คุณประโยชน์และข้อควรระวังของฟอสฟอรัสในอาหาร

<p>Phosphorus is a mineral or mineral salt that is important and necessary for the body to function normally. Most of it is stored in the bones and teeth. It helps regulate the nervous system and muscles, especially the heart muscle.</p>
<ul>
<li>Bones and teeth 89%</li>
<li>Muscles 10%</li>
<li>Internal organs 4%</li>
<li>Blood 1%</li>
</ul>
<h2><strong><span style="color: #00826a;">Functions of Phosphorus</span> </strong></h2>
<ul>
<li>Works with calcium as the structure of bones and teeth</li>
<li>Stimulates muscle contraction</li>
<li>Stimulates the nervous system</li>
</ul>
<h2><span style="color: #00826a;"><strong>Chronic Kidney Disease Patients</strong></span></h2>
<p>The efficiency of phosphorus excretion decreases, causing phosphorus to accumulate in the blood.</p>
<p><strong>Appropriate phosphorus target</strong> is more than 4.6 mg/dL, indicating hyperphosphatemia.</p>
<ul>
<li>Thin and brittle bones, calcium deposits on tissues</li>
<li>Parathyroid gland enlargement, arterial calcification</li>
</ul>
<p><strong>Phosphorus level target for chronic kidney disease patients</strong> is 2.7-4.6 mg/dL.</p>
<h2><span style="color: #00826a;"><strong>Why control phosphorus levels?</strong></span></h2>
<ol>
<li>When consuming food, phosphorus is absorbed into the body.</li>
<li>For kidney disease patients, kidney function decreases, so phosphorus cannot be eliminated.</li>
<li>This causes high phosphorus levels in the blood, known as &#8220;hyperphosphatemia.&#8221;</li>
<li>It stimulates the parathyroid gland to secrete &#8220;parathyroid hormone.&#8221;</li>
<li>This hormone breaks down calcium from bones to bind with excess phosphorus, which causes itching on the skin, thin and brittle bones, parathyroid gland enlargement, and arterial calcification eventually.</li>
</ol>
<h2><span style="color: #00826a;"><strong>Prevention of Phosphorus Condition</strong></span></h2>
<ul>
<li>Limit phosphorus intake from food to 800-1,000 mg/day.</li>
<li>Maintain blood phosphorus levels within 2.7 – 4.6 mg/dL.</li>
</ul>
<h2><span style="color: #00826a;"><strong>How can we control blood phosphorus levels?</strong></span></h2>
<ul>
<li>Control</li>
<li>Diuretics</li>
<li>Dialysis</li>
</ul>
<p>The use of phosphorus binders and blood dialysis may not be sufficient compared to the daily intake, so dietary control is necessary.</p>
<h2><span style="color: #00826a;"><strong>Phosphorus in Food is Divided into 2 Types</strong></span></h2>
<table>
<tbody>
<tr>
<td width="308">
<p style="text-align: center;"><strong>From Natural Sources</strong></p>
</td>
<td width="308">
<p style="text-align: center;"><strong>Synthetic Components</strong></p>
</td>
</tr>
<tr>
<td width="308">Found in common foods regularly consumed</td>
<td width="308">Found in food additives</td>
</tr>
<tr>
<td width="308">High-protein foods usually have high phosphorus, except egg whites</td>
<td width="308">To supplement minerals, enhance texture, such as crispy cereals and granola</td>
</tr>
<tr>
<td width="308">The body absorbs 40-60%</td>
<td width="308">To aid fermentation and leavening of starch, such as bakery products with yeast and baking powder</td>
</tr>
<tr>
<td width="308"></td>
<td width="308">To prevent moisture loss and extend shelf life, such as frozen shrimp/fish and ready-to-eat foods</td>
</tr>
<tr>
<td width="308"></td>
<td width="308">To enhance flavor and bouncy texture, such as ham, nuggets, meatballs, sausages</td>
</tr>
<tr>
<td width="308"></td>
