Phosphates

[Bajanne]

I am much more concerned about my phospate intake that my potassium.   I noticed that there has been some phosphate discussion in the Potassium thread.  Could we move our sharing concerning phosphates to this thread. 
What are the biggest offenders where phosphates are concerned?

[angieskidney]

I most probably know more about the renal diet than her.

lol ya ... I told my Renal Dietician about how some rootbeers have phosphate while her list said that all rootbeer is safe

WRONG!! Certain brands ADD Phosphate!! READ THE LABELS!!

Safe Rootbeer in MY area (Canada .. ontario):

• A&W
• Mug

NOT Safe rootbeer:

• Hires
• Barq's

Also ... other things I have notice about drinks and foods regarding the phosphate content:

certain brands that are fine in the bottles are not fine in the cans (I don't know why they add phosphate to a product that doesn't have it in bottle form and put it in the can form when it is the same product) and vice versa.

Like certain iced teas. I love to drink Nestea Iced Tea but if you get the plastic bottle of the Brisk Nestea Iced tea it is loaded with Phosphate. The glass bottle however is safe. But other brands are bad and the powered kind is bad.

hmm.. what else ..

egg yolks are bad but egg whites are great for dialysis patients as that part doesn't have all the phosphate yet is high in protein!

I am much more concerned about my phospate intake that my potassium. I noticed that there has been some phosphate discussion in the Potassium thread. Could we move our sharing concerning phosphates to this thread.
What are the biggest offenders where phosphates are concerned?

As far as the "biggest offenders" are concerned, I think milk, cheese, chocolate, and breaded products as well as fast food. Oh ya, and whole wheat. And coke and pepsi!

[Panda_9]

I think my main problem with phosphate was forgetting to take binders with snacks and lunch.

[Rerun]

I've been off work for 2 weeks now and my latest labs had my Phosphorous in the normal range.  My dietition and I both about fainted.  I attribute the success to me cooking noodles and rice like I'm supposed to instead of eating fast food and trying to be good.  I always take my binders, so that part didn't change.

[angieskidney]

I came across this and thought I would share it.
 
Content information of US Coke products:
http://www2.coca-cola.com/mail/goodanswer/utility.html
http://www2.coca-cola.com/mail/goodanswer/soft_drink_nutrition.pdf
(I came across these links from the Davita Forums)
 
- Angie

[Bajanne]

Very useful information.  Thank you, Angie!

[angieskidney]

Very useful information.  Thank you, Angie!

You are very welcome! I am glad it is appreciated! 

here is more that is on my site (I am putting my site back on Jeff's server temporarily and came across this):

We are told what food are high in phosphate but what about the ingredients in foods we dont understand?

List B- Additives with suspect ingredients - USA and Canada

• Acetylated distarch phosphate
• Acid calcium phosphate
• Acid sodium pyrophosphate
• Ammonium phosphate dibasic
• Ammonium phosphate monobasic
• Ammonium phosphatides
• Ammonium polyphosphates
• Ammonium salts of phosphatic acid
• Bone phosphate, edible
• Calcium hydrogen orthophosphate
• Calcium phosphate dibasic
• Calcium phosphate monobasic
• Calcium phosphate tribasic
• Calcium polyphosphates
• Dicalcium diphosphate
• Disodium dihydrogen diphosphate
• Disodium dihydrogen pyrophosphate
• Disodium hydrogen orthophosphate
• Distarch phosphate
• Edible bone phosphate
• Guanosine 5' - (disodium phosphate)
• Hydroxypropyl distarch phosphate
• Inosine 5' - (disodium phosphate)
• Magnesium hydrogen dibasic
• Magnesium hydrogen phosphate
• Magnesium hydrogen tribasic
• Monocalcium orthophosphate
• Monostarch phosphate
• Orthophosphoric acid
• Phosphated distarch phosphate
• Phosphoric Acid
• Polyphosphates, ammonium
• Polyphosphates, calcium
• Polyphosphates, potassium and sodium
• Potassium dihydrogen orthophosphate
• Potassium phosphate dibasic
• Potassium phosphate monobasic
• Potassium phosphate tribasic
• Potassium polyphosphates
• Potassium tripolyphosphate
• Riboflavin-5'-phosphate sodium
• Sodium acid pyrophosphate
• Sodium aluminium phosphate, acidic
• Sodium aluminium phosphate, basic
• Sodium dihydrogen orthophosphate
• Sodium phosphate dibasic
• Sodium phosphate monobasic
• Sodium phosphate tribasic
• Sodium polyphosphates
• Sodium pyrophosphate
• Sodium tripolyphosphate
• Tetrapotassium diphosphate
• Tripotassium orthophosphate
• Tetrasodium diphosphate
• Trisodium diphosphate
• Trisodium orthophosphate

[sandman]

Wow!  That's a lot of phosphate.

[angieskidney]

also since we are talking in the diet and recipes section .. here is a good site to check out for a free cookbook (States only) and more.

[Black]

Thanks Angie!  I ordered two so I can pass one on to the PKD support group at our next meeting.

[Zach]

Hi everyone!  I hope you're all doing well. 

Part of my problem is the way our diet is presented to us by some of the dietitians.  There's a complete disconnect of information.  We need to be concerned about protein intake K/DOQI (http://www.kidney.org/professionals/kdoqi/guidelines/) and calories, and at the same time phosphorus and potassium.

If we don't eat enough protein, then we could have muscle wasting.  But eating the right amount of protein will raise our phosphorus & potassium.  And if we don't take in enough calories, the protein will be used for energy, and not for muscle.

