When you have kidney disease you need to be careful with your phosphorus intake. This is because eating foods containing this mineral can lead to high phosphorus levels. Read on to learn about the importance of this nutrient and how a kidney diet containing low phosphorus foods can prevent further damage to the kidneys.
Table of Contents
What is Phosphorus?
Phosphorus is an essential mineral that exists in two forms:
Organic phosphorus is phosphorus that occurs naturally in foods. It also makes up your bones, teeth, DNA, and cell membranes.
Inorganic phosphorus is made in a lab. It is added to food as a preservative. Inorganic phosphorus is more dangerous for people with kidney issues.
What is the Function of Phosphorus in the Body?
Phosphorus is needed for healthy bones. Other benefits of phosphorus include the following
- Energy production
- Regulating gene function
- Balancing body pH
Additionally, phosphorus regulates vitamin D and parathyroid hormone (PTH) levels needed for bone growth.
How Much Phosphorus Per Day Is Needed for Body Function?
Phosphorus has a daily intake set at 1,250 mg per day for adult men and women 18 years and older.
Normal blood phosphorus levels should fall between 2.5 to 4.5 mg/dL (0.81 to 1.45 mmol/L).
Healthy kidneys are needed to keep phosphate levels regulated. They will filter extra phosphorus from the blood and move it out of the body via the bladder.
On the other hand, damaged kidneys lose their ability to function. So people with chronic kidney disease (CKD) will have trouble filtering phosphorus out of the body.
Too much Phosphorus Can Be Dangerous
You want to be in a safe zone when it comes to phosphorus. According to the National Kidney Foundation, too much of this nutrient is dangerous to the body.
As a patient with CKD, it is important to learn how to manage your phosphorus levels.
If you don’t know your status, ask a member of your healthcare team where your phosphorus lies. Write the number down and keep track of how it’s doing from that point.
Too Much Phosphorus in the Diet Leads to High Phosphorus Levels
Damage from CKD and other kidney disorders like polycystic kidney disease weaken kidneys leaving them unable to properly filter phosphorus.
Eating foods high in phosphorus will also elevate blood levels of this nutrient. As a result, further damage to the kidneys and overall health will ensue.
Signs of High Blood Phosphorus
One way to tell if you have high blood phosphorus is to be on the lookout for symptoms of high phosphorus. They include:
- High blood pressure
- Weakened bones
- Low vitamin D status
- Reduced calcium levels
- Muscle cramps or spasms
- Numbness or tingling around the mouth
- Bone and joint pain
- Itchy skin
Elevated phosphorus levels can also result in calcium deposits in the blood vessels, lungs, eyes, and heart. This can increase your risk of cardiovascular disease, stroke, and death.
These side effects of high phosphorus are not visible. Consequently, they are only discovered through clinical lab testing.
How to Lower Phosphorus Levels with Low Phosphorus Foods
Are you suffering from any of the symptoms above? Have you been told your phosphorus level is elevated?
Unfortunately, low phosphorus levels will not magically change all by themselves. Like other aspects of kidney disease, lowering phosphorus levels requires a little work on your part.
The biggest factor in influencing phosphorus is diet. So if you’re left wondering what should I eat if my phosphorus is high? Have no fear, the answer is simple. Incorporate more low phosphorus foods.
What Foods Contain Phosphorus?
To figure out how to lower your blood phosphorus we must first establish what are the foods that contain phosphorus.
Dietary phosphorus sources include both foods that naturally contain this mineral and those that have had it added during food processing.
The foods containing phosphorus include many food groups. Some examples of phosphorus-rich foods are
- Animal proteins
The body soaks up phosphorus in some foods more easily than others. Animal sources of phosphorus have an absorption rate between 40 and 70 percent. This is higher than plant sources.
The best source of phosphorus comes from dairy products making up about 20 percent of the total intake in the United States.
The phosphorus content of foods varies from high to low. Below we will go over a list of both high and low phosphorus foods.
What Foods Are High in Phosphorus?
You may be wondering what foods to avoid if phosphorus is high? This section will tell you exactly what you should steer clear of if you have high blood phosphorus.
We have put together a handy list of food high in phosphorus for your convenience. High phosphorus foods include the following:
Foods High In Phosphorus Chart
Yogurt (not Greek)
Nuts, Seeds, & Legumes
Pork and beans
|Whole grains||Bran cereal and other bran products (bran muffin)|
Dark colas with milk
Canned/bottled iced teas
Pepper-type soda (Dr. Pepper)
|Other||Most processed/prepared foods|
Many deli meats/hot dogs/bacon/sausage
Some of the other foods highest in phosphorus include those with phosphate additives. They will contribute between 300 and 1,000 mg of phosphorus to the diet. Approximately between 70 and 100 percent of inorganic phosphorus is absorbed when these substances are consumed.