<td width="308">To enhance color, aroma, preservatives, such as soft drinks, sweetened beverages, tea</td>
</tr>
<tr>
<td width="308"></td>
<td width="308">The body absorbs more than 90%</td>
</tr>
</tbody>
</table>
<p>&nbsp;</p>
<h2><span style="color: #00826a;"><strong>Hidden Phosphorus</strong></span></h2>
<p>Read nutrition labels before purchasing. Look for &#8220;phosphate,&#8221; &#8220;phos,&#8221; &#8220;phosphate,&#8221; &#8220;phos.&#8221; If found, avoid.</p>
<h2><span style="color: #00826a;"><strong>Food Groups High in Phosphorus and Alternatives</strong></span></h2>
<table>
<tbody>
<tr>
<td width="205">
<p style="text-align: center;"><strong>Food Group</strong></p>
</td>
<td width="205">
<p style="text-align: center;"><strong>High Phosphorus Foods</strong></p>
<p style="text-align: center;"><strong>Should Avoid</strong></p>
</td>
<td width="205">
<p style="text-align: center;"><strong>Alternative Foods</strong></p>
</td>
</tr>
<tr>
<td width="205">Beverages</td>
<td width="205">Milk and all dairy products, cream, whipping cream, powdered milk, sweetened/unsweetened condensed milk, fermented milk, fresh soy milk, yogurt, ice cream</p>
<p>Beverages with milk or creamer such as cocoa, iced tea, milk tea, iced coffee, chocolate, 3 in 1 coffee</p>
<p>Bottled or canned ready-to-drink beverages, soft drinks</p>
<p>Grain drinks, vegetable and fruit juices such as soy milk, green bean juice, barley milk, malt milk, mixed fruit juice, alcohol</td>
<td width="205">Black coffee, Chinese/Western tea without milk</p>
<p>Limit to 1-2 cups/day</p>
<p>Still contains some phosphorus; excessive intake can raise phosphorus levels, so avoid dark-colored drinks</p>
<p>Herbal water, ginger water, pandan, lime, butterfly pea, lime soda are recommended</td>
</tr>
<tr>
<td width="205">Snacks</td>
<td width="205">Snacks containing baking powder, yeast, cheese, nuts, butter, egg yolk</p>
<p>Such as bakery items, stuffed bread, donuts, cakes, mooncakes, thong yip, thong yod, foi thong, med kanun, steamed buns, deep-fried dough sticks</p>
<p>Steamed dumplings, wafers, roti, pancakes, croissants</td>
<td width="205">Thai desserts mainly made from flour or protein-free flour</p>
<p>Such as jelly, grass jelly, sarim, Singaporean lod chong</p>
<p>Layered desserts, sago pudding</td>
</tr>
<tr>
<td width="205">Meat</td>
<td width="205">Egg yolk, fish eggs, ant eggs, animal organs, tofu</p>
<p>Foods eaten with bones such as dried shrimp, crispy fish, dried fish</p>
<p>(fried crispy, crushed in curry) small fried fish</p>
<p>(crispy fish, fish paste) fried fins/tails/heads, grilled frogs, lizards</p>
<p>Whole bones, various fried insects</p>
<p>Processed meat and products such as fermented pork, pork/chicken sausage</p>
<p>Pork sheets, pork strips, fish strips (hu guai), seasoned pork/chicken, shredded pork/chicken</p>
<p>Chinese sausage, ham, sausages, bologna, bacon, pork/beef/chicken/</p>
<p>sun-dried fish, northern Thai sausage, meatballs, frozen processed meat, nuggets</p>
<p>Crab sticks, smoked salmon, canned tuna, canned fish</td>
<td width="205">Egg whites, a good quality protein source</p>
<p>Low phosphorus, various fish avoiding bones, fins, cheeks, tails, lean beef, pork, chicken, duck without fat or skin</td>
</tr>
<tr>
<td width="205">Grains and Rice</td>
<td width="205">Various beans and bean products, mung beans, soybeans, red beans</p>
<p>Black beans, peanuts, almonds, macadamia, walnuts</p>
<p>Cashews, pistachios, hazelnuts, ready-made peanut butter</p>
<p>Various seeds, unrefined flour</p>
<p>Corn, brown rice, oats, rice bran, noodles, muesli, tofu skin</p>
