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Carrera-Juliá S, Estrela JM, Zacarés M, Navarro MÁ, Vega-Bello MJ, de la Rubia Ortí JE, Moreno ML, Drehmer E. Nutritional, Clinical and Sociodemographic Profiles of Spanish Patients with Amyotrophic Lateral Sclerosis. Nutrients 2024; 16:350. [PMID: 38337635 PMCID: PMC10857415 DOI: 10.3390/nu16030350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is a chronic and progressive neurodegenerative disease that leads to the loss of motor neurons. The dietary intake of ALS patients is thought to influence the prognosis and progression of the disease. The aim of this study was to examine the nutritional, clinical and sociodemographic characteristics of ALS patients in Spain. A cross-sectional descriptive study with demographics, clinical anamnesis and anthropometric assessment was carried out. Nutritional intake was recorded and compared with dietary reference intakes (DRI). Forty subjects (25 males; 15 females) aged 54.7 ± 10.17 were included in the study. The mean weight and height were 67.99 ± 8.85 kg and 167.83 ± 8.79 cm, respectively. Clinical phenotype, time to diagnosis, year of onset and family history were not associated with the place of origin. Clinical phenotype had no influence on time of diagnosis. Caloric and protein intakes were adequate, while carbohydrate, vitamin B8 and iodine intakes were significantly lower than the DRI. Lipids; vitamins B1, B2, B3, B5, B6, B12, C and E; sodium; phosphorus; and selenium intakes were significantly higher than the recommended nutritional standards. ALS patients, who are homogeneously distributed throughout our national territory, should modify their dietary habits to minimize ultra-processed products and prioritize foods rich in healthy fats and fiber.
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Affiliation(s)
- Sandra Carrera-Juliá
- Department of Nutrition and Dietetics, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain;
| | - José M. Estrela
- Department of Physiology, University of Valencia, 46010 Valencia, Spain;
| | - Mario Zacarés
- Department of Basic and Transversal Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (M.Z.); (M.Á.N.)
| | - Mari Ángeles Navarro
- Department of Basic and Transversal Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain; (M.Z.); (M.Á.N.)
| | - María Jesús Vega-Bello
- Department of Anatomy and Physiology, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain;
| | | | - Mari Luz Moreno
- Department of Anatomy and Physiology, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain;
| | - Eraci Drehmer
- Department of Health and Functional Assessment, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain;
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Avesani CM, Cuppari L, Nerbass FB, Lindholm B, Stenvinkel P. Ultraprocessed foods and chronic kidney disease-double trouble. Clin Kidney J 2023; 16:1723-1736. [PMID: 37915903 PMCID: PMC10616474 DOI: 10.1093/ckj/sfad103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Indexed: 11/03/2023] Open
Abstract
High energy intake combined with low physical activity generates positive energy balance, which, when maintained, favours obesity, a highly prevalent morbidity linked to development of non-communicable chronic diseases, including chronic kidney disease (CKD). Among many factors contributing to disproportionately high energy intakes, and thereby to the obesity epidemic, the type and degree of food processing play an important role. Ultraprocessed foods (UPFs) are industrialized and quite often high-energy-dense products with added sugar, salt, unhealthy fats and food additives formulated to be palatable or hyperpalatable. UPFs can trigger an addictive eating behaviour and is typically characterized by an increase in energy intake. Furthermore, high consumption of UPFs, a hallmark of a Western diet, results in diets with poor quality. A high UPF intake is associated with higher risk for CKD. In addition, UPF consumption by patients with CKD is likely to predispose and/or to exacerbate uraemic metabolic derangements, such as insulin resistance, metabolic acidosis, hypertension, dysbiosis, hyperkalaemia and hyperphosphatemia. Global sales of UPFs per capita increased in all continents in recent decades. This is an important factor responsible for the nutrition transition, with home-made meals being replaced by ready-to-eat products. In this review we discuss the potential risk of UPFs in activating hedonic eating and their main implications for health, especially for kidney health and metabolic complications of CKD. We also present various aspects of consequences of UPFs on planetary health and discuss future directions for research to bring awareness of the harms of UPFs within the CKD scenario.