Drinks and foods with phosphate additives are those that have phosphorus added during processing. To check the food for inorganic phosphorus all you have to do is look at the ingredient list. If you see the words “PHOS” it means the food contains a phosphorus additive.
Here is a list of common phosphate additives added to foods:
- Dicalcium phosphate
- Disodium phosphate
- Monosodium phosphate
- Phosphoric acid
- Sodium hexameta-phosphate
- Trisodium phosphate
- Sodium tripolyphosphate
- Tetrasodium pyrophosphate
You want to limit or avoid high phosphorus foods, especially phosphate additives, as much as possible. Instead, focus on adding more low phosphorus foods to the diet.
What Foods Are Low in Phosphorus?
To keep phosphorus levels in check and prevent any further kidney damage, you need to start a low phosphorus diet.
This means adding more low phosphorus foods into your meals. To make this more digestible (pun intended) for you below we will discuss the various categories of foods with low phosphorus. They are
- Meats and Poultry
- Grains, Breads, and Pasta
- Snack foods
- Foods low in phosphate additives
Low Phosphorus Vegetables
If you’re wondering which vegetables are low in phosphorus, the answer is basically all of them. For a complete list of vegetables low in phosphorus check out this renal grocery list.
The National Kidney Foundation also recommends carrot sticks and cucumbers as two great low phosphorus foods to add to the diet.
Low Phosphorus Fruits
Foods low in phosphorus include fruits. The following fruits have been regarded as good low phosphorus foods to eat:
- Canned Apricots
- Canned cranberry sauce
- Canned or Fresh figs
- Fruit cocktail
- Mandarin oranges (canned)
- Passion fruit
However, the way the fruit is prepared can increase the amount of phosphorus. As a result, packaged/processed fruits should be avoided if phosphorus control is an issue.
Low Phosphorus Dairy
- Cottage cheese
- Vegan cheese
- Greek yogurt
Phosphorus in milk is easily absorbed. Therefore, completely eliminating this food is necessary to lower phosphorus levels. Rice milk and almond milk are two low phosphorus foods that can substitute in place of regular milk.
Read more about milk and kidney disease in this post.
Low Phosphorus Meats and Poultry
Low phosphorus meats and poultry include the following foods:
- Egg whites
However, many types of meat have injections and additives that can include phosphorus. Be sure to read the label. If ordering at the butcher counter, ask if there have been any enhancements to the meats.
Warning: they won’t always know what has been put in the meats. This is why meats may seem low in phosphorus when they are actually not.
Low Phosphorus Fish/Seafood
Fish and seafood are low phosphorus foods that can be added to your diet. Fish that have been recommended are
- Canned (phosphate additive free) tuna and salmon
- Fresh cod, haddock, salmon, tuna
- Fish sticks (no phosphate added)
- Crab sticks
Frozen fish and seafood often have added phosphates used as preservatives. Again, this is not recommended and would not be considered a low phosphorus food.
Low Phosphorus Pasta, Grains, and Breads
Whole grains may be high in phosphorus, their low absorption rate makes them qualify as a low phosphorus food. These foods also offer fiber which is an essential nutrient for kidney disease and its associated health conditions. So feel free to add pasta, grains, and breads like these to your diet
- Brown rice
- Wild rice
- Whole wheat bread bagels, and buns
- Wheat berries
Low Phosphorus Beverages
When we think of low phosphorus foods we may not take into account the phosphorus in our beverages. So it is important to look at what you are drinking to avoid any added phosphorus from beverages.
To limit your phosphorus incorporate these drinks instead:
- Rice milk (unenriched)
- Apple juice
- Cranberry juice
- Grape juice
- Ginger ale
- Lemon lime soda
- Orange soda
- Root beer
Read more about kidney-friendly drinks in this post.
Low Phosphorus Snacks
Just because you have kidney diseases does not mean you can’t indulge in a snack every once in a while. The problem with many snack foods is they contain inorganic phosphorus. So ultimately, they will have an unhealthy amount of phosphorus.
This snack list offers low phosphorus foods to keep your blood phosphorus regulated:
- Rice cakes
- Pretzels unsalted
- Popcorn unsalted
- Crackers unsalted
- Sugar cookies
If you’re interested in learning more about a low phosphate diet check out this post.
