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Abstract: TH-PO931

Exposure Estimates of Both Inorganic and Organic Phosphate-Containing Food Additives in US Grocery Household Food Sales in 2022 Validates Need for Labeling Phosphorus Content

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism


  • Uribarri, Jaime, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Dunford, Elizabeth K., The George Institute for Global Health, Newtown, New South Wales, Australia
  • Calvo, Mona S., Icahn School of Medicine at Mount Sinai, New York, New York, United States

A new paradigm based on the degree of food processing to assess the health of dietary patterns has replaced the traditional approach based on the nutrient content of the foods consumed. Dietary patterns where ultraprocessed foods (UPF) dominate are linked to adverse health conditions including CKD, CVD and mortality. Industrial use of food additives is a hallmark of UPF with 60% of foods purchased by Americans containing food additives, a 10% increase in use since 2001. Use of phosphate (PO4) additives in UPF is a possible mechanism underlying CKD and other conditions by contributing to the total excessive dietary PO4 intake. Average underestimated intake of 1400 mg P/d by the general public was significantly linked to increased mortality.


Since no databases exist to estimate phosphate additive intake from processed foods, our objective was to use 2 proxy methods to estimate exposure to all commonly used PO4-containing food additives, both inorganic salts and less studied organic PO4 additives (e.g., lecithins, phosphated modified starches). We used household grocery product food label information from USDA’s Branded Food Product Database (BFPD) to estimate the number of foods being sold to American consumers that contain inorganic and organic PO4 additives in foods (Table). Sales data from Euromonitor International were then used to identify products sold by the top 25 food and beverage manufacturers in the US. The proportion of products from these top 25 manufacturers that contained both organic and inorganic phosphates was also determined.


Only 3% of products in the BFPD displayed P content compared to 5% in foods from the top 25 manufacturers. Both proxy measures showed a much higher proportion of products contained inorganic and organic additives than what displayed P on the label.


These findings justify the need for P content labeling of foods to accurately link the health consequences of excessive P intakes in CKD and the general public.

No. of Grocery FoodsUSDA BFPD
N=396,062 (% total number)
Top 25 Grocery Producer Sales
N=36,763 (% matched foods)
No. with Inorganic PO4 additives77,659 (20%)11,209 (30%)
No. with Inorganic & Organic PO4 additives140,111 (35%)20,741 (56%)
No. Total Data Set with P on Label12,046 (3%)1,888 (5%)