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Affiliation(s)
- Carla Maria Avesani
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
| | - Lilian Cuppari
- Division of Nephrology and Nutrition Program, Federal University of São Paulo and Sāo Paulo, Brazil
| | | | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Instituted, Stockholm, Sweden
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3
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Kalantar-Zadeh K, Forfang D, Bakris G, Martin KJ, Moe SM, Sprague SM. Managing Phosphate Burden in Patients Receiving Dialysis: Beyond Phosphate Binders and Diet. KIDNEY360 2023; 4:1650-1656. [PMID: 37870525 PMCID: PMC10695651 DOI: 10.34067/kid.0000000000000262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/07/2023] [Indexed: 10/24/2023]
Abstract
Most patients receiving dialysis rely on dietary restriction and phosphate binders to minimize the risk of hyperphosphatemia, which is associated with increased mortality. However, dietary restriction is difficult because of hidden phosphate additives in processed foods and medications. Restriction of dietary phosphate sources such as protein may increase the risk of malnutrition. Phosphate binders, the only pharmacologic option for phosphate management since aluminum salts were introduced several decades ago, are often insufficient for binding the 1400-2500 mg of phosphate potentially consumed daily. Over the last decade, serum phosphate levels in the United States have risen, and >69% of patients receiving dialysis exhibited a most recent phosphate level >4.5 mg/dl (above the normal range), indicating an urgent need for new, more effective therapies to manage phosphate burden. Novel, nonbinder therapies such as transcellular and paracellular phosphate absorption inhibitors may be used for phosphate management, and future studies should examine whether they allow fewer dietary restrictions for patients receiving dialysis, potentially improving patient quality of life and nutritional status. It is imperative that we collaborate to move beyond the restrictive approaches available today and provide patients and clinicians with an array of strategies so that they may choose the most appropriate patient-centered therapy.
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Affiliation(s)
- Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine, Irvine, California
| | - Derek Forfang
- The Co-Chair of the National Forum of ESRD Network's Kidney Patient Advisory Council (KPAC), Henrico, Virginia
- National Kidney Foundation, Public Policy Committee, New York, New York
| | - George Bakris
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago, Chicago, Illinois
| | - Kevin J. Martin
- Department of Internal Medicine, Division of Nephrology, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Sharon M. Moe
- Division of Nephrology and Hypertension, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stuart M. Sprague
- Division of Nephrology and Hypertension, NorthShore University Health System-University of Chicago Pritzker School of Medicine, Evanston, Illinois
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4
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He B, Zhu Y, Xie D, Nie Y, Mei Y. Removal of Al 3+ and Mg 2+ ions in wet-process phosphoric acid via the formation of aluminofluoride complexes. ENVIRONMENTAL TECHNOLOGY 2023; 44:936-947. [PMID: 34605717 DOI: 10.1080/09593330.2021.1989055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
With the decrease in the phosphate rock grade, the minor element ratios (MER) [(Fe2O3 wt% + Al2O3 wt% + MgO wt%)/P2O5 wt%] of wet-process phosphoric acid (WPA) exhibits a linear upward trend. This can lead to a huge challenge for the high-quality production of feed calcium phosphate salt (FCPS). In the present study, we proposed a novel and economical strategy to precipitate Al3+ and Mg2+ via the formation of aluminofluoride complexes (NaMgAlF6·H2O) with the anhydrous sodium sulfate (Na2SO4) and hydrofluoric acid (HF) as precipitation agents. Because of the low solubility of the complexes in WPA, the removal efficiencies of Al3+ and Mg2+ ions could reach 99.5% and 64.8%, respectively. The maximum mass loss of P2O5 was less than 0.5%. The precipitates could be separated and converted into the HF and Na2SO4 for reuse, thus further decreasing the cost of WPA purification.