<p>Tofu pudding, soy milk, crispy corn, cornflakes, pumpkin seeds</p>
<p>Sunflower seeds, watermelon seeds</p>
<p>&nbsp;</td>
<td width="205">Refined flour</p>
<p>Such as white rice, wide rice noodles, thin rice noodles, vermicelli</p>
<p>Glass noodles, Shanghai noodles</td>
</tr>
<tr>
<td width="205">Vegetables</td>
<td width="205">Root vegetables such as sweet potatoes, taro, water chestnuts, canned pickled vegetables/frozen vegetables</p>
<p>&nbsp;</td>
<td width="205">Leafy/fresh vegetables</p>
<p>&nbsp;</td>
</tr>
<tr>
<td width="205">Fruits</td>
<td width="205">Dried fruits such as raisins, prunes, dates, crispy durian</p>
<p>Dried strawberries, mango leather</p>
<p>&nbsp;</td>
<td width="205">Fresh fruits</p>
<p>&nbsp;</td>
</tr>
<tr>
<td width="205">Condiments</td>
<td width="205">Salad dressings, mayonnaise, ketchup, seasoning powder/cubes, mustard</p>
<p>&nbsp;</td>
<td width="205">Reduce seasoning with condiments</p>
<p>&nbsp;</td>
</tr>
<tr>
<td width="205">Ready-to-eat Foods</td>
<td width="205">Ready-to-eat or frozen fast foods</p>
<p>Such as hamburgers, pizza, French fries, hot dogs</td>
<td width="205">Fresh unprocessed foods</td>
</tr>
</tbody>
</table>
<p><strong> </strong></p>
<h2><strong><span style="color: #00826a;">Important to Know</span> </strong><span style="color: #00826a;"><strong>?</strong></span></h2>
<p>Although egg yolks contain high phosphorus, they are a good quality protein source. It is recommended to eat one whole egg per day (for healthy individuals). For patients with high blood lipids, diabetes, and cardiovascular disease, it is advisable to eat every other day.</p>
<h2><span style="color: #00826a;"><strong>Energy and Nutrients of Chicken Eggs</strong></span></h2>
<p>One whole egg contains 0 fiber, 72 kilocalories, consisting of 0.36 grams carbohydrates, 6.28 grams protein, 4.76 grams fat, and 186 milligrams cholesterol.</p>
<h2><span style="color: #00826a;"><strong>Tips to Reduce Phosphorus When Eating Out</strong></span></h2>
<ol>
<li>Reduce/avoid adding or dipping sauces as they are hidden sources of phosphorus.</li>
</ol>
<p>Tip: Order dishes that do not require additional dipping or ask for sauces separately.</p>
<ol start="2">
<li>Avoid ready-made dishes or boxed meals as they are high in sodium and phosphorus.</li>
<li>Eating low-phosphate foods in large amounts or frequently can still result in high phosphorus intake, such as buffet meals.</li>
<li>Avoid processed meats and meat products with bones.</li>
<li>Choose low-phosphate snacks and avoid bakery and Thai desserts containing egg yolks.</li>
<li>Choose to drink mainly water and avoid milk, tea, and coffee as they are high in phosphorus.</li>
</ol>
<p>&nbsp;</p>
<p style="text-align: right;">Dialysis Center, Phyathai 2 Hospital, 14th Floor, Building A, Tel. 02-617-2444 ext. 1683, 1684</p>
<div dir="ltr" style="text-align: right;"><strong>References</strong></div>
<div dir="ltr" style="text-align: right;">
<p>Manual for Chronic Kidney Disease Patients</p>
<div>Undergoing Hemodialysis</div>
<div dir="ltr"></div>
<div></div>
<div><strong>Prepared by</strong></div>
</div>
<div dir="ltr" style="text-align: right;">Department of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Nephrology Unit, Department of Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society</div>


Phosphorus is a mineral or type of mineral salt that is important and essential to the body, enabling the body to function normally. Most of it is stored in the bones and teeth.

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