Nutrition Diet: What Should I Eat If My Phosphorus Is High?

According to the National Kidney Foundation, your body can absorb almost 100% of the inorganic phosphorus found in food additives, which can significantly raise blood phosphorus levels. A low-phosphorus diet is crucial for managing hyperphosphatemia, a condition where phosphorus levels are too high, and knowing what should I eat if my phosphorus is high? is the first step toward better health.

Quick Summary

This guide explains the importance of managing high phosphorus levels, detailing which foods to limit and which to prioritize. It focuses on avoiding processed foods with phosphate additives and selecting natural, low-phosphorus ingredients to create a kidney-friendly diet.

Key Points

• Prioritize Fresh, Whole Foods: Avoid processed and packaged foods, as their added inorganic phosphorus is almost completely absorbed by the body.

• Read Ingredient Labels Carefully: Look for additives containing 'phos' (e.g., phosphoric acid) and avoid products that include them.

• Choose Low-Phosphorus Alternatives: Replace high-phosphorus dairy, meats, and grains with low-phosphorus options like unenriched rice milk, fresh fish, and white rice.

• Limit High-Phosphorus Foods: Reduce intake of dairy products, nuts, seeds, and dark-colored sodas.

• Take Phosphate Binders as Prescribed: For many with high phosphorus, binders are necessary alongside dietary changes to manage levels effectively.

• Consult a Professional: Work with a dietitian specializing in kidney health for a personalized, balanced meal plan.

The Importance of a Low-Phosphorus Diet

High phosphorus, or hyperphosphatemia, is a common issue for individuals with chronic kidney disease (CKD), as damaged kidneys are less efficient at removing excess phosphorus from the blood. Over time, this buildup can lead to serious health complications, including weak bones, itchy skin, and hardened blood vessels, increasing the risk of heart disease, heart attack, and stroke. Managing dietary phosphorus is a cornerstone of treatment, and a registered dietitian specializing in kidney health can offer personalized guidance.

The key to a successful low-phosphorus diet is understanding the different types of phosphorus and their absorption rates. The body absorbs almost all of the inorganic phosphorus added to processed foods, while only absorbing 40–60% of the naturally occurring organic phosphorus found in whole foods. This distinction means focusing on fresh, unprocessed foods is more beneficial than just counting milligrams of phosphorus.

Foods to Limit or Avoid

Certain food categories are known to be high in phosphorus, especially those containing additives. To manage high phosphorus levels, it is essential to minimize or avoid these items.

• Processed and Packaged Foods: This is the most critical category to reduce. Look for words containing "phos" on ingredient labels, such as phosphoric acid, disodium phosphate, or calcium phosphate. Common culprits include processed meats (hot dogs, ham, sausage), instant puddings, baked goods made from mixes, and frozen meals.
• Dark-Colored Sodas: Colas and pepper-type sodas often contain phosphoric acid and should be avoided. Lighter-colored sodas, plain water, and homemade iced tea are better alternatives.
• Dairy Products: Many dairy items, including milk, cheese, and yogurt, are naturally high in phosphorus. Intake should be limited, often to a single serving per day, depending on individual needs.
• High-Phosphorus Protein Sources: Organ meats (liver, kidney), sardines with edible bones, and certain nuts and seeds are rich in natural phosphorus. While natural phosphorus is absorbed less, portion control is still important.
• Whole Grains: While healthy in many ways, bran cereals and some whole-grain products are higher in phosphorus. Plant-based sources, like whole grains, are generally less bioavailable, but a dietitian can help you balance your intake.

What Should I Eat If My Phosphorus is High? Lower-Phosphorus Alternatives

Fortunately, a low-phosphorus diet offers many delicious and nutritious options. The focus should be on fresh, whole foods that are naturally lower in phosphorus.