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Affiliation(s)
- Binbin He
- School of Chemical Engineering, Kunming University of Science and Technology, Yunnan Provincial Key Laboratory of Energy Saving in Phosphorus Chemical Engineering and New Phosphorus Materials, Kunming, People's Republic of China
| | - Yuanzhi Zhu
- School of Chemical Engineering, Kunming University of Science and Technology, Yunnan Provincial Key Laboratory of Energy Saving in Phosphorus Chemical Engineering and New Phosphorus Materials, Kunming, People's Republic of China
| | - Delong Xie
- School of Chemical Engineering, Kunming University of Science and Technology, Yunnan Provincial Key Laboratory of Energy Saving in Phosphorus Chemical Engineering and New Phosphorus Materials, Kunming, People's Republic of China
| | - Yunxiang Nie
- School of Chemical Engineering, Kunming University of Science and Technology, Yunnan Provincial Key Laboratory of Energy Saving in Phosphorus Chemical Engineering and New Phosphorus Materials, Kunming, People's Republic of China
| | - Yi Mei
- School of Chemical Engineering, Kunming University of Science and Technology, Yunnan Provincial Key Laboratory of Energy Saving in Phosphorus Chemical Engineering and New Phosphorus Materials, Kunming, People's Republic of China
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5
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Derivatization reaction-based multi-spectroscopic techniques for ultrasensitive and rapid detection of phosphate in food using Nile blue A as probe. Microchem J 2023. [DOI: 10.1016/j.microc.2022.108280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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6
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Liu J, Liu Y, Wang W, Zhang S, Tang L, Ma P, Song D, Fei Q. A ratiometric fluorescent sensor for the detection of phosphate. LUMINESCENCE 2023; 38:152-158. [PMID: 36597958 DOI: 10.1002/bio.4434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023]
Abstract
Over the past few years, ratiometric fluorescent nanoprobes have garnered substantial interest because of their self-calibration characteristics. This research developed a ratiometric fluorescent sensor to detect phosphate. Through encapsulating luminescent materials, gold nanoclusters (AuNCs) and carbon dots (CDs) into a zeolitic imidazolate framework-8 (ZIF-8), the fluorescence signal of AuNCs was enhanced, while that of CDs was suppressed. After phosphate was added, it could decompose ZIF-8, and AuNCs and CDs were released, which weakened the fluorescence signal of the AuNCs while restoring that of the CDs. Thereby, this makes CDs/AuNCs@ZIF-8 a potential fluorescent sensor for phosphate determination. The ratiometric sensor had facile synthesis, good selectivity, and a low detection limit. Therefore, this sensor was an effective tool for the detection of phosphate.
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Affiliation(s)
- Jiayi Liu
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Yibing Liu
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Wei Wang
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Siqi Zhang
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Li Tang
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Pinyi Ma
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Daqian Song
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
| | - Qiang Fei
- College of Chemistry, Jilin Province Research Center for Engineering and Technology of Spectral Analytical Instruments, Jilin University, Qianjin Street 2699, Changchun, China
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7
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Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD). Int J Mol Sci 2022; 23:ijms231810814. [PMID: 36142725 PMCID: PMC9504787 DOI: 10.3390/ijms231810814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.
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8
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Sinha S, Haque M. Obesity, Diabetes Mellitus, and Vascular Impediment as Consequences of Excess Processed Food Consumption. Cureus 2022; 14:e28762. [PMID: 36105908 PMCID: PMC9441778 DOI: 10.7759/cureus.28762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 12/15/2022] Open
Abstract
Regular intake of ready-to-eat meals is related to obesity and several noninfectious illnesses, such as cardiovascular diseases, hypertension, diabetes mellitus (DM), and tumors. Processed foods contain high calories and are often enhanced with excess refined sugar, saturated and trans fat, Na+ andphosphate-containing taste enhancers, and preservatives. Studies showed that monosodium glutamate (MSG) induces raised echelons of oxidative stress, and excessive hepatic lipogenesis is concomitant to obesity and type 2 diabetes mellitus (T2DM). Likewise, more than standard salt intake adversely affects the cardiovascular system, renal system, and central nervous system (CNS), especially the brain. Globally, excessive utilization of phosphate-containing preservatives and additives contributes unswervingly to excessive phosphate intake through food. In addition, communities and even health experts, including medical doctors, are not well-informed about the adverse effects of phosphate preservatives on human health. Dietary phosphate excess often leads to phosphate toxicity, ultimately potentiating kidney disease development. The mechanisms involved in phosphate-related adverse effects are not explainable. Study reports suggested that high blood level of phosphate causes vascular ossification through the deposition of Ca2+ and substantially alters fibroblast growth factor-23 (FGF23) and calcitriol.
