title: Hidden sources of phosphorus: presence of phosphorus-containing additives in processed foods.
abstract: OBJECTIVE
  An increased consumption of processed foods that include phosphorus-containing additives has led us to propose the following working hypothesis: using phosphate-rich additives that can be easily absorbed in processed foods involves a significant increase in phosphorus in the diet, which may be considered as hidden phosphorus since it is not registered in the food composition tables.
  
  
  METHODS
  The quantity of phosphorus contained in 118 processed products was determined by spectrophotometry and the results were contrasted with the food composition tables of the Higher Education Centre of Nutrition and Diet, those of Morandeira and those of the BEDCA (Spanish Food Composition Database) Network.
  
  
  RESULTS
  Food processing frequently involves the use of phosphoric additives. The products whose label contains these additives have higher phosphorus content and higher phosphorus-protein ratio. We observed a discrepancy with the food composition tables in terms of the amount of phosphorus determined in a sizeable proportion of the products. The phosphorus content of prepared refrigerated foods hardly appears in the tables.
  
  
  CONCLUSIONS
  Product labels provide little information on phosphorus content. We observed a discrepancy in phosphorus content in certain foods with respect to the food composition tables. We should educate our patients on reviewing the additives on the labels and on the limitation of processed foods. There must be health policy actions to deal with the problem: companies should analyse the phosphorus content of their products, display the correct information on their labels and incorporate it into the food composition tables. Incentives could be established to prepare food with a low phosphorus content and alternatives to phosphorus-containing additives.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Lou-Arnal
authors.forename: Laura
authors.initials: L
authors.lastname: Arnaudas-Casanova
authors.forename: Alberto
authors.initials: A
authors.lastname: Caverni-Muñoz
authors.forename: Antonio
authors.initials: A
authors.lastname: Vercet-Tormo
authors.forename: Rocío
authors.initials: R
authors.lastname: Caramelo-Gutiérrez
authors.forename: Paula
authors.initials: P
authors.lastname: Munguía-Navarro
authors.forename: Belén
authors.initials: B
authors.lastname: Campos-Gutiérrez
authors.forename: Mercedes
authors.initials: M
authors.lastname: García-Mena
authors.forename: Belén
authors.initials: B
authors.lastname: Moragrera
authors.forename: Rosario
authors.initials: R
authors.lastname: Moreno-López
authors.forename: Sara
authors.initials: S
authors.lastname: Bielsa-Gracia
authors.forename: Marta
authors.initials: M
authors.lastname: Cuberes-Izquierdo
mesh_terms: D003430:Cross-Sectional Studies; D005503:Food Additives / Q000032:analysis*; D005504:Food Analysis; D005525:Food-Processing Industry; D016226:Phosphorus, Dietary / Q000032:analysis*
chemical_list: D005503:Food Additives; D016226:Phosphorus, Dietary