PRODUCT UPDATE
Feature Editor: Sharon Stall, MPH, RD, CSR
Considering Greek Yogurt for Chronic Kidney
Disease
Sharon Stall, MPH, RD, CSR
I T IS THE big time for Greek yogurt. It is
packed full of protein, it is lower in sodium
and sugar than regular yogurt, it is relatively easy
to eat, and it tastes good. Sales have skyrocketed,
and three new yogurt plants are revitalizing the
dairy industry of New York state, which will bring
jobs to Batavia NY (the site of the annual Council
of Renal Nutrition conference in that region).
Remarkably, Chobani yogurt, which is the lead-
ing brand of Greek yogurt, was an official sponsor
of Team USA for the London 2012 Olympics.
This shines the national spotlight on this new
food product and company, which arrived on su-
permarket shelves just 7 years ago.
Part of the appeal of Greek yogurt is its simple
and pure recipe. Traditionally, Greek yogurt is
made with three ingredients—milk, cream, and
live cultures—and is strained to get its signature
texture and flavor. It is thick and tangy. As an ex-
ample, it takes 40 oz of milk strained 3 times to
make 16 oz of yogurt.1 This explains the other
draw—its appealing nutritional profile. There
are up to 18 g of protein in a 6-oz cup. However,
Greek yogurt is expensive. Much to the dismay of
purists, some manufacturers have turned to food
technology to produce a product that mimics
Greek yogurt produced the traditional way.2 For
example, Yoplait adds thickeners such as milk pro-
tein concentrate and organic cornstarch to their
formulation. This allows for production to meet
market demand and it cuts cost. Although there
is a Standard of Identity for yogurt, there is no
standard for Greek yogurt.2
Unity Hospital Dialysis at Spencerport, Rochester, New York.
Financial Disclosure: The author declares that there are no relevant
financial interests.
Address reprint requests to Sharon Stall, MPH, RD, CSR,
Unity Hospital Dialysis at Spencerport, 5 Land-Re Way, Rochester,
NY 14559. E-mail: sharonstall@aol.com.
Ó 2012 by the National Kidney Foundation, Inc. All rights
reserved.
1051-2276/$36.00
http://dx.doi.org/10.1053/j.jrn.2012.09.001
Journal of Renal Nutrition, Vol 22, No 6 (November), 2012: pp e57-e62
Greek yogurt requires careful consideration to
be included in the meal plan for a person on dial-
ysis. It is high in protein, phosphorus, and potas-
sium. Yogurt can be found on more than one ‘‘to
avoid’’ list for persons with chronic kidney disease
(CKD). However, dialysis patients need protein.
The National Kidney Foundation Kidney Disease
Outcomes Quality Initiative protein recommen-
dation for a person on hemodialysis is 1.2 g pro-
tein/kg body weight and for peritoneal dialysis
patients it is 1.2-1.3 g protein/kg body weight.3
Dietary manipulation of phosphorus and phos-
phate binders is the foundation of treatment for
maintaining phosphorus levels trending toward
normal.4 High serum phosphorus levels are asso-
ciated with increased mortality and cardiovascular
risk in persons with CKD.4 Strategies to control
phosphorus often end up in a tug of war of protein
versus phosphorus.
The phosphorus-to-protein ratio has been
suggested as a metric to evaluate the phosphorus
content of food for use in the CKD diet. This
ratio has been recommended by the Kidney Dis-
ease Outcomes Quality Initiative guidelines.5
Kalantar-Zadeh et al.6 further described the utility
of this method in evaluating the protein versus
phosphorus dilemma. This ratio has been parti-
cularly powerful in demonstrating the effect of
phosphate additives in food. For example, the
phosphorus-to-protein ratio for cola soda might
be 50; there is no protein in soda. A guide to using
the phosphorus-to-protein ratio is the lower the
value, the more appropriate the food for inclusion
in the diet. In the case of Greek yogurt with its
powerful protein punch, the calculated 13-15
mg phosphorus/g protein ratio is an improvement
over the average ratio of 20 mg/g for dairy prod-
ucts.7 Although it is suggested to consume foods
with a ratio of 10 mg/g or less, most organic phos-
phorus from animal proteins ranges between 10
and 20 mg/g.7 It seems like the thoughtful dieti-
tian may consider Greek yogurt in the meal plan
e57
e58 STALL