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9
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Carvalho AB, Nerbass FB, Cuppari L. Control of hyperphosphatemia and maintenance of calcemia in CKD. J Bras Nefrol 2021; 43:632-638. [PMID: 34910797 PMCID: PMC8823913 DOI: 10.1590/2175-8239-jbn-2021-s105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - Lilian Cuppari
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Tsuchiya K, Akihisa T. The Importance of Phosphate Control in Chronic Kidney Disease. Nutrients 2021; 13:nu13051670. [PMID: 34069053 PMCID: PMC8156430 DOI: 10.3390/nu13051670] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 12/12/2022] Open
Abstract
A series of problems including osteopathy, abnormal serum data, and vascular calcification associated with chronic kidney disease (CKD) are now collectively called CKD-mineral bone disease (CKD-MBD). The pathophysiology of CKD-MBD is becoming clear with the emerging of αKlotho, originally identified as a progeria-causing protein, and bone-derived phosphaturic fibroblast growth factor 23 (FGF23) as associated factors. Meanwhile, compared with calcium and parathyroid hormone, which have long been linked with CKD-MBD, phosphate is now attracting more attention because of its association with complications and outcomes. Incidentally, as the pivotal roles of FGF23 and αKlotho in phosphate metabolism have been unveiled, how phosphate metabolism and hyperphosphatemia are involved in CKD-MBD and how they can be clinically treated have become of great interest. Thus, the aim of this review is reconsider CKD-MBD from the viewpoint of phosphorus, its involvement in the pathophysiology, causing complications, therapeutic approach based on the clinical evidence, and clarifying the importance of phosphorus management.
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Affiliation(s)
- Ken Tsuchiya
- Department of Blood Purification, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
- Correspondence:
| | - Taro Akihisa
- Department of Nephrology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan;
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11
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Low frequency magnetic field plus high pH promote the quality of pork myofibrillar protein gel: A novel study combined with low field NMR and Raman spectroscopy. Food Chem 2020; 326:126896. [DOI: 10.1016/j.foodchem.2020.126896] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
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12
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Rastogi A, Bhatt N, Rossetti S, Beto J. Management of Hyperphosphatemia in End-Stage Renal Disease: A New Paradigm. J Ren Nutr 2020; 31:21-34. [PMID: 32386937 DOI: 10.1053/j.jrn.2020.02.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/27/2020] [Accepted: 02/08/2020] [Indexed: 12/12/2022] Open
Abstract
Bone and mineral metabolism becomes dysregulated with progression of chronic kidney disease (CKD), and increasing levels of parathyroid hormone serve as an adaptive response to maintain normal phosphorus and calcium levels. In end-stage renal disease, this response becomes maladaptive and high levels of phosphorus may occur. We summarize strategies to control hyperphosphatemia based on a systematic literature review of clinical trial and real-world observational data on phosphorus control in hemodialysis patients with CKD-mineral bone disorder (CKD-MBD). These studies suggest that current management options (diet and lifestyle changes; regular dialysis treatment; and use of phosphate binders, vitamin D, calcimimetics) have their own benefits and limitations with variable clinical outcomes. A more integrated approach to phosphorus control in dialysis patients may be necessary, incorporating measurement of multiple biomarkers of CKD-MBD pathophysiology (calcium, phosphorus, and parathyroid hormone) and correlation between diet adjustments and CKD-MBD drugs, which may facilitate improved patient management.
