title: Intakes of Calcium and Phosphorus and Calculated Calcium-to-Phosphorus Ratios of Older Adults: NHANES 2005-2006 Data.
abstract: BACKGROUND
  High intakes of dietary phosphorus (P), relative to calcium (Ca) intake, are associated with a lower calcium:phosphorus ratio (Ca:P) ratio which potentially has adverse health effects, including arterial calcification, bone loss, and death. A substantial percentage of older adults (50 to 70 and 71 plus years) who have a higher risk of fracture rate than younger adults typically have low intakes of dietary Ca that are dominated by higher intakes of dietary P from natural and fortified foods, and lower Ca:P ratios than desirable.
  
  
  OBJECTIVE
  This investigation was undertaken to examine Ca and P intakes and the resulting Ca:P ratios (by mass) across gender and older adult age groups, using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006.
  
  
  METHODS
  NHANES data are based on a cross-sectional sample of the non-institutionalized United States (US) population within various regions. This sample is selected to be representative of the entire US population at all ages. National Cancer Institute (NCI) methods and SAS survey procedures were used for analyses. Ca:P ratios were calculated using total Ca from both foods and supplements, whereas P intakes were calculated from food composition values and supplements. The amounts of P additives in processed foods are not available.
  
  
  RESULTS
  Mean Ca and P intakes demonstrated lower intakes of Ca and higher intakes of P compared to current Recommended Dietary Allowances (RDAs). The Ca:P ratios in older male and female adults were influenced by both low-Ca and high-P dietary consumption patterns.
  
  
  CONCLUSIONS
  Both low total Ca intakes and high P amounts contribute to lower Ca:P ratios, i.e., ~0.7:1.0, in the consumption patterns of older adults than is recommended by the RDAs, i.e., ~1.5:1.0. Whether Ca:P ratios lower than recommended contribute to increased risk of bone loss, arterial calcification, and all-cause mortality cannot be inferred from these data. Additional amounts of chemical P additives in the food supply may actually reduce even further the Ca:P ratios of older adults of both genders, but, without P additive data from the food industry, calculation of more precise ratios from NHANES 2005-2006 data is not possible.
authors.affiliation: Departments of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7461, USA. radat223@email.unc.edu.
authors.forename: Reuben
authors.initials: R
authors.lastname: Adatorwovor
authors.affiliation: Departments of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7461, USA. kathy_roggenkamp@unc.edu.
authors.forename: Kathy
authors.initials: K
authors.lastname: Roggenkamp
authors.affiliation: Departments of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7461, USA. jjb_anderson@unc.edu.
authors.forename: John J B
authors.initials: JJ
authors.lastname: Anderson
mesh_terms: D000368:Aged; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000032:analysis / Q000592:standards; D003430:Cross-Sectional Studies; D004032:Diet; D019587:Dietary Supplements; D005260:Female; D005511:Food Handling; D006801:Humans; D008297:Male; D008875:Middle Aged; D054547:National Cancer Institute (U.S.) / Q000592:standards; D009749:Nutrition Surveys; D016226:Phosphorus, Dietary / Q000008:administration & dosage* / Q000032:analysis / Q000592:standards; D064167:Recommended Dietary Allowances; D012307:Risk Factors; D014481:United States
chemical_list: D002136:Calcium, Dietary; D016226:Phosphorus, Dietary
keywords: NHANES; RDA; bone mineral density; calcium; calcium:phosphorus ratio; phosphorus