Table 1. Comparison of Dannon Nonfat Plain

†Chobani states in the FAQ section of the website ‘‘Every 6-oz cup of Chobani contains about 120 mg of potassium and 240 mg of phosphorus.’’8 Potassium and phosphorus is
*Calcium information is provided as a percentage of the DV. This has been converted to grams grams for ease of comparison; for example, 20% of the 1,000 DV for

Phosphorus information is provided as a percentage of the DV. This has been converted to grams for ease of comparison; for example, 20% of the 1,000 DV 5 200 mg.
Yogurt Versus Chobani Greek Nonfat Plain Yogurt

Fat (g)

3.5
4
0

0
10

0
0
Greek Yogurt
Yogurt Nonfat Nonfat Plain,
Nutrient Plain, Dannon Chobani

Calories
(kcal)

130

80
80
150
100
190
100

120
Amount 6 oz 6 oz
Calories 80 80
Protein (g) 9 18

CHO (g)
Phosphorus (mg) 250* 240†

12
8
7
8
7
7

6
6
Phosphorus- 28‡ 13‡
to-protein
ratio (mg/g)‡

Potassium
Sodium (mg) 120 80

120†
120†
300§ 200§

(mg)
Calcium (mg)

N/A

N/A
N/A

N/A
230
160
Potassium (mg) 400 120†
Sugar (g) 12 6
Greek yogurt has almost 2 times the protein and less so-

Sodium
dium, potassium, calcium, and sugar (carbohydrate).

(mg)

65
80
70
65
70

60
50
115
*Phosphorus information is provided on the Nutrition
Facts label as a percentage of the DV. This has been con-
verted to milligrams for ease of comparison; for example,

Calcium
20% of the DV of 1,000 mg for phosphorus 5 200 mg.

(mg)*

200*
200*
200*
200*
200*

450*
200*
150*
†Chobani states in the FAQ section of the website
‘‘Every 6-oz cup of Chobani contains about 120 mg of po-
tassium and 240 mg of phosphorus.’’8 Potassium and
Table 2. Plain Yogurt by Brand in Descending Order by Protein Content per Serving Size
Phosphorus-

Ratio (mg/g)
phosphorus information is not provided on the Nutrition
to-Protein

Facts label. N/A

N/A
N/A

N/A
14
13

21
13
‡Phosphorus-to-protein ratio: Dannon nonfat plain
yogurt: 250 mg phosphorus/9 g protein 5 27.7 5 28;
Chobani nonfat plain yogurt: 240 mg phosphours/18 g
protein 5 13.3 5 13.
Phosphorus (mg)

§
Calcium information is provided as a percentage of the
DV that appears on the Nutrition Facts label. This has been
240†
240‡

350‡
200‡
N/A

N/A
N/A

converted to grams for ease of comparison; for example, N/A

20% of the 1,000 mg DV for calcium 5 200 mg.

for a person with CKD. Within the context of

healthy eating and wellness, perhaps the person
Protein (g)

with CKD might even feel like an Olympian.

20
18
18
18
17
17
15
15

Table 1. Shows the comparison of plain nonfat

CHO, carbohydrates; N/A, no information available.

yogurt with Greek nonfat yogurt. This highlights

the benefits of Greek yogurt, which is higher in
6 oz/170 g
7 oz/200 g
6 oz/170 g
7 oz/200 g
6 oz/170 g
6 oz/170 g

5.3 oz/150 g
5.3 oz/150 g

protein and lower in sodium, potassium, and sugar

Serving
Size (g)

than traditional yogurt. The calculations for the

not provided on the Nutrition Facts label.

phosphorus-to-protein ratio are provided for ex-

ample; notice the favorable ratio for Greek yogurt.
Table 2 lists the top-selling brands (Chobani, Fage,
Fage Total 0% nonfat yogurt

Oikos, and Yoplait) of plain Greek yogurt in de-

Stonyfield organic Oikos

scending order of protein. It is important to note

Dannon Oikos Greek

that the quantities of yogurt vary. The tables

Fage Total classic

calcium 5 2,000 mg.

