title: Impact of Phosphorus-Based Food Additives on Bone and Mineral Metabolism.
abstract: BACKGROUND
  Phosphorus-based food additives can substantially increase total phosphorus intake per day, but the effect of these additives on endocrine factors regulating bone and mineral metabolism is unclear.
  
  
  OBJECTIVE
  This study aimed to examine the effect of phosphorus additives on markers of bone and mineral metabolism. Design and Setting, and Participants: This was a feeding study of 10 healthy individuals fed a diet providing ∼1000 mg of phosphorus/d using foods known to be free of phosphorus additives for 1 week (low-additive diet), immediately followed by a diet containing identical food items; however, the foods contained phosphorus additives (additive-enhanced diet). Parallel studies were conducted in animals fed low- (0.2%) and high- (1.8%) phosphorus diets for 5 or 15 weeks.
  
  
  METHODS
  The changes in markers of mineral metabolism after each diet period were measured.
  
  
  RESULTS
  Participants were 32 ± 8 years old, 30% male, and 70% black. The measured phosphorus content of the additive-enhanced diet was 606 ± 125 mg higher than the low-additive diet (P < .001). After 1 week of the low-additive diet, consuming the additive-enhanced diet for 1 week significantly increased circulating fibroblast growth factor 23 (FGF23), osteopontin, and osteocalcin concentrations by 23, 10, and 11%, respectively, and decreased mean sclerostin concentrations (P < .05 for all). Similarly, high-phosphorus diets in mice significantly increased blood FGF23, osteopontin and osteocalcin, lowered sclerostin, and decreased bone mineral density (P < .05 for all).
  
  
  CONCLUSIONS
  The enhanced phosphorus content of processed foods can disturb bone and mineral metabolism in humans. The results of the animal studies suggest that this may compromise bone health.
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: Orlando M
authors: OM
authors: Gutiérrez
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: Alexandra
authors: A
authors: Luzuriaga-McPherson
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: Yiming
authors: Y
authors: Lin
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: Linda C
authors: LC
authors: Gilbert
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: Shin-Woo
authors: SW
authors: Ha
authors: Division of Nephrology, Department of Medicine (O.M.G., A.L.-M.), and Department of Epidemiology (O.M.G.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Endocrinology, Metabolism, and Lipids, Department of Medicine (Y.L., S.-W.H., G.R.B.), Emory University, Atlanta, Georgia, 30322; The Atlanta Department of Veterans Affairs Medical Center (L.C.G., G.R.B.), Decatur, Georgia 30033; and The Winship Cancer Institute (G.R.B.), Emory University, Atlanta, Georgia 30322.
authors: George R
authors: GR
authors: Beck
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000328:Adult; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects; D019485:Bone Morphogenetic Proteins / Q000097:blood; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood; D005503:Food Additives / Q000494:pharmacology*; D005819:Genetic Markers; D006801:Humans; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D008903:Minerals / Q000378:metabolism*; D015675:Osteocalcin / Q000097:blood; D053495:Osteopontin / Q000097:blood; D017553:Phosphorus Compounds / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; C000717427:FGF23 protein, human; C000717428:Fgf23 protein, mouse; D005503:Food Additives; D005819:Genetic Markers; D008903:Minerals; D017553:Phosphorus Compounds; C422903:SOST protein, human; D015675:Osteocalcin; D053495:Osteopontin; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23