title: Prevalence of Phosphorus-Based Additives in the Australian Food Supply: A Challenge for Dietary Education?
abstract: OBJECTIVE
  Phosphorus-based food additives may pose a significant risk in chronic kidney disease given the link between hyperphosphatemia and cardiovascular disease. The objective of the study was to determine the prevalence of phosphorus-based food additives in best-selling processed grocery products and to establish how they were reported on food labels.
  
  
  METHODS
  A data set of 3000 best-selling grocery items in Australia across 15 food and beverage categories was obtained for the 12 months ending December 2013 produced by the Nielsen Company's Homescan database. The nutrition labels of the products were reviewed in store for phosphorus additives. The type of additive, total number of additives, and method of reporting (written out in words or as an E number) were recorded.
  
  
  METHODS
  Presence of phosphorus-based food additives, number of phosphorus-based food additives per product, and the reporting method of additives on product ingredient lists.
  
  
  RESULTS
  Phosphorus-based additives were identified in 44% of food and beverages reviewed. Additives were particularly common in the categories of small goods (96%), bakery goods (93%), frozen meals (75%), prepared foods (70%), and biscuits (65%). A total of 19 different phosphorus additives were identified across the reviewed products. From the items containing phosphorus additives, there was a median (minimum-maximum) of 2 (1-7) additives per product. Additives by E number (81%) was the most common method of reporting.
  
  
  CONCLUSIONS
  Phosphorus-based food additives are common in the Australian food supply. This suggests that prioritizing phosphorus additive education may be an important strategy in the dietary management of hyperphosphatemia. Further research to establish a database of food items containing phosphorus-based additives is warranted.
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Jemma
authors.initials: J
authors.lastname: McCutcheon
authors.affiliation: Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Campbell
authors.affiliation: Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia.
authors.forename: Maree
authors.initials: M
authors.lastname: Ferguson
authors.affiliation: School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Day
authors.affiliation: Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia. Electronic address: m.rossi@uq.edu.au.
authors.forename: Megan
authors.initials: M
authors.lastname: Rossi
mesh_terms: D001315:Australia; D004032:Diet; D005503:Food Additives / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis*; D005515:Food Labeling; D005523:Food Supply; D006801:Humans; D054559:Hyperphosphatemia / Q000139:chemically induced / Q000517:prevention & control; D010353:Patient Education as Topic; D010758:Phosphorus / Q000008:administration & dosage / Q000009:adverse effects / Q000032:analysis*
chemical_list: D005503:Food Additives; D010758:Phosphorus