Many patients with chronic kidney disease are advised to eat a diet low in phosphates. But which foods actually contain how much phosphate?
Fruit & Vegetables
Very generally, you can say "bring it on" to fruits & vegetables in terms of phosphate. A healthy, vegetable-rich, Mediterranean diet is recommended and contains relatively little phosphate. But please be careful: if you have to watch your potassium, you should favor fruits & vegetables with less potassium.
Often guides inform you about legumes being phosphate-rich (e.g. peas, chickpeas, lentils, beans). However, in terms of phosphate, it doesn't really matter, because even though they contain phosphate, your body can't absorb plant-based phosphate as well as it can from dairy products and in meat. Legumes can be an important source of protein. However, as you may know, there is a lot of potassium in some legumes. So again, depending on your potassium level, you might want to watch out a little bit here. Sorry, it's a little confusing sometimes…
Eggs
Two eggs correspond approximately to the phosphate content of a portion of meat or fish and are therefore okay in principle. The additional use of egg yolks, e.g. to refine dishes or coat pastries in baking, is better avoided.
Milk & dairy products
In general, dairy products are rather rich in phosphates. However, there are big differences in the phosphate content of different types of cheese, for example. Cream cheese, sour cream, cottage cheese, parmesan, brie or camembert contain little phosphate. They therefore belong to the better types of cheese for you! On the other hand, you should be careful with Emmental, Raclette or Mozzarella.
Unfortunately, processed cheeses are real phosphate bombs across the board. You should really avoid them, because 25 grams of processed cheese can contain up to 600 mg of phosphate. For many of them, that's more or less half of your recommended daily phosphate intake.
You should also be careful with large amounts of yogurt, milk and drinking chocolate. For sauces, you can often easily replace milk with a mixture of cream and water (1/3 cream, 2/3 water).
As a rough rule of thumb, you should not consume more than 100g of milk and dairy products per day.
Potatoes, bread & cereals
White breads and products made from light wheat flour usually contain less phosphate than whole grain products. Potatoes contain little phosphate. However, as you probably already know, you have to be careful with potatoes, especially because of the potassium.
You may also choose breads made with yeast dough over those with sourdough. Yeast dough leaves the phosphate in the grain untouched, which means that a good part is directly excreted again. Sourdough, on the other hand, releases the phosphate from its compound as it germinates, allowing more phosphate to enter your bloodstream.
Nuts
Nuts usually contain a relatively high amount of phosphate (and potassium too). For example, 100g of peanuts are already a third of your daily phosphate & potassium guideline. You should therefore only consume nuts in very small quantities when your phosphate is too high.
Sweets
There are many sweets that contain rather little phosphate. For example, you can easily eat larger amounts of gummy bears. Chocolate, however, you should reduce and especially try avoid eating a whole bar.
Fish, meat & sausages
Just as with cheeses, there are big differences in different meat and sausage products. Salami, Mortadella, belly bacon, corned beef, boiled ham or beer ham, for example, contain very little phosphate. On the other hand, liver products, white sausage or rabbit meat quickly fill half of your daily reference values of phosphate.
Your nephrologist will usually recommend a high-protein diet with an increased amount of meat when on dialysis, because you also have to eat more proteins than usual.
There are also differences with fish. Interestingly, fish fingers, for example, contain only about half the phosphate of a portion of salmon.
Drinks
Beer contains a lot of phosphate, even non-alcoholic beer . Phosphate is also hidden in wine. So try to avoid getting drunk purely on beer and wine. Jokes aside, you should consume alcohol in smaller amounts only anyway. In case that you do drink a glass, dose your phosphate binders - if you take any - correctly to your consumption. Also, be careful with cola and instant drinks. Always look as closely as possible at what contains a lot versus little phosphate and make the decision on what to drink based on that.
Spices
In principle, spices also contain phosphate. However, this phosphate is not so well absorbed by the body, because it is plant-based. Therefore, in terms of phosphate, you can actually diligently reach for spices.
Finished products & additives
There are a number of food additives that are allowed to be used in the EU as flavor enhancers and preservatives. They are labelled on processed products with E-numbers. For example, E339 is sodium phosphate, or E340 is potassium phosphate. Unfortunately, this phosphate is particularly well absorbed by the body. Such products are therefore better left on the shelf. It's healthier for you anyway for many reasons!
The total dose is the most important thing
Since phosphate fluctuates rather slowly compared to potassium, it is most important for you that the total amount of phosphate balances out over time. If you take your phosphate binders regularly, primarily eat fresh foods, and also make sure that you choose phosphate-poor foods when shopping, you should easily be able to reach your target phosphate level.