A Nutrition Facts Label Identifies Low Phosphorus Foods
If you’re worried about how to find packaged foods low in phosphate you’re in luck! This section will tell you exactly how to spot those high phosphorus foods.
What you need to do is go to the food’s nutrition facts label and look for the ingredient list. Scan the list from top to bottom for the word “PHOS.”
It will usually be attached to another ingredient name like “sodium hexametaphosphate.” This tells you that there is phosphorus in the product. If you see PHOS put it back on the shelf and look for another product without the phosphate additives.
Doing this will ensure you are getting only low phosphorus foods.
For more tips and tools on spotting phosphorus in your food check out this post.
Phosphorus Levels Affects Other Nutrient Levels
The thing to remember about nutrients in the body is that they work in tandem sometimes. So the levels of one mineral can affect another. Three nutrients that are affected by phosphorus include
Calcium and Phosphorus
Earlier we briefly talked about how elevated phosphorus levels can lead to a reduction in calcium. This is dangerous for bone health.
When phosphorus is high the body will want to right its calcium level. So then the body will take calcium from the bone to compensate for the low blood levels. As phosphorus levels rise calcium will continue to be taken and bone health is at risk.
The recommended calcium to phosphorus ratio should be 2 to 1. Preventing bone breakdown starts with getting low phosphorus foods and adequate calcium in the diet.
Potassium and Phosphorus
The relationship between potassium and phosphorus is less known than that of calcium and phosphorus. However, some research showed a low potassium diet could also impact bone health.
So anyone with an intake of low phosphorus and potassium foods needs to make sure they get enough nutrients to compensate for potential bone problems.
Phosphorus and Sodium
The relationship between phosphorus and sodium is different from other nutrient interactions. Instead, it is the effects when these two electrolytes are combined that are of importance.
The mixture of phosphorus and sodium is very harmful to people with CKD. Excess intake of these nutrients can lead to heart and bone disease.
Additional Ways to Lower Phosphorus Levels
Sometimes incorporating low phosphorus foods may now be enough to reduce phosphorous levels. Additional interventions may be needed. They include
- A kidney transplant
Phosphorus Medication Helps Lower Phosphorus Levels
Phosphorus medication can be given to lower phosphorus levels. They are called phosphate binders. These should be taken with meals and snacks.
They come in a pill, chewable tablet, powder, or liquid form. Some examples of phosphate binders include
- calcium carbonate
- calcium acetate
- sevelamer hydrochloride
- lanthanum carbonate
- magnesium hydroxide
Natural phosphorus binders are made from food or vitamins. Niacin, nicotinamide, and chitosan chewing gum fall into this category. The research has not proved these products to be as effective as other phosphate binders.
Consequently, there are also side effects of phosphate binders. They include nausea, diarrhea, constipation, abdominal pain, gas, and changes in stool color. Side effects are often seen with initial use and will often subside after a few weeks.
Some binders also contain calcium, while others do not. Phosphate binders should only be taken under the supervision of your doctor or renal RD. If you are curious about these medications ask your healthcare team to know if binders are right for you.
Learn more about phosphate binders in this post.
Dialysis Can Help Lower Phosphorus Levels
Dialysis will also remove excess phosphorus from the blood. However, you still need to regulate phosphorus levels between dialysis treatments to prevent phosphorus buildup. So you still may need to implement low phosphorus foods into the diet.
If you are on dialysis and still have high phosphorus levels. Ask your doctor and renal RD what you should be doing between dialysis treatments.
A Kidney Transplant Can Lower Phosphorus Levels
Having a kidney transplant can also lower phosphorus levels.
See A Renal Dietitian for More Help with Low Phosphorus Foods
If you’re wondering how much phosphorus is allowed on a renal diet. It depends on the person.
Your renal dietitian can help determine your phosphorus needs. If you have a restriction they will help you find low phosphorus foods and create a meal plan that is just right for you.
Learn about working with a dietitian at Plant-Powered Kidneys here.
Phosphorus is an essential nutrient that is found in foods and is also added during food processing. It is needed by the body to produce energy, maintain bone health, regulate DNA, and balance pH levels.
Phosphorus levels depend on the kidneys’ filtration system. Unfortunately, damage from health conditions like CKD causes high levels of phosphorus to build up in the blood.
As a result, individuals with kidney damage need to limit their intake of foods high in phosphorus. One way to regulate phosphorus levels is through consuming more low phosphorus foods. These can be found among all food groups and can be easily integrated into the diet with the help of your renal dietitian.
If diet alone is not cutting it you can talk to your healthcare team about additional treatments that may lower phosphorus levels and prevent the kidneys from further harm.
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