I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Diet and Recipes => Topic started by: hatedialysis2 on April 23, 2016, 12:23:30 PM
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I decided to splurge a little yesterday and bought a dark chocolate bar (I believe by Ghirradeli.) After I ate two small squares, I looked at the label to check the ingredients and was disappointed to find a phosphorus additive "phosphorus oxide" This got my curiosity going and decided to look it up and came across this DaVita article on the wide spread use of phosphours additives in many of the prepared foods. As an example, I was at Whole Foods Market and was looking at the labels on some of the prepared foods at their salad bar and was surprised to find that there was a mile long list of unrecognizable additives in simple foods like meat balls! THis is a health food superstore that I go out of my way and spend a fortune to get the healthiest food money can buy, how can that be? I called the department manager and he insisted that the ingredients were harmless and they were just scientific names. Below is the article from DaVita which highlights foods to watch out for:
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Hidden Phosphorus in Your Diet and How to Control It
Written by Lisa Gutekunst, DaVita® MSEd, RD, CSR, CDN
As someone with chronic kidney disease (CKD), you faithfully take your phosphate binders as directed by your doctor, and you no longer drink milk, add cheese to your burgers or indulge in chocolate or chili. But still you see your phosphorus levels higher than you or your healthcare team wants them. Frustrated, you wonder what you’re doing wrong.
The reason behind your high phosphorus may be due to hidden sources of dietary phosphorus.
Hidden phosphorus and the food industry
The food industry is adding more phosphate additives to foods that are traditionally considered low-phosphorus foods. The following are a few foods and beverages that now contain hidden phosphorus:
Flavored waters
Iced teas
Sodas and other bottled beverages
Enhanced meat and chicken products
Breakfast (cereal) bars
Nondairy creamers
Bottled coffee beverages
The number of products containing these additives grows weekly. This makes it virtually impossible for dietitians and those with CKD to know what’s “safe” and what should be limited.
The food industry is adding additional dietary phosphorus to meet the demands of the American public for wholesome foods. We are now a grab-and-go society, looking for quick, healthy snacks and meals that take very little time to prepare.
Phosphates are added to foods for a variety of reasons. They are considered a Jack-of-all-trades because of their versatility and their low cost to the manufacturer. Phosphorus additives can be used to make foods creamier, allow foods that wouldn’t normally melt to melt, maintain the juiciness of meat and prevent beverages from separating into individual ingredients. Phosphate additives also make food last longer. For example, phosphate salts are added to meats to extend the shelf life.
Locating hidden phosphorus in your diet
Locating hidden sources of phosphorus in your diet requires patience, diligence and a lot of label reading. However, it’s worth the effort to help you reduce the amount of phosphorus in your diet. Looking for the following ingredients on food packages will help you identify foods that should either be eliminated or avoided:
Phosphoric acid
Sodium polyphosphate
Pyrophosphate
Sodium tripolyphosphate
Polyphosphate
Tricalcium phosphate
Hexametaphosphate
Trisodium phosphate
Dicalcium phosphate
Sodium phosphate
Monocalcium phosphate
Tetrasodium phosphate
Aluminum phosphate
Strategies to help control hidden phosphorus in your diet
First, be mindful of where you shop. Because phosphate additives are inexpensive, budget markets and multipurpose mega centers tend to carry a lot of these products.
Second, look for alternative foods and beverages that are lower in phosphorus. For example, many plastic bottled orange-flavored and fruit punch flavored beverages contain phosphorus. However, most refrigerated orange drink and fruit punches don’t have added phosphorus. Many premixed punches contain phosphorus, but a popular unsweetened mix does not. You just have to add sugar and water. And, the unsweetened powder is less expensive than the premixed products. Regular, old-fashioned oats, though a high-phosphorus food that should be limited, contains far less phosphorus and sodium than the instant oatmeal.
Third, let your dietitian know when you find a food or beverage that doesn’t contain added phosphorus so he or she can pass along the information to other patients with CKD. Your dietitian will appreciate your help in keeping everyone up to date on what’s new in the market. The more products you find that you and others on a low-phosphorus diet can have, the more dietitians can add to the food choices in your CKD diet.
Finally, limit phosphorus where you can. You may need to purchase meat products enhanced with phosphorus, but you can cut out additional phosphorus at your meal by using fresh rice instead of instant rice, and using fresh or frozen vegetables that do not contain additional sauce.
https://www.davita.com/kidney-disease/diet-and-nutrition/diet-basics/hidden-phosphorus-in-your-diet-and-how-to-control-it/e/5322
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Here is a more comprehensive list of foods to watch out for phosphorus additives
http://www.foodadditives.org/phosphates/phosphates_used_in_food.html
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................ I called the department manager and he insisted that the ingredients were harmless and they were just scientific names. .................................
