bread, rice, pasta, potatoes and other starchy foods
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- Baking powder is high in phosphate. Try to limit its use.
- Self-raising flour has some baking powder already added to it. Try to use in moderation.
- Plain flour is low in phosphate and can be used freely.
Other information
There is no need to limit your intake of fruit and vegetables unless advised differently by the dietitian
Foods high in fat and/or sugar
Choose from these lower phosphate foods
Limit these high phosphate foods
Tip
- *Shop-bought cakes and biscuits often contain phosphate additives. Check the label and try to choose cakes and biscuits without phosphate additives.
- Home-made cakes and biscuits still contain some phosphate as the recipe often uses self-raising flour or baking powder (see tips on page 11). Cakes and biscuits made with plain flour and no added baking powder will be lower in phosphate.
- Choose biscuits or confectionary with a thin coating of chocolate e.g. Blue Riband, single Twix.
- Cream or creme fraiche are lower phosphate alternatives to custard or ice-cream to serve with puddings.
Drinks
Choose from these lower phosphate foods
Limit these high phosphate foods
Tips
- For a milky coffee that is lower in phosphate – add a little hot milk to an Americano.
- If you prefer to have a milky barista-style coffee e.g. latte, choose the smallest size available and include as part of your milk intake for the day (see page 6).
- If drinking cola, choose one that does not contain phosphoric acid.
Information contained in this booklet is correct at the time of production. Manufacturers are continually changing the ingredients of their products and altering portion sizes. Such changes may affect the phosphate content of these foods.
Useful websites
Phosphate binders
If your blood phosphate level remains high, you may be prescribed a phosphate binder to help lower the level. Phosphate binders are available in different forms, including tablets and powders.
Back to topWhen do I take phosphate binders?
Phosphate binders must be taken with meals or snacks, including when you eat away from home. They should be taken whenever you eat high phosphate foods (e.g. dairy foods, eggs, meat, fish or pulses). The timing of your phosphate binders depends on the type you have been prescribed.
Your doctor will recommended when to take your phosphate binder and the dosage.
If you do not have anything to eat at a mealtime, do not take a binder. Taking binders at the wrong time can cause side-effects such as stomach pains and could also lead to a high level of calcium in the blood.
If you are unable to tolerate the phosphate binder prescribed, please speak to the Renal Dietitian.
How can I remember to take my phosphate binders?
- Keep them in your cutlery drawer, on your table or where you eat your meals.
- Set a reminder on your mobile phone to go off at mealtimes.
- Ask the dietitian for a small pot for your phosphate binders, then keep a supply in your jacket pocket or handbag for when you are away from home.
- If you attend dialysis, bring your phosphate binder to have with your sandwich or snack, while you are on dialysis.
Your diet and phosphate binders may change depending on your appetite and any other medications and treatment for your kidney condition.
If you find following a low phosphate diet limits your food intake, please discuss this with the Renal Dietitian. They can discuss with the Renal Doctor if it is useful to start a phosphate binder, or to increase your dose of binders if you are already taking them. Please do not alter your dose of binders without medical advice.
If you have any suggestions or comments regarding this leaflet, please let your dietitian know.
The information contained within this leaflet is intended for your specific needs and should not be passed on to anyone else.
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