title: Dietary phosphorus excess: a risk factor in chronic bone, kidney, and cardiovascular disease?
abstract: There is growing evidence in the nephrology literature supporting the deleterious health effect of excess dietary phosphorus intake. This issue has largely escaped the attention of nutrition experts until this symposium, which raised the question of whether the same health concerns should be extended to the general population. The potential hazard of a high phosphorus intake in the healthy population is illustrated by findings from acute and epidemiologic studies. Acute studies in healthy young adults demonstrate that phosphorus intakes in excess of nutrient needs may significantly disrupt the hormonal regulation of phosphorus contributing to disordered mineral metabolism, vascular calcification, bone loss, and impaired kidney function. One of the hormonal factors acutely affected by dietary phosphorus loading is fibroblast growth factor-23, which may be a key factor responsible for many of the cardiovascular disease (CVD) complications of high phosphorus intake. Increasingly, large epidemiological studies suggest that mild elevations of serum phosphorus within the normal range are associated with CVD risk in healthy populations. Few population studies link high dietary phosphorus intake to mild changes in serum phosphorus due to study design issues specific to phosphorus and inaccurate nutrient composition databases. The increasing phosphorus intake due to the use of phosphorus-containing ingredients in processed food and the growing consumption of processed convenience and fast foods is an important factor that needs to be emphasized.
authors.affiliation: Department of Medicine, The Mount Sinai School of Medicine, New York, NY.
authors.forename: Jaime
authors.initials: J
authors.lastname: Uribarri
authors.forename: Mona S
authors.initials: MS
authors.lastname: Calvo
mesh_terms: D015415:Biomarkers / Q000097:blood; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002908:Chronic Disease; D003226:Congresses as Topic; D004032:Diet / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D057140:Fast Foods / Q000009:adverse effects; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D005503:Food Additives / Q000009:adverse effects; D006801:Humans; D052756:Nutritional Sciences / Q000379:methods / Q000639:trends; D010758:Phosphorus / Q000009:adverse effects* / Q000097:blood; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012958:Societies, Scientific; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D005503:Food Additives; D010758:Phosphorus; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23