Low Phosphate Diet

Phosphorus (phosphate) is a mineral that is found in food. It helps your body make energy and keeps bones, teeth and muscles healthy. 

The level of phosphate in your blood can build up if your kidneys are not working as well as they should. High phosphate levels can cause itchy skin, red eyes and bone or joint pain. In the long term, high phosphate levels can affect your bones causing them to become weak and not grow properly. It can also lead to a build-up of mineral deposits causing damage to your heart and blood vessels, which can lead to heart disease.

Choosing low phosphate foods can help lower your blood phosphate levels. The foods listed below have been split into three categories to help you choose lower phosphate containing foods and suggests how often you can have them.

The categories are:

• Foods lower in phosphate – can have daily
• Foods moderate in phosphate – can have twice a week or as advised within the list
• Foods high in phosphate – avoid or limit to once a week

Meat

Foods lower in phosphate – can have daily

• Fresh, unprocessed beef, lamb, pork, chicken, turkey – ideally no larger than fist size (50g) 
• Home-made chicken nuggets, home-made beef burger, home-made meatballs

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Sausages (2)

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Processed meat e.g. chicken / turkey slices, chicken nuggets, meat pies, sausage rolls, Frankfurters, hot dogs, spam
• Offal e.g. liver, kidney, heart, brain and foods made from offal e.g. pâté, haggis, liver sausages
• Partridge, pheasant, pigeon
• Tinned meats, meat paste, pate

Fish

Foods lower in phosphate – can have daily

• Cod, crab (canned only), haddock, hake, halibut, lemon sole, mackerel, salmon (fresh or canned), scampi (canned), skate, plaice, trout, tuna (fresh or canned) – ideally no larger than fist size (50g)
• Cockles, mussels, prawns, squid (50g portions)
• Fish paste (thinly spread)
• Home-made fish fingers 

• Shop bought fish products / dishes: Fish cake (maximum 1 per day); fish fingers (maximum 2 per day); Fisherman’s pie, Kedgeree, seafood cocktail, seafood pasta

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Squid / calamari in batter 

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Anchovies, cod roe, cod (battered), coley, crab (boiled), herring, kippers, monkfish, pilchards, sardines, scallops, scampi (breaded), seabass, smoked salmon, smoked mackerel, swordfish 

• Fish products / dishes: Taramasalata, fish paste

Non-meat protein, beans and pulses 

Foods lower in phosphate – can have daily

• Butterbean (50g / day), broad beans (50g / day), chickpeas (50g / day), mushy peas (50g / day), red lentils (50g cooked / day), hummus (maximum 30g / day)
• Quorn pieces (50g / day)
• Tofu (50g) 
• Home-made vegetable burger

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Baked beans (135g)
• Brown / green lentils (50g cooked/day), Soya beans (50g cooked/day), Red kidney beans (50g) 
• Tahini paste (1 tablespoon) 

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Aduki beans, black eyed beans
• Nuts, seeds
• Quorn mince
• Quiche 

• Non-meat products / dishes: Processed bean burger, processed nut roast, processed veggie-burger, processed veggie-sausages

Dairy foods 

Foods lower in phosphate – can have daily

• Cottage cheese (50g)
• Cream cheese e.g. Philadelphia, ricotta, mascarpone (50g)
• Egg whites 
• Cream – double, single, whipping
• Tzatziki (1 tablespoon)
• Crème fraiche (60g)
• Milk substitutes e.g. Oat milk (avoid those containing calcium phosphate – check label) 
• Vegan, coconut or soya oil cheese

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Brie, camembert (50g)
• Yogurt, fromage frais, Greek yogurt 
• Ice cream 
• Custard

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Cow’s milk (dietitian will advise on your weekly allowance)
• Dried milk powder, UHT milk
• Most cheese e.g. Cheddar, Cheshire, Double Gloucester, 
  Edam, feta, Gouda, Gruyere, parmesan, paneer, Red Leicester, Stilton, processed cheese e.g. Dairylea, Laughing Cow (30g), Primula (30g), cheese slices (x2)
• Whole eggs or egg yolks (dietitian will advise on your weekly allowance)
• Tinned milk e.g. Marvel, condensed milk, evaporated milk
• Ice cream, Kulfi (Indian ice cream) 
• Milk puddings, instant dessert powder e.g. Angel Delight

Fruits and vegetables 

Foods lower in phosphate – can have daily

• No restrictions

Starchy foods 

Foods lower in phosphate – can have daily

• Rice, pasta, couscous, noodles
• Baked goods without phosphate-containing raising agents (avoid baking powder) e.g. croissants, English muffins, hot cross buns, white bread, pitta bread, chapattis
• Cornflakes, Cheerios, Frosties, Rice Krispies, Coco Pops, Weetos, Shreddies, Sugar Puffs, Special K, Weetabix (x1), porridge oats made with water
• Yorkshire pudding (x1 small)

