Why do I need to eat less phosphate?
Phosphate (also known as phosphorus) is found in a variety of foods. It is needed for healthy bones. The kidneys help control the amount of phosphate in the blood and when they are not working properly, the level of phosphate in the blood can rise.
The normal range for blood phosphate is between 0.8mmol/l and 1.5mmol/l.
High levels of phosphate can cause:
- Hardening of blood vessels.
- Damage to your heart.
- Weak bones.
- Aching joints.
- Itchy skin.
- Sore eyes.
How can I control my phosphate levels?
You can help to lower phosphate levels in your blood by reducing foods that are high in phosphate. If your phosphate levels stay high you may be prescribed tablets called phosphate binders. These are taken with food to reduce the amount of phosphate absorbed from food. The dietitian can give you more information on how and when to take these tablets if they are prescribed.
How can I eat less phosphate?
- Avoid phosphate additives where you can and eat more fresh foods.
- Choose foods lower in phosphate.
- Choose meals based on beans, lentils, tofu or Quorn when you can (instead of meat, fish and dairy foods).
- Eat moderate amounts of dairy foods.
- Eat the right amount of protein for you.
If you are following another diet please remember to continue. Your dietitian can help you with this.
Eating less processed food
- Processed foods and ready meals can be high in phosphate if additives containing phosphate are used to preserve or flavour the food.
- The phosphate from the additives is well absorbed by your body. Additives can have a large effect on your blood phosphate levels.
- Choose fresh, unprocessed food to help you eat less phosphate from additives.
The table in the section below shows a list of additives containing phosphate.
Your dietitian can also give you a phosphate additives card to help identify these on labels when shopping.
Phosphate additives
| E number | Name | Where found |
|---|---|---|
| E338 | Phosphoric acid | Processed meat, sweets, cakes, chocolate, cola drinks |
| E339 | Sodium phosphates | Dried milk powder, canned soup, breaded chicken and fish, UHT |
| E340 | Potassium phosphates | Processed meats and cheeses, sports drinks, dried milk powder |
| E341 | Calcium phosphates | Shop-bought desserts and powder dessert mixes, instant pasta mixes |
| E343 | Magnesium phosphates | Bakery products, liquid egg, salt substitutes |
| E450 | Diphosphates | Bakery products, processed meat and cheeses, soups and sauces |
| E451 | Triphosphates | Processed cheese, icing sugar, flavoured syrups |
| E452 | Polyphosphates | Processed potato products |
How do I eat fewer phosphate additives?
You will always see the name of phosphate additives, or their E numbers listed on the ingredients labels where they have been used. Look out for additives with ‘phos’ in their name as these will contain phosphate. You may be able to swap to a different brand without additives.
To help you avoid phosphate additives, here are some examples of food labels showing how phosphate additives are listed on a food label.
Sausages
Cake
If a food contains phosphate additives try checking other brands or similar alternatives to find one without.
Eating moderate amounts of dairy foods
Dairy foods such as milk, cheese, yoghurts and eggs contain phosphate. They are also good sources of protein and calcium which are essential for a healthy diet. It is recommended that you eat moderate amounts of these foods.
A healthy amount for most people is 2 portions per day from this list
- 1/3 pint or 200ml milk per day (including milk in drinks, puddings and sauces).
- 125g or a small pot of yoghurt per day.
- 1oz or 30g cheese (size of a small matchbox) per day.
Tip – cottage, ricotta, and cream cheese are lower in phosphate. Your dietitian can advise you on appropriate portion sizes.
Eggs
A healthy amount for most people is 4-6 per week. Your dietitian may advise on a different amount for you.
Choosing foods lower in phosphate
| Food | Lower phosphate foods - Your dietitian can advise you on amounts to eat. |
|---|---|
| Meat | Fresh meat e.g. beef, lamb, pork, chicken, turkey |
| Fish | Fresh fish e.g. haddock, cod, salmon, trout. Tinned tuna, salmon or mackerel - without bones |
| Shellfish | Tinned crab |
| Cheese | Eat in moderation. See above |
| Milk | Eat in moderation. See above |
| Potato products | Any fresh potatoes |
| Nuts/seeds | Chestnuts |
| Snacks | Popcorn, breadsticks, prawn crackers, corn snacks, pretzels, potato crisps |
| Breakfast cereals | Weetabix, cornflakes, porridge, rice krispies |
| Bread | White, wholemeal, granary bread, pitta, croissants, english muffins |
| Cakes | Madeira cake, doughnuts, meringues, jam swiss roll, danish pastry (without nuts), jam tart, iced bun |
| Biscuits | Plain biscuits, cream biscuits, shortbread, plain crackers e.g. water biscuits, cream crackers |
| Confectionary | Fruit pastilles, boiled sweets, sherbet, peppermints, marshmallows, chewing gum, turkish delight, fruit gums |
| Drinks | Tea, coffee, herbal tea, drinking chocolate made with water, fizzy drinks (except cola), fruit squash, fruit juice. Spirits, sherry, cider, white wine |
| Miscellaneous | Jam, marmalade, honey |
Higher phosphate foods to limit
| Food | Higher phosphate foods |
|---|---|
| Meat | Liver, liver sausage, liver paté, saveloy sausage |
| Fish | Sardines, pilchards, whitebait, fish paste |
| Shellfish | Scampi, fresh crab |
| Cheese | Cheese spread, processed cheese e.g. cheese triangles |
| Milk | Condensed milk, evaporated milk, coconut cream, coconut milk, dried milk powder |
| Potato products | Frozen, chilled, dried potato products e.g. chips, waffles, instant mashed potato |
| Nuts/seeds | All other nuts, seeds, pine nuts |
| Snacks | Twiglets, oriental mix |
| Breakfast cereals | Muesli, cereals with nuts or chocolate |
| Bread | Naan bread, crumpets |
| Cakes | Scones, muffins, chocolate cake, packet cake mixes |
| Biscuits | Biscuits with nuts, seeds or chocolate, oat cakes, cereal bars |
| Confectionary | Chocolate, marzipan, fudge |
| Drinks | Cocoa, Ovaltine, Bournvita, Horlicks, milk shakes, cola, drinking yoghurts. Guinness, stout, red wine |
| Miscellaneous | Marmite, peanut butter, pesto |
Useful websites
Patients Know Best
An easy-to-use online service that allows you to monitor your own blood test results. You can find out more and register to use it at:
Register to Patients Know Best - Patients Know Best
Kidney Kitchen
Kidney-friendly cooking and eating, information, recipes and Kidney Kitchen videos.
Next steps: what I can do to help control my phosphate
It can be helpful to write down what you can do to help control your phosphate.
Contact your dietitian if you need further help.
© North Bristol NHS Trust. This edition published August 2023. Review due August 2026. NBT003420.
Contact Nutrition & Dietetics
Kendon House
Kendon Way
Southmead Hospital
Bristol
Telephone: 0117 414 5428 or 0117 414 5429
