Phosphorus Update: And You Thought Dark Colas were Bad News

So you’ve been avoiding dark colas to help manage your serum phosphorus level. Yet, you are still struggling to keep it in goal range. Well, I’m here to tell you there are other phosphorus laden beverages that may cause phosphorus to run high.

The food industry has been using more and more phosphate additives to preserve or lengthen the shelf life of a variety of foods and beverages. The problem is there are no regulations for the nutrition facts label to include phosphorus content. This is true whether it happens to be a phosphate additive or naturally occurring. This is an issue for people who closely monitor daily phosphorus intake: those with chronic kidney disease (CKD) and end stage renal disease (ESRD).

The Usual Suspects

Dark colas or soft drinks have been well known to the ESRD community to contain highly absorbable phosphate additives. Cow’s milk is high in phosphorus, leading to limits on the amount to include in a kidney diet.

The Mystery Bunch

Surprisingly, certain brands of flavored waters, iced teas and sodas now contain phosphate additives. These additives are used for coloring, flavor enhancement, emulsification and to extend the product’s shelf life. Patients with CKD or ESRD have been encouraged to limit certain fruit juices due to high potassium content. Aside from potassium, some varieties of sugared juice-like drinks (with 0% actual fruit juice) and lemonades are some of the biggest culprits for phosphate additives. Specialty coffee drinks that are made with milk (i.e. lattes, cappuccinos and mochas) are also a significant source of phosphorus. Even some powdered drink mixes contain phosphate additives. Included are those that contain calories and the calorie-free options. Why? The phosphate additive keeps the powder from clumping.

Bottom Line

Read the nutrition facts label AND ingredient list on beverages. Become a label reading expert and choose beverages wisely. Look for items in the ingredient list that include “phos” anywhere in the name. Examples include but are not limited to:

• Phosphoric acid
• Sodium polyphosphate
• Tricalcium phosphate
• Hexametaphosphate
• Tetrasodium pyrophosphate
• Calcium phosphate

Healthier Choices to Consider

• Zevia® soda varieties, many sparkling waters and energy drinks are made with natural flavor and no phosphate additives
• Unenriched almond and rice milk are great alternates to cow’s milk;  Homemade Almond Milk, Homemade Rice Milk on DaVita.com
• Ginger-Apple Sparkler, Orange 7 UP, Raspberry-Lime Flavored Water
• Today’s Kidney Diet Juices, Smoothies and Drinks cookbook on DaVita.com

Resources

Wickham, E. (2014). Phosphorus Content in Commonly Consumed Beverages. Journal of Renal Nutrition, 24(1), e1-e4.

DaVita.com

This article is for informational purposes only and is not a substitute for medical advice or treatment. Consult your physician and dietitian regarding your specific diagnosis, treatment, diet and health questions.