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Affiliation(s)
- Anjay Rastogi
- David Geffen School of Medicine at UCLA, Los Angeles, California.
| | - Nisha Bhatt
- Division of Nephrology, Department of Medical Affairs, Amgen Inc., Thousand Oaks, California
| | - Sandro Rossetti
- Division of Nephrology, Department of Medical Affairs, Amgen Inc., Thousand Oaks, California
| | - Judith Beto
- Division of Nephrology and Hypertension, Loyola University Chicago, Maywood, Illinois
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Sawin DA, Ma L, Stennett A, Ofsthun N, Himmele R, Kossmann RJ, Maddux FW. Phosphates in medications: Impact on dialysis patients
. Clin Nephrol 2020; 93:163-171. [PMID: 32049627 PMCID: PMC7264818 DOI: 10.5414/cn109853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 03/13/2020] [Indexed: 12/12/2022] Open
Abstract
Maintaining phosphorus balance in in-center hemodialysis (ICHD) patients is problematic despite recommended dietary restriction, dialysis, and phosphate binder use. Rarely is P content in prescribed medications considered, but this source should raise concern. Data was obtained from the Fresenius Kidney Care (FKC) electronic data warehouse Knowledge Center and MedReview-eRx accessed Surescripts, housing > 80% of US-filled prescriptions. Adult FKC ICHD patients prescribed ≥ 1 medication in the MedReview-eRx database were analyzed (695,759 prescriptions). Information collected included medication dose, dose unit, dose timing, strength, start and stop dates, refills, demographic information, admission history, and modality type. Numbers of patients, prescriptions by individual medication, and drug class were then analyzed. Medications prescribed > 100 times were reported. Median doses/day (number of tablets) were calculated for each medication (open order on randomly selected day). Phosphate content of medications taken in FKC clinics was assessed using routinely used pharmacology references, and potential resulting phosphate and pill burden were also calculated. The top five prescribed drug classes in FKC dialysis patients were calcium-channel blockers (22%), proton pump inhibitors (PPIs; 18%), acetaminophen-opioid (AO; 13%), angiotensin-converting enzyme inhibitors (ACEi; 10%), and α2-agonists (9%). The maximum phosphate added for different medications varied by manufacturer. For instance, at median daily doses, phosphate contributions from the top five medications prescribed were 112 mg for amlodipine, 116.2 mg from lisinopril, 6.7 mg from clonidine, 0 mg from acetaminophen, and 200 mg for omeprazole. Prescribing these together could increase the daily phosphate load by 428 mg, forcing the patient to exceed the recommended daily intake (RDI) with food and drink. Phosphate content in medications prescribed to HD patients can substantially contribute to the daily phosphate load and, in combination, may even exceed the daily recommended dietary phosphate intake. Healthcare providers should monitor all medications containing phosphate prescribed in order to minimize risk of uncontrolled hyperphosphatemia and poor adherence.
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Affiliation(s)
- Dixie-Ann Sawin
- Fresenius Medical Care North America, Renal Therapies Group, and
| | - Lin Ma
- Fresenius Kidney Care, Waltham, MA, USA
| | | | | | - Rainer Himmele
- Fresenius Medical Care North America, Renal Therapies Group, and
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14
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WENDLING AL, BALBINO KP, RIBEIRO PVDM, EPIFÂNIO ADPS, MAROTA LD, HERMSDORFF HHM. Processed and ultra-processed food consumption are related to metabolic markers in hemodialysis subjects. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To investigate the consumption of processed and ultra-processed foods and evaluate its relationship with the nutritional and metabolic status of hemodialysis patients in a single center in Brazil. Methods This cross-sectional study enrolled 73 individuals in hemodialysis (50 men and 23 women, 21-87 years-old). Clinical and lifestyle variables were assessed by a semi-structured questionnaire and dietary data by food frequency questionnaire. Anthropometric and metabolic data are collected from medical records. Results Processed and ultra-processed foods represented 11.0% of daily caloric intake, 53.0% of trans fatty acid, and 12.5% of salt consumed in the study sample. Individuals who had high intake of this food group (≥128.4g/day, median intake) had higher serum phosphorus and pre-dialysis urea values (p=0.038; p=0.013, respectively). Also, individual with higher consumption of processed meat, sausages and ready prepared food had higher pre-dialysis serum urea (p=0.021), while serum potassium was higher among the subjects who consumed more sauces and salt-based seasonings (p=0.002). Conclusion Higher consumption of processed and ultra-processed foods was associated with important biomarkers of metabolic control for hemodialysis subjects, probably due to non-health dietary composition. Nutritional guidelines and intervention strategies must be promoted to reduce consumption of these food-group in thisspecific population.
