Low Phosphate Dietary Advice
Date issued: October 2022
Review date: October 2024
Ref: C-354/dietetics/KO/Low phosphate dietary advice v3
PDF: Low phosphate dietary advice final October 2022 v3.pdf [pdf] 212KB
What is Phosphate?
Phosphate is a mineral that is found in a range of different foods. It helps to maintain healthy bones.
Why do I need to lower my phosphate levels?
The kidneys usually control the amount of phosphate that is in your blood. When the kidneys are not working properly phosphate levels can start to rise and this can lead to hardening of the blood vessels, weak bones and itchy skin. Prolonged high phosphate levels can also cause bony deposits, known as ‘calcification’, to form in the blood vessels, heart, skin, lungs and joints. Calcification increases the risk of heart attacks and strokes.
You can reduce your phosphate levels by:
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Limiting your intake of phosphate additives
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Reducing your intake of high phosphate foods
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Taking your phosphate binders (if you are prescribed them)
Phosphate additives
Many processed foods contain phosphate additives, which are often used as stabilisers and raising agents. This type of phosphate is more readily absorbed by the body than phosphate found naturally in food.
Check the ingredients list on food labels to see if they contain phosphate additives.
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Common phosphate additives:
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Food labels to check:
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Reducing your phosphate intake
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High in phosphate |
Lower phosphate alternative |
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Cheese: Hard or processed cheese Cheese spread e.g.Dairylea®/Primula®, Cheese sauces Limit cheese to 3-4 oz (90-120 g) per week Cow’s milk or milk alternative (fortified) - limit to ½ pint (300 mls) per day Evaporated or condensed milk Milk puddings and yoghurt (include in milk allowance) |
Cottage cheese, cream cheese Cream or crème fraiche |
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Processed meat: Pre-packed sliced meats, ham, processed meat products Offal (liver, kidney, pate) |
Unprocessed Meat: Beef, pork, lamb, chicken, turkey |
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Fish with edible bones e.g. mackerel, pilchards, sardines, whitebait, fish paste Shellfish: scampi, fresh crab, mussels |
Fresh unprocessed fish: Cod, haddock, salmon, trout, boneless tinned fish, tinned crab, scallops |
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Plant proteins: Baked beans, hummus, kidney beans Nuts and seeds |
Tofu, Quorn®, textured soya protein If you are a vegetarian, continue to use beans and pulses as a source of protein |
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Drinks: Dark coloured fizzy drinks e.g., Dr Pepper® & cola, drinking chocolate, malted drinks (Horlicks® & Ovaltine®), milkshakes, Bovril Alcoholic drinks: Lager, beer, stout |
Pale coloured fizzy drinks e.g. lemonade, tea, fruit squash, coffee, cordial Wine, spirits, cider |
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Confectionary: Chocolate, fudge, biscuits containing chocolate, nuts or seeds, cereal bars Cakes containing baking powder |
Fruit pastilles, boiled sweets, marshmallows, plain biscuits (gingernuts, digestives, rich tea), shortcake, doughnuts, cream cakes |
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Breakfast Cereals: All Bran®, Branflakes, Muesli, any cereals containing nuts or chocolate |
Cornflakes, Rice Krispies®, Special K®, Porridge oats, Weetabix® |
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Miscellaneous: Peanut butter, Marmite®, pesto, Bovril, instant sauces |
Jam, marmalade, honey
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Phosphate binders
If your phosphate levels remain high, or you are not able to follow a low phosphate diet, you may be prescribed phosphate binders. For these tablets to work effectively, they need to be taken immediately before, during or immediately after food.
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Renacet/Phosex (Calcium Acetate)
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Calcichew (Calcium Carbonate)
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Fosrenol tablets, Fosrenol powder (Lanthanum Carbonate)
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Renvela (Sevelamer Carbonate)
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Renagel (Sevelamer Hydrochloride)
If you have any issues with your prescribed phosphate binder, speak with your dietitian, consultant or specialist nurse who may be able to advise on a suitable alternative.
