Nutrition and Dietetics Older People Directorate
Reducing phosphate in your
diet
Nutrition and Dietetics
2 Oxford Health NHS Foundation Trust | www.oxfordhealth.nhs.uk
Contact details
Oxford clinics
If you would like to see the dietitian, we are available in the
clinic each morning. Please ask the receptionist to inform the
dietitian if you would like to be seen.
Satellite unit clinics
Some of these clinics are covered by a dietitian. Please ask the
receptionist if you would like to be seen.
Alternatively you may call the above telephone number which
has a 24-hour answerphone service. Messages are checked
Monday to Friday.
Oxford renal dietitians telephone: 01865 225 061
Swindon renal dietitians telephone: 01793 605 292
Reducing phosphate in your diet
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What is phosphate?
Phosphate is a mineral naturally found in many foods in your
diet.
Why is my phosphate level high?
Phosphate levels in the blood can increase when the kidneys
are not working properly.
The target phosphate levels are:
0.9 - 1.5mmol/L for a chronic kidney patient
1.1 - 1.7mmol/L for a dialysis patient
What happens if my phosphate level is too
high?
High blood phosphate levels may initially cause red eyes and
itchy skin.
Prolonged high blood phosphate levels can lead to:
brittle bones that are more susceptible to breaking
aching joints
hardened blood vessels, increasing your risk of heart
disease and circulation problems
Nutrition and Dietetics
4 Oxford Health NHS Foundation Trust | www.oxfordhealth.nhs.uk
What can I do to control my phosphate level?
The first step to controlling your phosphate level is to follow a
low phosphate diet. You may also be prescribed phosphate
binder tablets.
How to achieve a low phosphate diet
Using this guide should help you choose suitable foods that
you enjoy while keeping your phosphate level controlled.
Eggs are not included in the table opposite. They are a good
source of protein but do contain a moderate amount of
phosphate. It is recommended that you eat no more than four
eggs per week.
Processed foods often have phosphate added to them. When
looking at food labels try to limit those that contain the words
phosphate or phosphoric acid. In particular, look out for these
ingredients in ham, breaded chicken, cake mixes, instant
sauces and dark-coloured fizzy drinks. Try to avoid consuming
these products regularly.
Dairy foods are high in phosphate but also contain essential
nutrients such as protein and calcium. In order to have enough
of these nutrients but not too much phosphate, choose two or
three points from the table opposite each day.
Reducing phosphate in your diet
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Condensed and evaporated milk are very high in phosphate so
avoid these. Cream can be taken in small quantities.
Dairy products: choose two - three points per day from
the options below
Three points
300ml (1/2 pint) cow’s milk (whole cream, semi-skimmed,
skimmed or UHT) or soya milk (fortified)
Two points One point
200ml (1/3 pint) cow’s milk or
soya milk (fortified)
100ml (1/2 cup) cow’s milk or
soya milk (fortified)
30g (1oz) of the following
hard cheeses:
Cheddar
Edam
Red Leicester
30g of the following cheeses:
Brie
feta
mozzarella
Stilton
15g parmesan cheese 60g cottage cheese or ricotta
150ml custard 2 scoops (120g) ice cream
200ml milk pudding 1 pot (90g) crème caramel
1 pot (150g) yoghurt 1 pot (125g) soya yoghurt
2 tbsp Greek style yoghurt 1 pot (100g) fromage frais
3 tsp (10g) dried milk powder 200ml oat, rice or soya
(unfortified) milk
Nutrition and Dietetics
6 Oxford Health NHS Foundation Trust | www.oxfordhealth.nhs.uk
The following table lists foods which are high in phosphate and
need to be avoided or consumed only occasionally. It also lists
foods which are lower in phosphate and can be chosen as
suitable alternatives.
Foods high in phosphate
to avoid
Lower phosphate
alternatives
Fish with edible bones such
as sardines, pilchards and
whitebait
Shellfish
Boneless tinned fish
Fresh, unprocessed fish such
as cod, haddock,
tuna and salmon
Processed meats such as
tinned meat and burgers
Liver and kidney
Fresh, unprocessed meat such
as beef, pork, chicken and
lamb
Nuts Corn snacks, rice cakes, bread
sticks
Peanut butter Jam, marmalade
Chocolate bars Plain biscuits or thinly
coated chocolate bars
Drinks such as cola,
Dr Pepper and drinking
chocolate and malted drinks
such as Horlicks
Tea
Fruit squashes, other fizzy
drinks
Condensed milk, evaporated
milk
Small quantity of cream
Naan bread, crumpets,
muffins and scones
Chapatti, toast, madeira cake,
teacake and plain biscuits
Reducing phosphate in your diet
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Try swapping sardines and pilchards for fresh,
unprocessed fish like salmon or cod.
Nutrition and Dietetics
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Phosphate binders
To reduce the amount of phosphate you absorb from your
food you may have been prescribed a medicine called a
phosphate binder.
Please see the list of phosphate binders below and how to take
them.
Phosphate binder How to take it
Calcichew/Calcium 500 (calcium
carbonate)
Osvaren (calcium acetate and
magnesium carbonate)
Chew thoroughly
immediately before food
Renagel (sevelamer hydrochloride)
Renvela tablets (sevelamer
carbonate)
Phosex/Phoslo (calcium acetate)
Alucaps
Swallow whole after two to
three mouthfuls of each
meal
Renvela powder (sevelamer
carbonate)
Dissolve in 60ml water and
take with meals
Fosrenol powder (lanthanum
carbonate)
Sprinkle over food and
consume within 15 minutes
Fosrenol tablets (lanthanum
carbonate)
Chew thoroughly
immediately after each meal
Reducing phosphate in your diet
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Phosphate binders continued
It doesn’t work as effectively, but if you forget to take a
phosphate binder you can still take it within 30 minutes of a
meal.
If you eat away from home (this includes attending dialysis)
please carry some binders with you. You can ask your dietitian
for a pill pot.
Your dietitian can advise on how best to match your binders to
your meal pattern as well as which snacks require a phosphate
binder.
If you have problems tolerating your phosphate binder please
inform your renal doctor.
Nutrition and Dietetics
10 Oxford Health NHS Foundation Trust | www.oxfordhealth.nhs.uk
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Reducing phosphate in your diet
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Concerns and complaints
We aim to provide you with a high quality service at all times.
However, if you have any concerns, complaints or comments
about your experience of our service then please tell a member
of the team or contact the PALS and complaints team on
freephone 0800 328 7971.
Nutrition and Dietetics
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Oxford Health NHS Foundation Trust
Trust Headquarters
Warneford Hospital
Warneford Lane
Headington
Oxford
OX3 7JX
Switchboard 01865 901 000
Email [email protected]
Website www.oxfordhealth.nhs.uk
OP 058.14
Our Older People Directorate includes community services which also provide care
for adults of a working age and young people.