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15
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Öztürk‐Kerimoğlu B, Serdaroğlu M. Powder/gelled inulin and sodium carbonate as novel phosphate replacers in restructured chicken steaks. J FOOD PROCESS PRES 2019. [DOI: 10.1111/jfpp.14243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Meltem Serdaroğlu
- Engineering Faculty Food Engineering Department Ege University Izmir Turkey
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16
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Tao X, Zhang H, Yang Y, Zhang C, Wang M. Daily dietary phosphorus intake variability and hemodialysis patient adherence to phosphate binder therapy. Hemodial Int 2019; 23:458-465. [PMID: 31328873 DOI: 10.1111/hdi.12769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/08/2019] [Accepted: 06/13/2019] [Indexed: 01/22/2023]
Affiliation(s)
- Xingjuan Tao
- School of NursingShanghai Jiao Tong University Shanghai China
| | - Haifen Zhang
- Department of Nephrology, Renji Hospital, School of MedicineShanghai Jiao Tong University Shanghai China
| | - Yan Yang
- Department of Nephrology, Renji Hospital, School of MedicineShanghai Jiao Tong University Shanghai China
| | - Caihong Zhang
- Department of Nephrology, Renji Hospital, School of MedicineShanghai Jiao Tong University Shanghai China
| | - Min Wang
- Department of Nephrology, Renji Hospital, School of MedicineShanghai Jiao Tong University Shanghai China
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17
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Phosphorus Counting Table for the control of serum phosphorus levels without phosphate binders in hemodialysis patients. Clin Nutr ESPEN 2019; 32:153-157. [PMID: 31221281 DOI: 10.1016/j.clnesp.2019.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/18/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Hyperphosphatemia constitutes one of the major problems faced by patients with chronic kidney disease, and nourishment plays a significant role in its control. The present study aimed to evaluate the maintenance of phosphorus serum levels by observing measurements before and after an intervention using the Phosphorus Counting Table (PCT), in hemodialysis patients lacking phosphate binder use. METHODS The assessment included fifty individuals on hemodialysis who underwent phosphate binder suspension 30 days prior to the intervention. The participants received food and nutrition education on the PCT tool, which assists in the control of dietary phosphorus intake, and followed its instructions for two months. Fasting blood samples were collected at three moments for phosphorus, total calcium, and parathyroid hormone (PTH) analysis. The study sample was initially analyzed as a whole, then sub-classified into two groups: adherence and non-adherence. RESULTS At the end of the study, no significant difference in serum phosphorus was observed in the total and the adherence groups (p > 0.05). The non-adherence group showed a substantial increase of 0.74 mg/dL in serum phosphorus levels and 6.16 mg2/dL2 in the calcium-phosphorus product after the intervention. Meanwhile, the calcium-phosphorus product improved from 56.42 ± 11.49 mg2/dL2 to 51.05 ± 10.67 mg2/dL2 in the adherence group. Serum calcium levels did not change throughout the study in the three groups. A significant increment in PTH serum levels was observed at the end of the study in all groups. CONCLUSION The PCT showed to be efficient in the maintenance of serum phosphorus in the individuals who adhered well to the tool, without the administration of phosphate binders. Such a method can assist in patient adherence to treatment and enables better diet flexibility. The present trial was registered under the Brazilian Clinical Trials Registry (Rebec). Registration number: RBR-2vzd48.
