Study: Do dietary phosphates influence the serum phosphorus?
Study: Do dietary phosphates influence the serum phosphorus?
reference
Moore LW, Nolte JV, Gaber Ao, Suki Wn. Association of dietary phosphate and serum phosphorus concentration according to levels of kidney function. am j clin nutr . 2015; 102 (2): 444-453.
objective
The relationship between the food intake of phosphorus-both from organic and inorganic sources-and the serum phosphorus concentration in a large cohort of healthy subjects and subjects with limited kidney function should be examined.
Design
This study was a cross-sectional assessment of the serum phosphorus concentration of the test subjects compared to the clinical characteristics and the food intake, which were reported for the period of 24 hours before the blood sample.
participant
The subjects were 7,895 adult participants (aged 20 to 85) at the National Health and Nutrition Examination Survey 2003-2006, who were not pregnant and were available for the 24-hour nutritional information and laboratory values for serum creatinine and phosphorus, urine creatinine, and albumin.
parameter evaluated
food phosphorus in food and nutritional supplements as well as its source (organic phosphorus compared to inorganic phosphate rates); socio -economic status (level of education and amount of family income); sober serum creatinine and phosphorus; Albumin and creatinine in urine; Kidney function [Estimated Glomerular Filtration Rate (EGFR); Albumin to creatinine ratio (ACR); Body Mass Index (BMI)]
Primary result measurements
The average age of the participants was 46.7; 52.8 % were Caucasians; The middle BMI was 28.4; 33.4 % were obese. Hypertension was 41.6 %; 11.8 % had increased serum glucose; The middle ACR was 27.7 mg/g. Groups with a lower kidney function contained a higher proportion of male subjects, were older and had a higher prevalence of high blood pressure and hyperglycemia. The population median value of the serum phosphate was 3.73 mg/dl (range 1.9–6.8 mg/dl) and varied depending on kidney function.
important knowledge
As expected, those with an EGFR <30 ml/min/1.73 m 2 had a significantly higher serum phosphate level than those with an EGFR> 105 ml/min/1.73 m 2 (4,12 ± 0.07 opposite 3.83 ± 0.02, p = 0.0009).
Submitted (BMI <18.5) had higher serum phosphorus concentrations than normal weight ( p = 0.003). Those who were overweight (BMI 25-29.9) or obese (BMI> 30) had a lower serum phosphate mirror ( p = 0.0007).
The consumption of dairy products was associated with a higher serum phosphate mirror. Each portion of dairy products with added inorganic phosphates led to a gradual increase in the phosphate mirror by 0.07 mg/dl ( p = 0.0098). In the case of dairy products without added inorganic phosphorus, an increase in serum phosphate would occur by 0.02 mg/dl ( p = 0.0002).
Each portion of cereals/grains that were added to inorganic phosphates led to a small but significant increase in serum phosphate (0.005 mg/dl, p = 0.0084).
neither the level of education nor the level of income correlated with serum phosphorus, in contrast to previous studies in which a lower socio-economic status was associated with a higher serum phosphorus.
practice implications
serum phosphate, even within the normal area, is associated with cardiovascular events, cardiovascular mortality and overall mortality in healthy subjects as well as patients with chronic kidney disease. Healthy population associated.
In terms of the phosphorus content of food supply, the current nutrient databases are incomplete and for the processed processes, it is assumed that they underestimate the phosphate by at least 30 %, since phosphate rates are considered grass (generally recognized as secure). , and the FDA does not require that food manufacturers specify the amounts of phosphate rates on the fool label. 3 In contrast to organic phosphate, the bioavailability of which is between 40 % (plant sources) and 60 % (animal sources), phosphate rates are absorbed to 90 % to 100 %.
Excessive phosphorus consumption was clearly associated with cardiovascular diseases, osteoporosis and overall mortality in the general, healthy population.
This study by Moore et al. It also confirms that phosphate rates in frequently consumed foods, in particular dairy products, grain and grain, significantly increase serum phosphate levels and thus increase the risk of cardiovascular diseases, kidney disease, osteoporosis and the overall mortality increase "healthy" population. Although their quantities are not specified on food labels, phosphate sets must be listed, and patients should be instructed to minimize the use of products they contain. A patient -friendly grocery list can be found in the table "Where the phosphates lurk and how to identify them" in the article of the author "(link removed)."
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