Phosphorus is a mineral naturally found in your bones. In combination with calcium, phosphorus keeps your bones and other parts of your body healthy and strong. Like everything else, however, phosphorus must be kept in balance in order for you to experience its benefits. Too much phosphorus can even harm you. If your doctor or dietitian has told you that you need to restrict your phosphorus, the National Kidney Foundation has some suggestions to help you eat safely while still enjoying your food.*

How can phosphorus harm your body?

Normal levels of phosphorus in your blood range from 2.5 to 4.5 mg/dL (milligrams per deciliter). When your kidneys are functioning fully or with minimal disruption, they can remove any extra phosphorus from your body to maintain those healthy levels. When kidneys are significantly damaged, they’re unable to perform this function. 

Extra phosphorus can leach calcium from your bones, leaving them weak and brittle. Excess phosphorus and calcium can also cause crystalized calcium deposits to build up in your eyes, blood vessels, heart, and lungs, increasing your risk of heart attack and stroke. When your kidneys can no longr remove excess phosphorus, you may need to restrict it in your diet. Dialysis can help, but you may still need to limit phosphorus in between treatments. 

Phosphorus and diet

Phosphorus can be found in many food items, and is more easily absorbed from animal-based foods than plant-based ones. It occurs in greater abundance in such high-protein foods as:

• Red meats, 
• Poultry (chicken, turkey), 
• Fish,  
• Dairy products, 
• Nuts, and 
• Beans.  

Phosphorus is also frequently added as a preservative to fast food, prepackaged foods, and many canned and bottled beverages. This form of phosphorus is completely absorbed into your body. It appears on food labels as some variety of phosphate. Examples include:

• Dicalcium phosphate
• Monosodium phosphate
• Phosphoric acid
• Sodium tripolyphosphate
• Tetrasodium pyrophosphate

Working with your doctor and a renal dietitian is the best way to craft a kidney-friendly diet for you that will be both safe and enjoyable, but here are a few guidelines that can help.

Foods to limit, and good alternatives

The following shows some foods to generally avoid when on a phosphorus-restricted diet, along with tasty alternatives.

Beverages

Avoid: beer and ale, chocolate drinks, dark colas and peppery sodas, canned iced teas, bottled drinks w/phosphate additives, milk-based drinks

Alternatives: water, coffee, tea, juice (apple, cranberry, grape), lemonade, unenriched rice milk, non-cola sodas (ginger ale, orange, root beer, lemon-lime)

Dairy

Avoid: cheese, ice cream, cream soups, milk, custard, yogurt (Greek ok), pudding

Alternatives: rice or almond milk, cottage cheese, vegan cheese, sherbet

Protein

Avoid: Sardines, fish eggs, oysters, organ meats like beef or chicken liver

Alternatives: Beef, chicken, eggs, fish (not sardines), lamb, pork, turkey, veal

Other food items

Avoid: caramel, chocolate, deli meats (and other processed meats like bacon, sausage, and hot dogs), prepared and prepackaged foods, pizza, oat bran muffins, brewer’s yeast

Alternatives: Fresh produce (apples, berries, carrot sticks, cucumber, grapes), rice cakes, pound cake, crackers, popcorn, and pretzels (all unsalted), sugar cookies

Can phosphorus be managed with medication?

There are medications called phosphate binders that you can take with food to help limit the amount of phosphorus that your body will absorb. Phosphate binders come in several forms, including pills, tablets, powders, and liquids. Consult with your doctor to determine your unique dietary needs, and only take the phosphate binder prescribed.

*National Kidney Foundation. (2023). Phosphorus and Your Diet. https://www.kidney.org/atoz/content/phosphorus#:~