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Li J, Wang L, Han M, Xiong Y, Liao R, Li Y, Sun S, Maharjan A, Su B. The role of phosphate-containing medications and low dietary phosphorus-protein ratio in reducing intestinal phosphorus load in patients with chronic kidney disease. Nutr Diabetes 2019; 9:14. [PMID: 30944300 PMCID: PMC6447592 DOI: 10.1038/s41387-019-0080-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 02/05/2023] Open
Abstract
Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in patients experiencing end-stage renal disease (ESRD). It includes abnormalities in bone and mineral metabolism and vascular calcification. Hyperphosphatemia is a major risk factor leading to morbidity and mortality in patients with chronic kidney disease. Increased mortality has been observed in patients with ESRD, with serum phosphorus levels of >5.5 mg/dL. Therefore, control of hyperphosphatemia is a major therapeutic goal in the prevention and treatment of CKD-MBD. The treatment of hyperphosphatemia includes decreasing intestinal phosphorus load and increasing renal phosphorus removal. Decreasing the intestinal load of phosphorus plays a major role in the prevention and treatment of CKD-MBD. Among the dietary sources of phosphorus, some of the commonly prescribed medications have also been reported to contain phosphorus. However, drugs are often ignored even though they act as a potential source of phosphorus. Similarly, although proteins are the major source of dietary phosphorus, reducing protein intake can increase mortality in patients with CKD. Recently, the importance of phosphorus/protein ratio in food have been reported to be a sensitive marker for controlling dietary intake of phosphorus. This review summarizes the progress in the research on phosphate content in drugs as an excipient and the various aspects of dietary management of hyperphosphatemia in patients with CKD, with special emphasis on dietary restriction of phosphorus with low dietary phosphate/protein ratio.
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Affiliation(s)
- Jiameng Li
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Liya Wang
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Mei Han
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Yuqin Xiong
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Ruoxi Liao
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Yupei Li
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Si Sun
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Anil Maharjan
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China
| | - Baihai Su
- Department of Nephrology, West China Hospital, Sichuan University, 610041, Chengdu, China.
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Nerbass FB, Canzi ER, Araujo RDA, Corrêa D, Santos RGD, Vieira MA, Morais JG. Differences in phosphatemia and frequency of consumption of dietary sources of phosphorus in hemodialysis patients in southern and northern Brazil. J Bras Nefrol 2019. [PMCID: PMC6534029 DOI: 10.1590/2175-8239-jbn-2018-0063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Introduction: Hyperphosphatemia is associated with unfavorable outcomes, and the percentage of patients presenting with this condition in hemodialysis (HD) in kidney foundation units in the state of Santa Catarina (SC) is historically higher than that of patients in the state of Tocantins (TO). Objective: To assess the frequency of consumption of the main dietary sources of phosphorus and to compare them between the two states. Methodology: A cross-sectional study was carried out involving 123 patients, 66 of SC and 57 of TO: 52% were men, average age was 46.9 ± 15.7 years, and mean HD time 48 (57-71) months. A food frequency questionnaire (FFQ) with 33 items that are dietary sources of phosphorus was applied. A consumption score was calculated for sources of organic, inorganic, and total phosphorus, and the six-month average of phosphatemia was obtained. Results: The mean phosphatemia of SC patients was higher (6.2 ± 1.5 vs 4.7 ± 1.3 mg/dL, p <0001) than TO patients, as well as the prevalence of hyperphosphatemia (62% vs 28%; p <10001). In the total sample, the foods most frequently consumed were milk and beans. Comparing the frequency of consumption between the two states, a significant difference was found in 17 items. In TO, beef and beans were the foods most frequently consumed, and in SC, fourteen other items of the FFQ (pork, sausages, dairy products, etc.) were the most frequently consumed. Phosphatemia correlated with the frequency of consumption of inorganic phosphorus sources. Conclusion: the frequency of consumption of several items was different between the states, and this explains the differences in phosphatemia between the two regions.
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Calvo MS, Sherman RA, Uribarri J. Dietary Phosphate and the Forgotten Kidney Patient: A Critical Need for FDA Regulatory Action. Am J Kidney Dis 2019; 73:542-551. [PMID: 30686528 DOI: 10.1053/j.ajkd.2018.11.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/14/2018] [Indexed: 02/07/2023]
Abstract
Careful dietary management that reduces high phosphate intake is recommended to slow the progression of chronic kidney disease (CKD) and prevent complications of CKD and may help reduce chronic disease risks such as incident CKD associated with high phosphate intake in the healthy general population. For patients treated with maintenance dialysis, control of serum phosphorus levels is considered a marker of good care and requires a coordinated plan that limits dietary phosphate intake, uses oral phosphate binders, and provides an adequate dialysis prescription. Even with traditional thrice-weekly hemodialysis or peritoneal dialysis, use of phosphate binders, and a concerted effort to limit dietary phosphate intake, adequately controlled serum phosphorus levels are not possible in all dialysis patients. Efforts to limit phosphate intake are thwarted by the underestimated and unquantified phosphate content of processed foods and some medications due to the hidden presence of phosphate additives or excipients added during processing or drug formulation. Effectively limiting phosphate intake could potentially be achieved through simple US Food and Drug Administration regulatory actions. Mandatory labeling of phosphate content on all packaged foods and drugs would enable identification of healthy low-phosphate foods and medications and permit critically important control of total phosphate intake. Simple changes in regulatory policy and labeling are warranted and would enable better management of dietary intake of phosphate at all stages of kidney disease, as well as potentially reduced health risks in the general population.
