Phosphorus-Containing Food Additives and the Accuracy of Nutrient Databases: Implications for Renal Patients
Objective
Phosphorus-containing additives are increasingly being added to food products. We sought to determine the potential impact of these additives. We focused on chicken products as an example.
Methods
We purchased a variety of chicken products, prepared them according to package directions, and performed laboratory analyses to determine their actual phosphorus content. We used ESHA Food Processor SQL Software (version 9.8, ESHA Research, Salem, OR) to determine the expected phosphorus content of each product.
Results
Of 38 chicken products, 35 (92%) had phosphorus-containing additives listed among their ingredients. For every category of chicken products containing additives, the actual phosphorus content was greater than the content expected from nutrient database. For example, actual phosphorus content exceeded expected phosphorus content by an average of 84 mg/100 g for breaded breast strips. There was also a great deal of variation within each category. For example, the difference between actual and expected phosphorus content ranged from 59-165 mg/100 g for breast patties. Two 100-g servings of additive-containing products contained, on average, 440 mg of phosphorus, or about half the total daily recommended intake for dialysis patients.
Conclusions
Phosphorus-containing additives significantly increase the amount of phosphorus in chicken products. Available nutrient databases do not reflect this higher phosphorus content, and the variation between similar products makes it impossible for patients and dietitians to accurately estimate phosphorus content. We recommend that dialysis patients limit their intake of additive-containing products, and that the phosphorus content of food products be included on nutrition facts labels.
⁎Division of Nephrology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
†Center for Reducing Health Disparities, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
‡Center for Health Care Research and Policy, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
§Departments of Medicine, Epidemiology and Biostatistics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
¶Biomedical Ethics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.
Address reprint requests to Ashwini R. Sehgal, MD, Division of Nephrology, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109.
This work was supported by grants DK51472 and GCRC M01RR00080 from the National Institutes of Health, Bethesda, Maryland.
ABSTRACT