I hope you're reading this after you're read my first post about phosphorus (Your Guide to Phosphorus, Part One: Phosphorus and Your Kidneys). If not, I suggest you check that out before reading more!
Okay, so we've covered some basics about phosphorus. Now we're going to dive a little deeper.
How much phosphorus do I need?
The U.S. Institute of Medicine determined the Estimated Average Requirement (EAR) for adults to be 580 milligrams per day, and the Recommended Dietary Intake (RDI) to be 1,000 milligrams per day.
The Upper Level (UL) for intake is 4,000 milligrams per day for ages 19-70 yrs old and 3,000 milligrams per day for anyone over the age of 70.
But don't worry about not getting enough.
Phosphorus is so commonly found in our diet, it's actually a bigger concern to have too much phosphorus rather than not enough.
In fact, some studies are suggesting even with fully functioning kidneys, the American diet is providing too much phosphorus and increases our risk of cardiovascular disease, kidney disease, and bone disease.
Where do I find phosphorus in my diet?
Phosphorus, while being a common mineral in our body, is also a very common mineral in our food. There are two general types of phosphorus in the diet - organic and inorganic.
What's organic phosphorus?
Organic phosphorus is found naturally in foods. Protein-rich foods will include phosphorus. Examples include
Dairy (milk, yogurt, cheese, cottage cheese)
However, there are other foods that will also contain organic phosphorus, such as
The good news is that organic phosphorus is not as easily absorbed compared to inorganic phosphorus!
This is why I still advocate my clients use whole foods rather than processed foods even with clients who have late-stage kidney disease.
So what's inorganic phosphorus?
Inorganic phosphorus is added to foods, typically as a preservative. Some of the most common phosphorus additives are
Essentially, when reading the ingredients list on the back of a food label, look for P-H-O-S, as highlighted above. The higher it is on the list, the more there is in that food/drink. But that doesn't mean you can ignore it if it's at the bottom!
Hard to read the ingredient list? They can be small, long, and tough to get through.
PRO TIP: Take a picture of the ingredient list with your smart phone, then zoom in to get a closer look!
One of the biggest culprits in our diet is beverages. Colas and other dark-colored beverages typically have large amounts of phosphoric acid. There are sodas that do not contain added phos- ingredients, such as orange sodas, lemon-lime sodas, and even some root beers!
I know, I know, I said dark-colored sodas. But there are exceptions to everything, right?
Inorganic phosphorus is also found most commonly in restaurant and fast food. Since it acts as a preservative, it helps prevent food waste with restaurants.
The down side? Inorganic phosphorus is absorbed at almost 100%!!
So while going out to eat can be an enjoyable part of life- and is sometimes unavoidable- it is not recommended to be the majority of your diet. (Among others, like sodium).
What can I do to control the phosphorus in my diet?
Target the inorganic phosphorus first. This can make the biggest change in your health in many ways. Remember, the absorption of inorganic phosphorus from fast foods and restaurants is much higher than a chicken drumstick or some lentils.
What's the best way to do this? Start keeping track of what- and how often- you are dining out.
Use a food journal to review what you're eating, and from where you're getting the food. (Is it take out? Pre-made? Frozen TV dinners?) The more packaged and processed foods in your diet, chances are the more phosphorus you have collecting in your bloodstream.
I provide my one-on-one clients with their own private food journal to do just that, and I give them feedback on their meals. This helps them understand more of why they're making the choices they are, because often we are on autopilot when it comes to food and eating!
But what about when I go out to eat?
It can be frustrating to be logging food all the time. Make it easy on yourself and just start with taking pictures of your food! We already post a lot of our food on social media, right? (#nomnomnom)
My client's have the option to just track by taking pictures for their journals, then add comments about the specific order or if the menu offered any nutrition information.
PRO TIP: Try placing an object, like a friend's phone or your car keys, next to your food so the portion is easier to determine.
Okay, but my phosphorus is still high!
Depending on your kidney disease stage, you may need to talk with your doctor about a phosphorus binder.
This is a prescribed medication that works in your stomach to bind to the phosphorus in your meal, and is excreted in your feces. Therefore, it is not absorbed into your blood and keeps your limits lowered.
Phosphorus binders can come in capsules, tablets, chewables, liquid, and powder form. Talk with your doctor and dietitian about which phosphorus binder is best for you.
Just learn about your phosphorus and not sure how to address your diet? Work with me for one-on-one coaching, often covered by your health insurance!
Disclaimer: Information provided by Jen Hernandez RD LLC is not intended to be used for medical diagnosis or treatment. The information is intended for general consumer health and understanding. The information provided is not intended to be a substitute for professional medical advice or treatment. Please consult with your doctor prior to starting or changing your diet or medications.