This page explains what a low phosphate diet is. It also provides information about foods you can eat and foods to avoid when taking a medicine called futibatinib.
If you have any questions about the low phosphate diet, futibatinib or information on this page, speak to your healthcare team.
Phosphate, also called phosphorous, is a mineral found in many foods. It is essential for the production of energy, muscle and nerve function, and bone health.
Futibatinib, the medication you are taking to treat your cancer, prevents the body from keeping phosphate within a healthy level. High phosphate levels can initially cause red eyes and itchy skin. Over a longer period of time, high phosphate levels can lead to weaker bones, aching joints and damaged blood vessels. A low phosphate diet can help to keep your phosphate levels within a normal range and prevent any ill health.
Phosphate is found in nearly every food. It’s derived mainly from animal proteins and plant foods (‘organic’ phosphate), and food additives (‘inorganic’ phosphate).
Organic phosphate:
- Found in animal proteins, such as meat, fish, milk and dairy produce, and eggs.
- Found in plant foods, such as cereal grains, seeds, nuts and pulses.
- Found in alcoholic drinks, such as wine and beer due to the way they are processed as well as any potential additives (which may not be declared on labels). Non-alcoholic drinks, such as non-alcoholic beer, or drinks low in alcohol also contain phosphate.
Inorganic phosphate:
- Found in food additives, which are included in many foods and can contribute large amounts of phosphate to the diet. Look out for these additives on food labels: E338-343, E450-458 and E540-545.
In the tables on pages 4 – 13 we’ve included foods to choose, limit and avoid in each food group.
| Breads/Flours/Cereals/Potatoes/Rice/Grains | |
|---|---|
| Starchy foods provide energy, B-vitamins and some fibre which helps with digestion. They are often low in phosphate but phosphate may be added in the manufacturing process (see above for information about phosphate-containing additives). | |
| Foods to choose | Foods to limit |
|
|
| Additional tips | |
| Boiling removes minerals from food. Boiling potatoes and discarding the water can reduce the phosphate content. You can then mash or finish cooking by roasting or baking. | |
| Dairy | |
|---|---|
| Dairy foods provide protein, vitamins and minerals, in particular calcium, iodine and vitamin B12. But they are also high in phosphate. | |
|
Foods to choose (follow standard portion size recommendations as included on the food label) |
Foods to limit (aim for one portion per day only) |
|
|
| Foods to avoid | |
|
|
| Additional tips | |
|
|
| Fruits and vegetables |
|---|
|
Fruits and vegetables are naturally low in phosphate and can be eaten freely on a low phosphate diet. They are an important source of vitamins, minerals and fibre, and you should aim to have a minimum of five portions of fruits and vegetables per day. One portion of fresh, frozen or tinned fruit or vegetables is 80g (for example, a small handful of berries or grapes; one small apple, orange or banana; three heaped tablespoons of cooked vegetables; one small bowl of salad). One portion of dried fruit is 30g (for example, a small handful of raisins, dried apricots, sultanas or currants). Beans and pulses can also count as a maximum of one portion (80g) of fruits/vegetables per day (for example, three heaped tablespoons of chickpeas, lentils, black-eye beans or turtle beans). |
| Protein – meat and fish | |
|---|---|
| Protein is important for building and maintaining your muscles. Protein foods contain phosphate, so it’s important to stick to the following portion sizes at meal times: 90 – 120g cooked meat (about the size of your palm, three slices of meat or one average chop), or one fish fillet (about the size of your palm) | |
|
Foods to choose |
Foods to limit (aim for one serving per week) |
|
|
| Foods to avoid | |
|
|
| Protein – eggs, beans, pulses, lentils, nuts and seed | |
|---|---|
| A portion of beans, dried soya mince, tofu or lentils can replace a portion of meat or fish without containing too much phosphate | |
| Foods to choose (up to two or three servings per day) one serving = 80g or three heaped tablespoons |
Foods to limit or avoid |
|
|
| Foods to avoid | |
|
|
| Fats and oils |
|---|
| Fats provide us with lots of energy in relatively small quantities. They are low in phosphate and can be included freely on a low phosphate diet. Monounsaturated and polyunsaturated fats are better for heart health than saturated fats. |
|
| Cakes, biscuits, snacks, desserts | |
|---|---|
| Many baked goods contain phosphate in the ingredients used to make the product (eggs, self-raising flour, milk, baking powder), as well as additives (see page 4 for further details on phosphate-containing additives). | |
| Foods to choose | Foods to limit |
|
|
| Additional tips | |
| Use cream or crème fraîche with desserts instead of custard or ice cream. | |
| Drinks | |
|---|---|
| Most drinks are low in phosphate but there are some you should avoid due to additives (see page 4 for further details on phosphate-containing additives) | |
| Drinks to choose | Drinks to avoid |
|
|
| Miscellaneous | |
|---|---|
| This group includes flavourings and condiments. | |
| Foods to choose | Foods to limit |
|
|
If needed, your consultant may decide to prescribe you a medicine called a phosphate binder to be taken alongside the low phosphate diet. Phosphate binders help to reduce the levels of phosphate in your blood. They work by soaking up some of the phosphate from the food in your stomach. Your pharmacist will advise you how to take these.
If you are losing weight and/or struggling with your appetite, the advice below will help to make sure you get the nutrients you need.
Eat little and often
Aim for three small meals + three high energy, high protein and low phosphate snacks per day.
Use the ‘Foods to choose’ lists in this booklet for snack ideas.
Fortifying foods
Simple, small additions to meals can greatly increase their calorie content. This can help you to maintain weight without increasing the quantity of food you eat.
- Use full-fat varieties or products rather than low fat.
- To potatoes (boiled or mashed) and vegetables add:
- 1 tablespoon of butter (110 Kcal)
- 2 tablespoons of double cream (140 Kcal)
- 1 tablespoon of olive oil (135 Kcal)
- 50 g cream cheese (140 Kcal, 2 g protein)
- To salads and sandwiches add:
- 2 tablespoons of olive oil (270 Kcal)
- 2 tablespoons of full-fat salad dressings (160 Kcal)
- 2 tablespoons of mayonnaise (200 Kcal)
- 50 g cream cheese (140 Kcal, 2 g protein)
- To porridge, breakfast cereals, fresh fruits and desserts add:
- 1 tablespoon of jam, honey or sugar (60 Kcal)
- 1 portion (30g) of dried fruit (100 Kcal)
- 2 tablespoons of double cream (140 Kcal) or full-fat crème fraîche (90 Kcal)
UCLH is a teaching Trust, and you may be asked if medical or nursing students can observe or assist with your care.
We are also a major centre for medical research. If you are interested in taking part in research projects, ask the person who is caring for you.
If you do not wish to take part in teaching of students and/or research, please tell us when you arrive. Not taking part in teaching or research will not affect your care.
Department of Nutrition and Dietetics
Tel: 020 3447 9289 (Monday to Friday, 9am to 5pm)
Email: uclh.
Services
Page last updated: 30 May 2024
Review due: 31 August 2024