title: Phosphorus-containing food additives and the accuracy of nutrient databases: implications for renal patients.
abstract: 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.
authors.affiliation: Division of Nephrology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Sullivan
authors.forename: Janeen B
authors.initials: JB
authors.lastname: Leon
authors.forename: Ashwini R
authors.initials: AR
authors.lastname: Sehgal
mesh_terms: D000818:Animals; D002645:Chickens; D016208:Databases, Factual; D005503:Food Additives / Q000032:analysis*; D005504:Food Analysis / Q000592:standards; D006801:Humans; D009747:Nutritional Physiological Phenomena; D010758:Phosphorus / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis*; D011202:Poultry Products / Q000032:analysis*; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000178:diet therapy* / Q000628:therapy
chemical_list: D005503:Food Additives; D010758:Phosphorus