I'm sorry but this really made me laugh.
Salesmen. I don't think I have anything good to say so I'll just shut up right here.
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I think he truly believed that all the additives written in scientific jumbo jumbo was safe to consume. Most folks pay no attention to labels or assume if they are at a health food store then it's all good. I guess having CKD all these years was a blessing in that it forced to me be aware of what I feed my family and they are healthier because of it.
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In defense of the salesman, they could very easily be safe for people with fully functioning systems.
Also, everything has a scary scientific name if you break it down to what it is actually containing. Water is really Dihydrogen Monoxide. Salt is really Sodium Chloride. Something containing Lactose would be called a disaccharide.
Everything is a chemical compound - even things that are completely ok to eat. It's not going to do any good to just avoid all "chemicals". You gotta know how whatever compounds you're eating will affect you. As we all know, something like the unnatural Rice Crispie is going to be fine for us to eat while an all natural Banana is gonna mess us up for a bit.
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Everything is a chemical compound - even things that are completely ok to eat. It's not going to do any good to just avoid all "chemicals". You gotta know how whatever compounds you're eating will affect you. As we all know, something like the unnatural Rice Crispie is going to be fine for us to eat while an all natural Banana is gonna mess us up for a bit.
I agree. Everything can be reduced to a lot of scary words. I was interested to read the list of hidden phosphorus to find coffee creamer and whipped topping on the list. I would never touch either of these with a ten-foot pole. I will use real cream (and heavy cream at that as it's lower in carbs) in my one cup of coffee. And if I wanted whipped topping on something ( I don't usually) I would get out my beater and some heavy cream and have the real thing. Quite low in phosphorus and much tastier and healthier as it turns out.
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And if I wanted whipped topping on something ( I don't usually) I would get out my beater and some heavy cream and have the real thing.
I love real whipped cream and never used the fake stuff including before dialysis. I've never really understood the draw of fake products like that. Maybe its because I don't use much added sugar, but why take something so wonderful and replace it with sugar + manufactured fat...
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The current generation is all about right now. Convenience, and no sense for real taste and quality.
And most definitely no patience.
Not many would recognize a butter churn or a hand crank ice cream maker. And even if they did, they wouldn't have a clue how to actually use one.
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Its worse there are kids out there who have no idea where food comes from. They think milk, vegetables,...etc all come from store.
In defense of the salesman, they could very easily be safe for people with fully functioning systems.
Also, everything has a scary scientific name if you break it down to what it is actually containing. Water is really Dihydrogen Monoxide. Salt is really Sodium Chloride. Something containing Lactose would be called a disaccharide.
Everything is a chemical compound - even things that are completely ok to eat. It's not going to do any good to just avoid all "chemicals". You gotta know how whatever compounds you're eating will affect you. As we all know, something like the unnatural Rice Crispie is going to be fine for us to eat while an all natural Banana is gonna mess us up for a bit.
Ingredient that are listed on a labels normally do not reflect their chemical names. If water is added they just say water not H2O or dihydrogen monoxide, sodium is reflected as salt, or sodium not sodium chloride . Ingredients in fresh made meatballs at a health food store should say meat, spices. It is safe to assume that if they are using chemical names then they are dangerous additives, actually I would bet money on that. What is considered dangerous for a kidney patient is also harmful for healthy folks, its just that the damage will take a longer time to take its toll and will show up with different symptoms depending on the persons constitution. Kidney patients don't have that luxury because our elimination organs are greatly compromised and dialysis does not remove all the toxins. As with rice crispies, that is not a healthy food, its denatured, and its not exactly a nutritious food that provides much substance. Having a banana is not going to mess you up if you avoid eating high potassium foods for that day or better yet if keep count of your potassium intake in mg. I would take a banana over rice crispie.
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But the fake coffee creamer and "Cool Whip" fixation is part of the "wonderful" official renal diet where they would sooner you die of fake plastic food than to take the huge risk of letting a drop of dairy cross your lips. I think this is hugely misguided and out of step. I'd rather have real food in measured amounts than fake, junk with their blessings.
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I was s
But the fake coffee creamer and "Cool Whip" fixation is part of the "wonderful" official renal diet where they would sooner you die of fake plastic food than to take the huge risk of letting a drop of dairy cross your lips. I think this is hugely misguided and out of step. I'd rather have real food in measured amounts than fake, junk with their blessings.
In my opinion, part of the renal nutritionist's goal is to reduce your potassium and phosphorus intake regardless of nutritional component of the food items , even if they are harmful empty calories. They refer to such foods at "Kidney Friendly" Look at the list of snacks that are recommended on the Renal Dietitians Academy of Nutrition and Dietitetics :
"Renal patients will need to choose kidney-friendly desserts, such as those listed below. The desserts
may also contain low-potassium fruit, such as those listed in the “Pies & Cobblers” section. Remember to
take your binder(s) with desserts, as they are not free of phosphorus.
