High Phosphate Foods Warning

As we explained in greater detail in Chapter 13, phosphorus (as inorganic phosphate) may accumulate in the blood of people with kidney failure, and can exacerbate kidney damage. Most patients following the very-low-protein diet do not have high blood phosphate levels, because low-protein foods are typically low-phosphorus foods as well. But occasionally people have a problem with high serum phosphate despite following the very-low-protein diet. They should consume high-phosphorus foods (see later) in limited amounts or avoid them entirely. Common foods in order of their phosphorus-to-calorie ratios are listed in Table 2. The reason for listing them in this order is the same as the reason for listing protein content in relation to calories: You are liable to limit your intake of these foods by satiety.

Most of this food phosphorus is in chemical forms other than inorganic phosphate, but it becomes a source of inorganic phosphate when eaten. This list of foods resembles the list in Table 1. However, there are important differences, because not all of the phosphorus in common foods is linked with proteins.

The only people who need to concern themselves with this second list are those whose serum phosphate concentration remains above normal (greater than 5 mg per dl) despite limiting their protein intake to 0.3 g per kg per day. These people should avoid, or consume only rarely and in small quantities, foods at the end of Table 2. Also, a number of instant beverages, sold as powders, contain added calcium phosphate to make the powder free-flowing; also avoid these (check the labels). Taking these measures will almost always bring serum phosphate concentration down into the normal range after a few weeks.

Table 2. Phosphorus Content of Common Foods Arranged in Order (Approximately) of Mg Phosphorus per 100 Calories

Food

Portion

Mg Phosphorus per Portion

Category I: Low-Phosphorus Foods

Vegetable oils

Margarine

Whipping cream

Mayonnaise

White wine

Corn flakes

Avocado

Apple

Pineapple

Apricot

Coconut, shredded Orange

Lemon meringue pie

Red wine

Pear

Dates

Chocolate

Watermelon

Grapes

1 tbsp 1 tbsp 1 tbsp 1 tbsp 1 glass 1 cup '/2 cup 1

1 cup

1 sector

1 glass 1

13 18 56 50

8 12

Food

Portion

Potato chips

10 chips

Rice

1 cup

Flour

2 tbsp

Butter

1 tsp

Grapefruit juice

1 cup

Banana

1

Boiled potato

1

Coca-Cola

12 oz

Pancakes

1 4-in cake

Macaroni

1 cup

Mustard

1 tsp

Rice Krispies

1 cup

Plum

1

Ketchup

3 tbsp

Figs

1

Honeydew melon

'/2 cup

Baked potato

1 small

Frankfurter

1

Beer

12 oz

Special K

1 cup

Tangerine

1

Peach

1

Sweet potato

'/2 cup

Prune

1

Sirloin steak

1 oz

Duck

1 oz

Ice cream

1 cup

Peanuts

2 tbsp

American cheese

1 oz

Bacon

1 slice

Sausage

1 oz

Tuna

1 oz

Orange

1 cup

Pork

1 oz

Grapefruit

1 cup

Lamb

1 oz

Chicken

1 oz

Mg Phosphorus per Portion 25 56

15 1

38 10 41 60 70 70

16 11

14 51 60 50 28

15 19 60

5 68 67 150 122 219 17 44 66 36 87 32 62

79 continued

Food Portion Mg Phosphorus per Portion

Food Portion Mg Phosphorus per Portion

Mushrooms

1 cup

81

Blackberries

1 cup

28

Whole wheat bread

1 slice

57

White bread

1 slice

24

Strawberries

1 cup

32

Carrots, cooked

1 cup

48

Corn

1 cob

69

Category II: Moderate-Phosphorus Foods

Raisins

1 cup

168

Oatmeal

1 cup

136

Peanut butter

2 tbsp

200

Cod

1 oz

78

Shredded Wheat

1 cup

158

Puffed Wheat

1 cup

48

Raspberries

1 cup

28

Turkey

1 oz

67

Onions, cooked

1 cup

62

Cantaloupe

1 cup

26

Cheddar cheese

1 oz

136

Green beans

1 cup

46

Haddock

1 oz

70

Milk

1 cup

228

Tomato, 2-in. diameter

1

25

Egg, large

1

103

Cottage cheese, creamed

1 cup

152

Salmon, fresh cooked

1 oz

117

Cabbage, fresh

1 cup

26

Peas

1 cup

158

Green pepper, fresh

1 cup

22

Brussels sprouts

1 cup

112

Radishes

1 cup

36

Calves' liver

1 oz

133

Lettuce

1 cup

118

Shrimp, cooked

1 oz

54

Lobster, cooked

1 oz

54

Cucumber

1 cup

Sardines Artichokes Coffee Tea

Portion

Mg Phosphorus per Portion 141 69 4 10

Sardines Artichokes Coffee Tea

Category III: High-Phosphorus Foods

Yogurt

1 cup

326

Skim milk

1 cup

234

Spinach, cooked

1 cup

68

Scallops

1 oz

95

Broccoli

1 cup

96

Rhubarb, cooked

1 cup

42

Cauliflower, cooked

1 cup

54

Okra

1 cup

66

Asparagus, fresh

1 cup

90

Oysters, raw

1 oz

91

Bran flakes

1 cup

125

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