We need the information not only "user friendly" but practical.

We've all received the same hand-outs about our diet.  They each address one issue, phosphorus or potassium or protein.  Rarely have I seen the information combined.  I think that would help us a lot.

Remember the old saying:  Give a person a fish, they'll eat for a day.  Teach a person to fish, they'll eat for a lifetime.

What do you all think??

Thanks,
--Zach

[Sara]

I think you are completely right, and it's incredibly difficult to get the right amounts of everything.  Sometimes I think the dieticians don't even know.   

[Zach]

Some don't.

[Rerun]

Yes, it is a delicate balance.  Sometimes I just say "screw it" and eat what I want, but most of the time I try.  I see where you eat Couscous Zach!  I've tried that once!  BHHK    My problem has been Phosphorus.  Having said that, my numbers were within range the last two blood draws.  Another problem I have is Appetite.  I'm not hungry and then when I am, nothing is ready and I just grab.  Any suggestions for "stay ready" food?

Like NOW I'm hungry and I'm going for a bowl of cereal!

[Zach]

A bowl of cereal is not bad.  It's low in everything.  1 Cup serving has about  100 kcal, 2 grams protein, 10 mg phosphorus, and 22 potassium.  I use ice water, so that's why I have Frosted Flakes.  But soy milk or non-dairy creamers are good, too.

I'm always struggling with phosphorus.  When it goes above 5.5, "they" look at me as if I were eating cheese sandwiches with a bottle of Coke all the time!  Following the K/DOQI Guidelines for calories and protein will raise your phosphorus.  I now use a combination of binders: 2 PhosLo and 1 Renagel, depending on the phosphorus load of the meal.

PhosLo sometimes raises my Calcium too high (10.1)  And Renagel gives me acid indigestion ( and it lowered my CO₂ ).  They seem to work better together ... I'm still experimenting.

PS: see my couscous recipe under, "Meal information that covers several of our food issues."

[MelissaJean]

Yes, it is a delicate balance.  Sometimes I just say "screw it" and eat what I want, but most of the time I try.  I see where you eat Couscous Zach!  I've tried that once!  BHHK    My problem has been Phosphorus.  Having said that, my numbers were within range the last two blood draws.  Another problem I have is Appetite.  I'm not hungry and then when I am, nothing is ready and I just grab.  Any suggestions for "stay ready" food?

Like NOW I'm hungry and I'm going for a bowl of cereal!

I know exactly how you feel.  I am definitely an "on the go" eater.  I eat a lot of bagels and cream cheese, cereal, carrots, and protein bars.  I also make dishes on Sunday to heat up for the rest of the week.

[Zach]

That's a great way to help control the phosphorus.  I try to do that as much as I can.  Lots of ziplock bags in my refrigerator!     

[kitkatz]

Zach, you are a label reader geek, right?   My hubby became a label reader when he was diagnosed with highblood pressure and type 2 diabetes.  Nothing comes into our house that is over 5% sodium, unless I buy it.

[Zach]

Hi kitkatz!

Actually, I'm more of an internet geek.  But only about kidney research.  The rest of the internet I'm quite the neophyte and still learning ... like posting to boards such as this one.

I really don't read the ingredients most of the time, just maybe on something new.   Labels on foods are now starting to list potassium and phosphorus, usually as Daily Values (DV) % in the part on the bottom with small print.  But it's not yet uniform for our needs.

I try the food company's web sites ... some are better than others.  Just don't let them tell you there's no phosphorus when there is a Milk Protein such as: Casein, Calcium Casinate, Sodium Casinate.  I believe they all contain some phosphorus ... just maybe not a lot.  Not all products are even tested for phosphorus!   

Below is a good site for finding out the values.  It is the U.S.D.A.'s Nutrient Data Laboratory web site.
Just hit the search link once you arrive.  It doesn't have everything, and you have to be precise in how you write the food item:  egg    not   eggs

Have fun!

http://www.ars.usda.gov/Main/docs.htm?docid=4451

[angieskidney]

Just don't let them tell you there's no phosphorus when there is a Milk Protein such as: Casein, Calcium Casinate, Sodium Casinate.  I believe they all contain some phosphorus ... just maybe not a lot.  Not all products are even tested for phosphorus! 

Wow that is a really great post! I didn't know to look for those ingredients as phosphate and I thought my extensive list I posted was complete!!  Thank you!

[mallory]

Last week they told me my potassium was a little high, but my phosphorus was fine.  So I've been cutting back on the high potassium foods, but, just to be on the safe side, I thought I'd better also start cutting back on drinking so much Tab, since I know it contains Phosphorus and it may become an issue.

I've been good all weekend, slugging back Fresca instead of Tab most of the time.  Today I thought I'd better just double check and make sure Fresca doesn't have phosphorus. Well, it doesn't.  IT CONTAINS 59 MG. of POTASSIUM IN 8 OUNCES!!!  Tab only has 12 mg. of Potassium! 

I better just stick with water.

[sandman]

What about one of those lemon - lime sodas?

[angieskidney]

I go into convenience stores (or if buying a case .. grocery stores) and look at the lables of all the drinks I might be interested in .. to get a better idea of my options  

[Zach]

Here is information on some soft drinks:

http://www2.coca-cola.com/mail/goodanswer/soft_drink_nutrition.pdf

[sandman]

Look at that.  Sprite has zero potassium and zero phosphorous.