were not standardized by amount; that is, the 7-

Chobani nonfat

Chobani lowfat
Yoplait Greek
Yogurt Brand

Fage 2% fat

oz Fage has more protein than the 6-oz Chobani

yogurt because it is a bigger portion. The thought
was that a person would eat a cup as packaged;
therefore, it would be best to provide the informa-
‡

tion per serving size. Table 3 shows the flavored

Table 3. Yogurt by Brand: Chobani, Fage, Oikos (Dannon and Stonyfield), and Yoplait
Phosphorus-
Serving to-Protein Calcium Sodium Potassium Calories
Yogurt Brand Size (g) Protein (g) Phosphorus (mg) Ratio (mg/g) (mg)* (mg) (mg) CHO (g) (kcal) Fat (g)

Chobani nonfat plain 6 oz/170 g 18 240† 13 200 80 120† 7 100 0

Chobani nonfat vanilla 6 oz/170 g 16 240† 15 200 75 120† 13 120 0
Chobani nonfat honey 6 oz/170 g 16 240† 15 200 75 120† 20 150 0
Chobani nonfat lemon 6 oz/170 g 15 240† 16 150 80 120† 20 140 0
Chobani nonfat bloody 6 oz/170 g 14 240† 17 150 85 120† 21 140 0
orange
Chobani nonfat 6 oz/170 g 14 240† 17 150 85 120† 21 140 0
raspberry
Chobani nonfat 6 oz/170 g 14 240† 17 200 65 120† 19 140 0
strawberry
Chobani nonfat peach 6 oz/170 g 14 240† 17 200 65 120† 20 140 0

GREEK YOGURT FOR CKD

Chobani nonfat apple 6 oz/170 g 14 240† 17 150 80 120† 20 140 0
cinnamon
Chobani nonfat 6 oz/170 g 14 240† 17 200 65 120† 20 140 0
blueberry
Chobani nonfat black 6 oz/170 g 14 240† 17 150 70 120† 22 140 0
cherry
Chobani lowfat plain 6 oz/170 g 17 240† 14 200 70 120† 7 130 3.5
Chobani lowfat 6 oz/170 g 14 240† 17 150 65 120† 19 160 3
strawberry banana
Chobani lowfat mango 6 oz/170 g 13 240† 18 150 65 120† 21 160 3
Chobani lowfat 6 oz/170 g 13 240† 18 150 65 120† 21 160 2.5
pineapple
Fage Total 0% plain 6 oz/170 g 18 N/A N/A 200 65 N/A 7 100 0
Fage Total 0% 5.3 oz/150 g 13 N/A N/A 150 45 N/A 17 120 0
raspberry
Fage Total 0% 5.3 oz/150 g 13 N/A N/A 150 45 N/A 17 120 0
strawberry
Fage Total 0% peach 5.3 oz/150 g 13 N/A N/A 150 45 N/A 17 120 0
Fage Total 0% cherry 5.3 oz/150 g 13 N/A N/A 150 50 N/A 17 120 0
Fage Total 0% 5.3 oz/150 g 13 N/A N/A 150 45 N/A 17 120 0
blueberry
Fage Total 0% cherry- 5.3 oz/150 g 13 N/A N/A 150 50 N/A 19 130 0
pomegranate
Fage Total 0% 5.3 oz/150 g 13 N/A N/A 150 45 N/A 18 120 0\
blueberry acai
(Continued)

e59
Table 3. (Continued)

e60
Phosphorus-
Serving to-Protein Calcium Sodium Potassium Calories
Yogurt Brand Size (g) Protein (g) Phosphorus (mg) Ratio (mg/g) (mg)* (mg) (mg) CHO (g) (kcal) Fat (g)
Fage Total 0% mango 5.3 oz/150 g 13 N/A N/A 150 45 N/A 18 120 0
guanabana
Fage Total 0% 5.3 oz/150 g 13 N/A N/A 150 50 N/A 17 120 0
strawberry goji
Fage Total 2% plain 7 oz/200 g 20 N/A N/A 200 65 N/A 8 150 4
Fage Total 2% 5.3 oz/150 g 12 N/A N/A 100 40 N/A 17 140 2.5
strawberry
Fage Total 2% peach 5.3 oz/150 g 12 N/A N/A 100 40 N/A 17 140 2.5
Fage Total 2% cherry 5.3 oz/150 g 12 N/A N/A 100 40 N/A 17 140 2.5
Fage Total 2% honey 5.3 oz/150 g 12 N/A N/A 100 40 N/A 17 140 2.5
Fage Total 2% 5.3 oz/150 g 12 N/A N/A 100 40 N/A 18 140 2.5
blueberry
Fage Total classic plain 7 oz/200 g 18 N/A N/A 200 70 N/A 8 190 10
Fage Total classic 5.3 oz/150 g 11 N/A N/A 100 45 N/A 18 170 6
blueberry
Fage Total classic 5.3 oz/150 g 11 N/A N/A 100 45 N/A 17 170 6

