Fact sheetDiet specifications

Published on 1 Nov 2011


Mineral / electrolyte diet - phosphate - low

This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.

Aim

To limit phosphate intake to 1200mg per day.

Characteristics

Limits foods high in phosphate.

Indications

  • renal failure
  • hyperphosphataemia
  • secondary hyperparathyroidism
  • chronic kidney disease.

Nutritional adequacy

Nutritionally adequate.

Precautions

Meat should be limited to two serves per day. Milk products should be limited to two serves per day.

Phosphate binders are usually used in conjunction with a low-phosphate diet. In some cases a low-phosphate diet is needed together with a high-protein diet, and the dietitian may then prescribe higher levels of protein foods than normally allowed on this diet (e.g. including eggs at breakfast). The specified levels of phosphate per serve for hot main dishes are a guide, but the actual content may not be known for many products and the examples of allowed and not allowed items should guide menu plans.

Paediatrics

Not suitable for use in paediatrics.

Specific menu planning guidelines

 Allowed Not allowed
Hot main dishes

< 300mg phosphate per serve (e.g. plain roasted meats, poultry, steamed fish and eggs)

Limit to two serves per day

≥ 300mg phosphate per serve (e.g. brains, liver, corned beef, crumbed fish, sardines, bacon, cheese, mornays, sausages, legumes)
Sauces, graviesAll othersCheese sauces and white sauces
Starchy vegetables / pasta / riceAll others

Brown rice

Wholemeal pasta

VegetablesAll others

Mixed beans

Vegetables served with cheese sauce or white sauce

SoupsAll others

Cream soups made with milk

Soups with added legumes (e.g. lentil soup, minestrone)

SandwichesAll breads

All sandwiches < 300mg phosphate and replacing a main meal
-
Salads, dressingsAll salads < 350mg phosphate-
Breads, cereals

All breads

Rice cakes

Rolled oats made with water

Most lower-fibre breakfast cereals (e.g. Weet-Bix™, Corn Flakes®, Rice Bubbles®)

Bran-based and high-fibre cereals

Muesli Rolled oats made with milk

Oat bran

SpreadsAll others, e.g.jam, honeyPeanut butter, Vegemite™, Marmite™
Hot breakfast choicesAll others, e.g. eggs, creamed corn, tomatoes, mushrooms, canned spaghettiBaked beans, sausages, bacon
FruitAll other fresh and canned fruitDried fruit
YoghurtYoghurt (one serve per day)-
DessertsAll other desserts <70mg phosphate per serve, including ice-cream, chocolate mousse

Milk-based desserts, e.g. custards, milky rice

Desserts made with dried fruit

Chocolate cake or pudding

Fruit cake

Milk and cheese

Milk for cereal, tea and coffee

Cottage cheese and ricotta

All milk (including soy milk), other than for cereal, tea and coffee

Semi-hard and hard cheeses

BeveragesAll others, including coffee, tea, non-cola-based soft drinksMilk drinks, Milo®, Aktavite®, Ovaltine®, cocoa and cola-based soft drinks
BiscuitsPlain refined flour biscuits (e.g. Milk Arrowroot™, Milk Coffee™)

Chocolate biscuits

Wheatmeal biscuits

MiscellaneousCream, sugar, herbs and spicesNuts, coconut, dried fruit, chocolate

References

  1. Food Standards Australia New Zealand. NUTTAB Online searchable database: foods that contain phosphorus.
  2. Dietitians Association of Australia. Nutrition manual. 8th ed. Canberra: DAA; 2009.
  3. American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 26 April 2010].
  4. Kariyawasam D. Phosphate management: a dietitian’s perspective. J Renal Care 2009;35 Suppl 1:79-83.
  5. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003;42(4) Suppl 3:S1-201.
Back to top