• Fresh Fruits and Vegetables: Most fruits and vegetables are naturally low in phosphorus and are a cornerstone of a healthy, kidney-friendly diet. Examples include apples, berries, grapes, carrots, green beans, and cauliflower.
• Lean, Fresh Proteins: Choose fresh, lean meats, poultry, fish, and eggs without added phosphate. Always check ingredient lists for hidden phosphorus additives. For example, a grilled chicken breast with no additives is a better choice than chicken nuggets.
• Egg Whites: The phosphorus in eggs is mainly in the yolk. Egg whites are a great low-phosphorus protein source.
• Low-Phosphorus Grains: Options include white rice, corn or rice cereals, pasta, and fresh white bread or rolls.
• Dairy Substitutes: Unenriched rice milk and certain types of almond milk can serve as lower-phosphorus milk alternatives. In moderation, low-fat sour cream or cream cheese are also options.
• Beverages: Stick to plain water, fresh-brewed coffee or tea, light-colored sodas, and homemade lemonade.
• Sweets and Snacks: Hard candies, jellybeans, and sherbet are lower-phosphorus sweet treats. For snacks, plain popcorn and unsalted pretzels are good choices.

The Role of Phosphorus Binders

For many individuals with high phosphorus levels, particularly those with advanced CKD or on dialysis, diet alone is not enough. Your doctor may prescribe phosphate binders, which are medications that bind to the phosphorus in food, preventing it from being absorbed by the body. These medications are typically taken with meals and snacks containing phosphorus. It is crucial to take binders as prescribed and to understand that they supplement, not replace, a low-phosphorus diet.

Crafting Your Meal Plan

Building a meal plan requires attention to detail, but it doesn't have to be restrictive. Consider the following example:

• Breakfast: An omelet made with egg whites, bell peppers, and spinach, served with a slice of white toast.
• Lunch: Fresh chicken salad (made with fresh chicken) on a white bread roll with lettuce and tomato.
• Dinner: Grilled fresh fish with a side of steamed carrots and white rice.
• Snacks: An apple, or some unsalted pretzels.

High vs. Low Phosphorus Food Choices

Food Category	High-Phosphorus Choice	Low-Phosphorus Alternative
Dairy	Milk, yogurt, processed cheese spreads	Unenriched rice milk, small amount of hard cheese, sorbet
Protein	Processed meats (bacon, hot dogs), organ meats	Fresh chicken, beef, fish, egg whites
Grains	Bran cereal, whole-wheat bread, oatmeal	Corn or rice cereals, white bread, pasta, white rice
Snacks	Nuts, seeds, peanut butter, chocolate	Hard candies, jellybeans, plain popcorn, unsalted pretzels
Beverages	Dark colas, bottled iced tea, milk drinks	Water, fresh-brewed tea, light-colored soda, lemonade

Conclusion

Managing a high phosphorus level is a critical component of kidney health. By focusing on fresh, unprocessed foods and meticulously checking for phosphate additives on ingredient lists, you can significantly lower your dietary phosphorus intake. Combining a careful diet with prescribed medications, like phosphate binders, and regular monitoring by your healthcare team offers the best strategy for maintaining a healthy balance. Starting with simple swaps, such as replacing processed meats with fresh ones or opting for fresh fruits and vegetables, can make a profound difference in your overall well-being. Always consult with a registered dietitian or nephrologist to create a personalized plan tailored to your specific needs.