STALL
strawberry
Fage Total classic 5.3 oz/150 g 11 N/A N/A 100 45 N/A 17 170 6
peach
Fage Total classic 5.3 oz/150 g 11 N/A N/A 100 45 N/A 17 170 6
cherry
Fage Total classic 5.3 oz/150 g 11 N/A N/A 100 45 N/A 29 210 6
honey
Dannon Oikos fat-free 5.3 oz/150 g 15 N/A N/A 150 50 160 6 80 0
plain
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 50 160 21 120 0
black cherry
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 50 160 20 130 0
blueberry
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 45 135 19 120 0
vanilla
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 50 150 21 130 0
honey
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 45 170 20 130 0
peach
Dannon Oikos fat-free 5.3 oz/150 g 12 N/A N/A 150 50 170 19 120 0
strawberry
Dannon Oikos 5.3 oz/150 g 11 N/A N/A 150 55 170 18 160 4.5
traditional strawberry
 Dannon Oikos 5.3 oz/150 g 11 N/A N/A 150 75 135 18 160 4.5
traditional key lime
Dannon Oikos 5.3 oz/150 g 11 N/A N/A 150 50 160 18 160 4.5
traditional raspberry
Stonyfield organic 5.3 oz/150 g 15 200‡ 13 200 60 230 6 80 0
Oikos plain
Stonyfield organic 5.3 oz/150 g 15 200‡ 13 200 60 220 12 110 0
Oikos vanilla
Stonyfield organic 5.3 oz/150 g 14 200‡ 14 150 65 210 14 110 0
Oikos honey fig
Stonyfield organic 5.3 oz/150 g 13 200‡ 15 150 70 190 16 120 0
Oikos blueberry
Stonyfield organic 5.3 oz/150 g 13 200‡ 15 150 50 190 18 120 0
Oikos honey
Stonyfield organic 5.3 oz/150 g 13 200‡ 15 150 60 210 19 130 0
Oikos peach mango
200‡

GREEK YOGURT FOR CKD

Stonyfield organic 5.3 oz/150 g 13 15 150 80 190 16 110 0
Oikos strawberry
Stonyfield organic 5.3 oz/150 g 13 200‡ 15 150 80 190 18 130 0
Oikos super fruit
Yoplait Greek 100 key 5.3 oz/150 g 13 N/A N/A 150 55 N/A 10 100 0
lime
Yoplait Greek 100 black 5.3 oz/150 g 10 N/A N/A 100 45 N/A 14 100 0
cherry
Yoplait Greek 100 5.3 oz/150 g 10 N/A N/A 100 45 N/A 14 100 0
mixed berry
Yoplait Greek 100 5.3 oz/50 g 10 N/A N/A 100 45 N/A 14 100 0
peach
Yoplait Greek 100 5.3 oz/50 g 10 N/A N/A 100 45 N/A 14 100 0
strawberry
Yoplait Greek plain 6 oz/170 g 17 350‡ 21 450 115 N/A 12 120 0
Yoplait Greek honey 6 oz/170 g 14 300‡ 21 400 120 N/A 22 150 0
vanilla
Yoplait Greek key lime 6 oz/170 g 14 300‡ 21 400 100 N/A 25 160 0
Yoplait Greek peach 6 oz/170 g 14 300‡ 21 400 100 N/A 25 160 0
Yoplait Greek 6 oz/170 g 14 300‡ 21 400 100 N/A 25 160 0
strawberry
Yoplait Greek blueberry 6 oz/170 g 12 250‡ 21 350 100 N/A 26 160 0
*Calcium information is provided as a percentage of the DV. This has been converted to grams for ease of comparison; for example, 20% of the 1,000 DV for calcium 5 2,000 mg.
†Chobani states in the FAQ section of the website ‘‘Every 6-oz cup of Chobani contains about 120 mg of potassium and 240 mg of phosphorus.’’ 8 Potassium and phosphorus
information is not provided on the Nutrition Facts label.
‡Phosphorus information is provided on the label as a percentage of the DV. This has been converted to milligrams for ease of comparison; for example, 20% of the DV of 1,000

