Browsing by Subject "kidney disease"

Background: The intake of phosphorus in Western countries is substantial comparing to recommendations. At the same time, consumption of foods with phosphorus-containing additives (P additives) such as processed meats and ready meals has become common. The use of P additives in the food industry is extensive due to their diverse functions in foodstuffs. Inorganic P additives are known to absorb almost completely in the intestinal tract whereas organic phosphorus that is naturally present in foods is less bioavailable. Excessive intake of phosphorus (P) is detrimental especially for chronic kidney disease patients and thus, P restriction diet is needed in maintaining normal serum phosphate concentration and to stop the progression of the disease. In addition, there is evidence suggesting that high dietary intake of P would also be harmful to bone and cardiovascular health in general population. Currently, estimation of the amount of dietary P is difficult due to lacking methods to determine added and natural P chemically in foodstuffs. Moreover, food composition databases do not necessarily take into account the amount of P additives in the total P contents if not analysed chemically. This creates a problem especially to chronic kidney disease patients who should avoid intake of P and especially inorganic P additives. Objective: The aim of this thesis was to determine the prevalence of P additives in the Finnish food supply. Further, the use of inorganic, organic and naturally phosphorus containing additives in different food categories and the labelling methods of P additives were examined. Also, the prevalence of modified starch in the food products was investigated. Materials and methods: The data were obtained from the foodie.fi website containing all the foodstuffs sold in the grocery stores of S Group. Altogether 6176 products were reviewed on foodie.fi and the relevant information was recorded. This information included food category, full product name, presence of P additives and reporting methods of P additives. Minimally processed food categories and categories known not to contain P additives were not reviewed. 1027 foodstuffs were excluded due to lacking package labelling, duplicates or other. Thus, the final data consisted of 5149 foodstuffs. The data were analysed using Microsoft Excel. Results: The prevalence of P additives in all the foodstuffs was 36 %. Among food categories the prevalence varied from 4 % in dairy based snacks to 67 % in meat products. Altogether 17 different P additives were observed in the data. Inorganic P additives were the most common P additive type as 20 % of the foodstuffs contained them. Naturally P containing additives were present in 19 % and organic P additives in 2 % of the foodstuffs. The three most often used P additives were lecithin (E 322), pyrophosphate (E 450), and triphosphate (E 451). Modified starch was used in 23 % of the foodstuffs. Of the reporting methods, E code was used in 49 % of the foodstuffs while in 44 % of the foodstuff's, phosphorus-containing food additives were reported using full name. Conclusions: The use of P additives is common in the Finnish food supply as over one-third of the foodstuffs reviewed contained P additives, inorganic P being the most common P additive type. Organic P additives were rare. However, modified starches that can be presented only by group were more common than any P additive types. Of 11 different modified starches, 5 contain phosphorus. Thus, the true prevalence of organic P additives remains unclear. This establishes a challenge especially in the treatment of chronic kidney disease patients and in their adherence on phosphorus restriction diet as well as in the evaluation of total phosphorus intake as the true amounts of P in the foodstuffs are not available. In addition, the reporting methods of P additives in the packaging might not be clear enough and require knowledge of P additives to be understood. For these reasons, there is a need for updated information on chemically analysed phosphorus contents in the foodstuffs but also more visible and comprehensible label information of P additive contents.