Pies &
Cobblers
Cakes Cupcakes and
Snack Cakes
Pastries Cookies Frozen
Desserts
Apple
Blackberry
Blueberry
Cherry
Lemon
Peach
Pineapple
Strawberry
Raspberry
Rhubarb
Angel food
Pound
Butter
Sponge
White
Yellow
Vanilla
Gingerbread
Spice
Jelly rolls
Golden crème
cakes
Vanilla snack
cakes
Lemon stix
Orange
cupcakes
Crispy cereal
treats
Fruit- lled
danish
Éclairs
Cinnamon roll
Fruit fritters
Plain donuts
(no nuts or
chocolate)
Toaster pastries
Butter
Fortune
Molasses
Shortbread
Gingersnaps
Animal/graham
crackers
Vanilla creams
Vanilla wafers
Cookie bars
Popsicles
Fruit ices
Sherbet
Fruit whips
Gelatin
Unlike most snacks and some desserts, candy has few vitamins or minerals and most candies are high in
sugar and/or fat. Because of this, candy may not be the healthiest choice for a snack. However, many
candies are sugar-free and may be helpful in relieving a dry mouth. Renal-friendly candies include:
Hard candies
(butterscotch;
lemon, spice, or
gum drops;
lollipops;
peppermints)
Butter mints,
marshmallows,
ta y, and
divinity
Fruit chews and
fruit leather
Candy corn,
jelly beans, and
orange slices
Gummy candies"
https://www.renalnutrition.org/files/uploads/Vol_33_No2_2014_handout.pdf
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I am not saying that it is their fault, but because I was told to get rid of all phosphorus and potassium containing items from my diet and given no other real guidance, I developed a bad sweet tooth while I was on dialysis. Never once did anyone ask me about my sugar intake, I guess because diabetes did not factor into my kidney failure.
Personally, I think that the average renal dietitian has too large of a patient load to be able to work constructively with their patients so they rely on giving out lists of foods without any real information behind them. It was a constant battle with my dietitian until I finally told her (twice, once with my in-center dietitian and once with my HHD dietitian) that because she had no useful information to provide and wasn't willing to work with my constraints, that I no longer had any need for her services.
But the fake coffee creamer and "Cool Whip" fixation is part of the "wonderful" official renal diet where they would sooner you die of fake plastic food than to take the huge risk of letting a drop of dairy cross your lips. I think this is hugely misguided and out of step. I'd rather have real food in measured amounts than fake, junk with their blessings.
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As a Type 2 diabetic that entire list is off limits to me. I limit myself to at most one small fruit/day-- if that. That list is pure poison to the huge % of CKD patients who are diabetic also. As it is I'm being "poisoned" by the PD fluid that is dextrose. Who's bright idea is it to fill diabetics with sugar? Oh. I forgot. It's all about $$$. The US medical system is so backward. Other countries have a variety of PD fluids that they use that aren't based on sugar. I know there is Ico, but that is only for long dwells and I no long have long dwells as I'm a high-average transporter. Sorry. I'm ranting.
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As a Type 2 diabetic that entire list is off limits to me. I limit myself to at most one small fruit/day-- if that. That list is pure poison to the huge % of CKD patients who are diabetic also. As it is I'm being "poisoned" by the PD fluid that is dextrose. Who's bright idea is it to fill diabetics with sugar? Oh. I forgot. It's all about $$$. The US medical system is so backward. Other countries have a variety of PD fluids that they use that aren't based on sugar. I know there is Ico, but that is only for long dwells and I no long have long dwells as I'm a high-average transporter. Sorry. I'm ranting.
That list of recommended deserts above is poison to healthy people as well.
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.......... Other countries have a variety of PD fluids that they use that aren't based on sugar. ....................
I didn't know this. I never thought to research if there are other means of doing PD. Or anything else other than hemo. Now you have me curious to learn what, where, how it works, etc.
I became full blown diabetic about 6 months after starting PD. So far so good. Always staying 'wet' hasmade me eat less, I feel full eating less than half what I used to so it never posed a problem with my diabetis. I must be fortunate.
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Here's an article you can start with;
http://cjasn.asnjournals.org/content/5/4/723.full
I didn't know this. I never thought to research if there are other means of doing PD. Or anything else other than hemo. Now you have me curious to learn what, where, how it works, etc.
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Surprise, surprise!
That is MY Neph at the VA!
This may be a contributing factor to his ordering Ico for me from day one.
I wonder if he will be surprised that I've read his papar. He knows that I read a LOT, constantly.
He really is a nice guy.