References

DaVita. 5 Tips to Lower Phosphorus Levels. (May 12, 2021). https://davita.com/diet-nutrition/kidney-diet-tips/5-tips-to-lower-phosphorus-levels/ American Kidney Fund. High Phosphorus (hyperphosphatemia). (March 06, 2024). https://www.kidneyfund.org/living-kidney-disease/health-problems-caused-kidney-disease/high-phosphorus-hyperphosphatemia National Kidney Foundation. Kidney Failure Risk Factor: Serum Phosphorus. https://www.kidney.org/kidney-failure-risk-factor-serum-phosphorus Nova Scotia Health. High Phosphorus Foods to Limit or Avoid. (August 2021). https://www.nshealth.ca/sites/default/files/documents/pamphlets/0549.pdf Mayo Clinic. Low-phosphorus diet: Helpful for kidney disease? https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/food-and-nutrition/faq-20058408 BC Renal. Phosphorus and Your Kidney Diet. https://www.bcrenal.ca/resource-gallery/Documents/Phosphorus_and_Your_Kidney_Diet.pdf National Kidney Foundation. Phosphorus and Your CKD Diet. (September 22, 2025). https://www.kidney.org/kidney-topics/phosphorus-and-your-ckd-diet American Kidney Fund. Your kidney-friendly food plan: Managing phosphorus. (February 23, 2015). https://www.kidneyfund.org/article/your-kidney-friendly-food-plan-managing-phosphorus Cleveland Clinic Abu Dhabi. Low-Phosphorus Diet Guidelines. https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/treatments-and-procedures/low-phosphorus-diet-guidelines Mayo Clinic. Low-phosphorus diet: Helpful for kidney disease? https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/food-and-nutrition/faq-20058408 DaVita. Top Low Phosphorus Foods for a Healthy Kidney Diet. https://davita.com/diet-nutrition/articles/top-low-phosphorus-foods-for-a-healthy-kidney-diet/ Indian Health Service. Phosphorus: Tips for People with Chronic Kidney Disease. https://www.ihs.gov/diabetes/education-materials-and-resources/diabetes-topics/kidney/phosphorus-tips-for-people-with-ckd/ Cambridge University Hospitals. Low phosphate diet. https://www.cuh.nhs.uk/patient-information/low-phosphate-diet/ Together by St. Jude™. Foods High in Phosphorus. https://together.stjude.org/en-us/medical-care/clinical-nutrition/high-phosphorous-foods.html Mayo Clinic. Low-phosphorus diet: Helpful for kidney disease? https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/expert-answers/food-and-nutrition/faq-20058408 National Institutes of Health (NIH). Healthy Eating for Adults with Chronic Kidney Disease. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/healthy-eating-adults-chronic-kidney-disease North Bristol NHS Trust. Phosphate binders - Information for kidney patients. (March 2023). https://www.nbt.nhs.uk/our-services/a-z-services/nutrition-dietetics/nutrition-dietetics-patient-information-kidney-disease/phosphate-binders-information-kidney-patients DaVita. Phosphorus Binders (Phosphate Binders) and the Dialysis Diet. https://davita.com/diet-nutrition/articles/phosphorus-binders-or-phosphate-binders-and-the-dialysis-diet/

Frequently Asked Questions

What is hyperphosphatemia?

Hyperphosphatemia is a condition where you have excess phosphorus in your blood, often due to chronic kidney disease. It can lead to weak bones, heart problems, and other complications if left unmanaged.

How do I spot phosphorus additives on food labels?

Look for the word 'phos' in the ingredient list. Examples include phosphoric acid, disodium phosphate, and calcium phosphate. These inorganic forms are highly absorbed by the body and should be avoided.

Are all whole grains bad if my phosphorus is high?

Not necessarily. While some whole grains are higher in phosphorus, the body absorbs less of the natural phosphorus from plant-based foods. A dietitian can help you incorporate them into your diet in controlled portions, and it's generally better to prioritize avoiding processed foods with additives.

Can I have any dairy products with high phosphorus?

Your dairy intake may need to be limited, but not necessarily eliminated. A dietitian can recommend appropriate portion sizes. Lower-phosphorus alternatives like unenriched rice milk or small amounts of hard cheese may also be options.

How do phosphate binders work?

Phosphate binders are medications that bind to the phosphorus in your food while it is still in your digestive tract. This prevents the phosphorus from being absorbed into your bloodstream, and it is then passed out of your body in your stool.

What kind of drinks should I avoid?

Avoid dark-colored sodas, bottled iced teas, and milk-based drinks that often contain phosphate additives. Stick to safer choices like water, clear sodas, fresh-brewed tea or coffee, and lemonade.

Is it better to get phosphorus from animal or plant-based foods?

The phosphorus from plant-based sources, such as beans and seeds, is less easily absorbed by the body than the phosphorus from animal sources like meat and poultry. Prioritizing plant-based protein is a helpful strategy for managing phosphorus levels.