e61
mg for phosphorus 5 200 mg.
e62
yogurts organized by brand as well as within brand
in descending order of protein. Although the plain
yogurts have the highest protein content, the fruit-
flavored yogurts are very popular. Most of the fruit
yogurts within a brand have similar nutrition
breakdowns with a bit less protein than plain yo-
gurt, but still a worthwhile source of protein.
Although this product update discusses using
the phosphorus-to-protein ratio, the manufacturer
does not always provide phosphorus information.
The dietitian must use judgment in estimating the
phosphorus content and perhaps extrapolate data
from other similar products. In the calculations
provided, the phosphorus content was extrapolated
from the information provided as percent daily
value (DV) for phosphorus. The Chobani website
responded to a question of ‘‘How much phospho-
rus and potassium are in Greek yogurt?’’ with
‘‘Every 6-oz cup of Chobani contains about 250
mg of potassium and 240 mg of phosphorus.’’ 8 In
both of these circumstances this is an estimate and
not an absolute value. In addition, if a yogurt con-
tains phosphate additives, then the phosphorus
content will be higher. As the Greek yogurt market
expands, the variety in yogurts and available por-
tion sizes will expand and the registered dietitian
will need to rely on the Nutrition Facts label, the
ingredient list, and professional judgment for deter-
mining inclusion in the diet.
Manufacturers Contact Information
 Fage http://www.fageusa.com
 Chobani http://chobani.com/
STALL
 Oikos-Dannon http://www.oikosyogurt.
com/
 Oikos-Stonyfield Organic (Dannon)
http://www.stonyfield.com/
 Yoplait http://www.yoplait.com/
References
1. Groom DJ. Greek-style yogurt popularity means going the extra
mile to find enough milk to keep up with demand. Syracuse, NY: The
Post-Standard; 2012. Available at: http://www.syracuse.com/
news/index.ssf/2012/07/popularity_of_greek-style_yogu.html.
Accessed August 3, 2012.
2. Charles D. High tech shortcut to Greek Yogurt leaves purist fum-
ing. Washington D.C.: The Salt NPR’s Food Blog; 2012. Available
at: http://www.npr.org/blogs/thesalt/2012/07/19/156997600/
high-tech-shortcut-to-greek-yogurt-leaves-purists-fuming. Ac-
cessed August 7, 2012.
3. National Kidney Foundation. K/DOQI Clinical practice
guidelines for nutrition in chronic renal failure. Am J Kidney
Dis. 2000;35(6 suppl 2):S40-S43.
4. KDIGO Clinical Practice Guidelines for the Diagnosis. Eval-
uation, prevention, and treatment of chronic kidney disease-mineral
and bone disorder (CKD-MBD). Kidney Int. 2009;76(suppl 113):
S51-S53.
5. National Kidney Foundation. K/DOQI Clinical practice
guidelines for bone metabolism and disease in chronic kidney dis-
ease. Am J Kidney Dis. 2003;42(6 suppl 3):S66-S70.
6. Kalantar-Zadeh K, Gutekunst L, Mehotra R, et al. Under-
standing sources of dietary phosphorus in the treatment of patients
with chronic kidney disease. Clin J Am Soc Nephrol. 2010;5:
519-530.
7. Noori N, Sims JJ, Kopple JD, et al. Organic and inorganic
dietary phosphorus and its management in chronic kidney disease.
Iran J Kidney Dis. 2010;4:89-100.
8. Chobani. Chobani Greek Yogurt FAQ. Available at: http://
chobani.com/products/faq/. Accessed August 9, 2012.