title: The prevalence of phosphorus-containing food additives in top-selling foods in grocery stores.
abstract: OBJECTIVE
  The objective of this study was to determine the prevalence of phosphorus-containing food additives in best-selling processed grocery products and to compare the phosphorus content of a subset of top-selling foods with and without phosphorus additives.
  
  
  METHODS
  The labels of 2394 best-selling branded grocery products in northeast Ohio were reviewed for phosphorus additives. The top 5 best-selling products containing phosphorus additives from each food category were matched with similar products without phosphorus additives and analyzed for phosphorus content. Four days of sample meals consisting of foods with and without phosphorus additives were created, and daily phosphorus and pricing differentials were computed.
  
  
  METHODS
  Presence of phosphorus-containing food additives, phosphorus content.
  
  
  RESULTS
  Forty-four percent of the best-selling grocery items contained phosphorus additives. The additives were particularly common in prepared frozen foods (72%), dry food mixes (70%), packaged meat (65%), bread and baked goods (57%), soup (54%), and yogurt (51%) categories. Phosphorus additive-containing foods averaged 67 mg phosphorus/100 g more than matched nonadditive-containing foods (P = .03). Sample meals comprised mostly of phosphorus additive-containing foods had 736 mg more phosphorus per day compared with meals consisting of only additive-free foods. Phosphorus additive-free meals cost an average of $2.00 more per day.
  
  
  CONCLUSIONS
  Phosphorus additives are common in best-selling processed groceries and contribute significantly to their phosphorus content. Moreover, phosphorus additive foods are less costly than phosphorus additive-free foods. As a result, persons with chronic kidney disease may purchase these popular low-cost groceries and unknowingly increase their intake of highly bioavailable phosphorus.
authors: MetroHealth Medical Center and Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44109, USA. janeen.leon@case.edu
authors: Janeen B
authors: JB
authors: León
authors: Catherine M
authors: CM
authors: Sullivan
authors: Ashwini R
authors: AR
authors: Sehgal
mesh_terms: D016208:Databases, Factual; D004034:Diet Surveys; D005503:Food Additives / Q000032:analysis*; D005523:Food Supply; D062407:Meals; D009820:Ohio; D016226:Phosphorus, Dietary / Q000032:analysis*
chemical_list: D005503:Food Additives; D016226:Phosphorus, Dietary
references: Clin J Am Soc Nephrol. 2009 Aug;4(8):1370-3
references: 19628683
references: JAMA. 2011 Jun 15;305(23):2432-9
references: 21673295
references: Appetite. 2010 Dec;55(3):498-506
references: 20832437
references: Am J Kidney Dis. 2008 Sep;52(3):519-30
references: 18514987
references: Clin Nephrol. 2010 Apr;73(4):268-75
references: 20353734
references: J Am Soc Nephrol. 2010 Nov;21(11):1953-60
references: 20847142
references: JAMA. 2009 Feb 11;301(6):629-35
references: 19211470
references: Dtsch Arztebl Int. 2012 Jan;109(4):49-55
references: 22334826
references: Public Health Nutr. 2009 Oct;12(10):1885-92
references: 19216809
references: Nephrol Dial Transplant. 2010 Oct;25(10):3241-9
references: 20308040
references: Atherosclerosis. 2008 Aug;199(2):424-31
references: 18093595
references: J Ren Nutr. 2008 Sep;18(5):466-70
references: 18721742
references: Semin Dial. 2003 May-Jun;16(3):186-8
references: 12753675
references: J Clin Endocrinol Metab. 2005 Mar;90(3):1519-24
references: 15613425
references: J Am Soc Nephrol. 2011 Oct;22(10):1913-22
references: 21903574
references: Kidney Int. 2006 Dec;70(12):2141-7
references: 17063170
references: J Clin Endocrinol Metab. 2006 Aug;91(8):3144-9
references: 16735491
references: Ren Fail. 2012;34(10):1258-63
references: 23013171
references: Calcif Tissue Int. 2007 Apr;80(4):251-8
references: 17401693
references: Am J Cardiol. 2010 Sep 15;106(6):793-7
references: 20816119
references: Am J Kidney Dis. 2003 Oct;42(4 Suppl 3):S1-201
references: 14520607
references: J Ren Nutr. 2011 Mar;21(2):140-8
references: 20537917
references: Am J Cardiol. 2010 Aug 15;106(4):564-8
references: 20691317
references: Pediatr Nephrol. 2011 Jun;26(6):945-51
references: 21359960
references: J Am Soc Nephrol. 2009 Feb;20(2):397-404
references: 18987306
references: Kidney Int Suppl. 2009 Aug;(113):S1-130
references: 19644521
references: J Ren Nutr. 2007 Sep;17(5):350-4
references: 17720105
references: Clin J Am Soc Nephrol. 2010 Mar;5(3):519-30
references: 20093346
references: JAMA. 2011 Mar 16;305(11):1119-27
references: 21406649