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Brown rice, bread roll, granary bread, wholemeal bread
• Baked goods containing chocolate or nuts

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Baked goods with phosphate-containing raising agents (baking powder) e.g. scones, naan bread, tortilla wraps, crumpets, English muffins 
• Wheaten bread, soda bread, potato bread
• Bran based e.g. All Bran, Branflakes, Ready Brek, oat bran, muesli

Biscuits, cakes, sweets and snacks 

Foods lower in phosphate – can have daily

• Crepes, doughnuts, Digestives, Rich Tea, shortcake, shortbread
• Breadsticks (x3), Cream crackers, water biscuits
• Meringue 
• Boiled sweets, chewy sweets, jelly sweets, pastilles, gums, sherbets, peppermints, marshmallows, popcorn
• Teacakes, cream cakes, plain cakes

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Foods containing chocolate or nuts

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Rye crispbread e.g. Ryvita, oatcakes, seeded crackers, cheesy biscuits
• Bourbon creams
• Chocolate 
• Cereal bars containing chocolate or nuts/seeds
• Cake, biscuit, pancake and dessert mixes

Miscellaneous 

Foods lower in phosphate – can have daily

• Oxo (gravy only, not as drink due to salt content)
• Butter, margarine, cooking oils, jam, marmalade, honey, lemon curd, syrup, biscuit spread
• Mayonnaise (2 tablespoons), salad cream (1 tablespoon)
• Hummus, guacamole, sour cream (1 tablespoon)
• Sugar, pepper
• Yeast
• Bicarbonate, Cream of tartar
• Pickle (1 tablespoon), vinegar, tomato puree
• Gelatine

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Nil

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Nuts, seeds, trail mix, marzipan, chocolate (milk or white), chocolate flavoured products
• Marmite, mustard
• Desiccated coconut
• Packet cheese sauces
• Baking powder
• Instant noodle or instant pasta dishes

Drinks

Foods lower in phosphate – can have daily

• Water
• Squash/cordial
• Decaf tea, decaf coffee, herbal and fruit teas
• Light coloured fizzy drinks e.g. lemonade, Sprite, Tango, cherryade, Fanta, Lucozade

Foods moderate in phosphate – can have twice a week 150-180mg / per 100g (unless otherwise stated)

• Nil

Foods high in phosphate – limit to once a week >180mg / per 100g (unless otherwise stated)

• Dark fizzy drinks e.g. Coca-Cola, Dr Pepper, Dandelion & Burdock, Pepsi
• Malted drinks e.g. Bovril, Horlicks, Ovaltine, hot chocolate / cocoa
• Milkshake (see ‘Dairy food’ section for milk allowance)

Phosphate Additives 

Phosphate can also be added to your food (phosphate additives) to add flavour, colour or to extend the shelf life of the product. These are easily absorbed by the body and can significantly increase your phosphate blood levels.

Phosphate additives tend to be added to processed foods such as processed cheeses, processed meats e.g. sausages, frozen products e.g. chicken nuggets, fizzy drinks e.g. Coca-Cola and some bakery products e.g. naan bread.

Phosphate additives are included in the ingredients list, either by name or E number:

E338 Phosphoric acid 

E339 Sodium phosphates

E340 Potassium phosphates 

E341 Calcium phosphates 

E343 Magnesium phosphates

E541 Sodium aluminium phosphate

E450 Diphosphates

E451 Triphosphates

E452 Polyphosphates

Checking food labels 

Look for any of the above phosphate additives on your food label – avoiding any foods that contain the additive(s). For example:

Chicken nuggets –

Ingredients: Chicken Breast (51%), Breadcrumbs (Wholemeal Wheat Flour (7%), Wheat Flour, Fortified Wheat Flour (Wheat, Calcium phosphate, Iron, Niacin, Thiamin), Salt, Yeast, Paprika, Turmeric), Rapeseed Oil, Water, Fortified Wheat Flour (Wheat, E451, Iron, Niacin, Thiamin), Flour (Maize, Rice), Salt, Wheat Starch, Cornflour, Natural Flavouring, Onion Powder, Garlic Powder

Tips on taking your phosphate binder

• Check with your doctor, pharmacist or dietitian when is the best time to take your binder as this can vary depending on which one has been prescribed
• Avoid taking at the same time as your iron supplement 
  (if prescribed)