Low-Phosphorus Diet Guidelines

What is phosphorus?

Phosphorus is a mineral that works with calcium to strengthen bones. When the kidneys do not work well, phosphorus rises in the blood, and calcium is pulled from the bones. This causes your bones to become weak and could harden the blood vessels to the lungs, eyes, and heart.

How can phosphorus levels in the blood be controlled?

Phosphorus buildup can be controlled by cutting down on foods rich in phosphorus. Protein-rich foods tend to have large amounts of phosphorus, but some intake is needed to maintain good health and strong muscles. All foods that come from animals, such as meat and milk, and other non-meat foods, such

as dried beans and seeds, are high in phosphorus. It is important to keep consistent and eat the same amount of protein-rich foods daily. Plans for vegetarians or other special diets should be discussed with a Registered Dietitian.

If your blood phosphorus cannot be controlled by diet alone, you may need to take a phosphorus binder (Renagel®, Renvela®, PhosLo®, or Fosrenol®). These medications must be taken with meals and snacks as prescribed. If you take a calcium supplement, do not take it with the phosphorus binder.

Normal phosphorus range: 2.5 - 4.5 mg/dL

The following list of foods is a guideline. Many prepared foods (frozen, boxed, canned) may have phosphorus added as a preservative or additive. Also, baking mixes and baked goods often contain phosphorus as an anti-caking agent.

Be sure to read the ingredient list for any ingredients containing the word phos. If you have questions about specific foods, please ask your dietitian.

Food Group	Choose these	Instead of these
Fruits and vegetables Serving size is ½ cup unless otherwise indicated	5 - 6 servings per day Almost all fruits and fruit juices Green beans. Green peas Zucchini Summer squash Butternut squash Cauliflower Carrots Corn Asparagus Brussels sprouts Mixed vegetables that don't contain vegetables in the opposite column Okra Cabbage Tomato (raw) Canned beets	1 - 2 servings per week Artichokes Chickpeas Split peas Lima beans Pinto beans Soybeans Black-eyed peas Canned dried beans Avocados Turnip greens Mushrooms Broccoli Seeds (i.e., sesame, sunflower pumpkin) Baked potato (small - 85g)
Milk and milk products Serving size is ½ cup unless otherwise indicated	Up to 4 servings per day Rice milk-not fortified or enriched with phosphorus (¼ cup) Non-dairy creamer (¼ cup) Cream cheese (28g or 2tbsp or 1oz)	Limit to 2 servings per day Milk Soy milk Cheese (28g or 2oz slice). Ice cream. Milkshakes Macaroni and cheese Yogurt Pudding Cream soups Cottage cheese
Meat and other protein	_________grams per day Whole eggs (2). Fresh meats (85g or 3 oz.) Fish Beef Chicken or Lamb Turkey Shrimp and oysters	1 serving per week Hot dogs (1) Sardines (28g or 1oz.) Organ meats (i.e., beef/ chicken liver, gizzards) (56g or 2oz) Luncheon meats (56g or 2oz)  Peanut butter (45g or 3oz)  Unsalted nuts (¼ cup) Baked beans (½ cup) Tofu, tempeh, miso Veggie or soy patties Canned tuna (85g or 3oz)
Breads and other grains	6 or more servings per day Grits White rice Spaghetti or macaroni Saltine crackers (6 each) Muffins (1 small) Bagel (½) White bread/rolls Pumpernickel or rye bread Corn- and rice-based cold cereals (1 cup) English muffins (½) Homemade pancakes/waffles (without milk) (7.5 - 10cm or 3-4 inch size)	1 - 2 servings per week or avoid Bran cereals Whole wheat cereals Oatmeal. Granola (¼ cup) Trail mix Wheat germ (30g or 2tbsp) Whole grain bread (1) Cornbread (5 x 5cm or 2 x 2 inch size ). Pancake made from a mix, frozen or fast food (2.45-15.24 cm or 1-6 inch size) Waffles (frozen) (2.45 - 15.24cm or 1 - 6 inch size) Biscuits
Other Foods Follow food labels for serving size unless otherwise indicated	In moderation Pound cake (1/10 of cake) Angel food cake Marshmallows Sugar cookies (2 small) Sugar wafers Sour balls Vanilla wafers Graham crackers Popsicles Jellybeans Gumdrops Rock candy Ginger ale Grape soda Orange soda Cranberry juice Clear sodas Lemonade Fruit punch Sorbet, sherbet Italian ice Gelatin Popcorn Unsalted pretzels	1 serving per week or avoid Chocolate (1 small) Molasses (½ cup) Cocoa (1 envelope) Brown sugar Coconut (1 cup shredded)