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Affiliation(s)
| | - Richard A Sherman
- Division of Nephrology, Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jaime Uribarri
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
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Jeong JY. Determining the Optimal Level of Natural Calcium Powders and Whey Protein Concentrate Blends as Phosphate Replacers in Cooked Ground Pork Products. Korean J Food Sci Anim Resour 2018; 38:1246-1252. [PMID: 30675117 PMCID: PMC6335130 DOI: 10.5851/kosfa.2018.e59] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/05/2018] [Accepted: 11/18/2018] [Indexed: 11/26/2022] Open
Abstract
This study was conducted to investigate the effects of the addition levels of a phosphate replacer blend in ground pork sausages. The phosphate replacer consisted of 0.2% oyster shell calcium powder, 0.3% egg shell calcium powder, and 0.25% whey protein concentrate. Depending on the presence or absence of synthetic phosphate and the addition level of phosphate replacer, the following products were processed: control (+) (0.3% phosphate), control (-) (non-phosphate), 20AL (20% replacer), 40AL (40% replacer), 60AL (60% replacer), 80AL (80% replacer), and 100AL (100% replacer). The pH values of pork sausages increased (p<0.05) with increasing addition level of the phosphate replacer. When more than 40% of the phosphate replacer was added to pork samples (40AL, 60AL, 80AL, and 100AL), cooking loss was significantly reduced compared to both the control (+) and control (-). However, no significant differences were observed in the moisture content and CIE L* values between the controls and the treatments with a phosphate replacer. The control (+) and 100AL treatment had the highest (p<0.05) hardness, but the samples with the phosphate replacer were not significantly different in cohesiveness and springiness from the control (+). As addition level increased, the gumminess and chewiness of the products with the phosphate replacer increased, which were lower than those of the control (+). Therefore, more than 40% of a phosphate replacer may possibly substitute synthetic phosphate to improve product yields in ground pork sausages, although further studies may be needed for improving the textural properties of the final products.
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Affiliation(s)
- Jong Youn Jeong
- School of Food Biotechnology & Nutrition, Kyungsung
University, Busan 48434, Korea
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Watanabe MT, Barretti P, Caramori JC. Dietary Intervention in Phosphatemia Control–Nutritional Traffic Light Labeling. J Ren Nutr 2018; 28:e45-e47. [DOI: 10.1053/j.jrn.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Avesani CM, Teta D, Carrero JJ. Liberalizing the diet of patients undergoing dialysis: are we ready? Nephrol Dial Transplant 2018; 34:180-183. [DOI: 10.1093/ndt/gfy309] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Carla M Avesani
- Renal Medicine and Baxter Novum, Department of Clinical Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
- European Renal Nutrition-ERN, Working Group at the European Renal Association – European Dialysis Transplant Association – ERA-EDTA
| | - Daniel Teta
- European Renal Nutrition-ERN, Working Group at the European Renal Association – European Dialysis Transplant Association – ERA-EDTA
- Service of Nephrology, Hospital of Sion, University of Lausanne, Switzerland
| | - Juan J Carrero
- European Renal Nutrition-ERN, Working Group at the European Renal Association – European Dialysis Transplant Association – ERA-EDTA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Puchulu MB, Ogonowski N, Sanchez-Meza F, Espinosa-Cuevas MLA, Miranda-Alatriste P. Dietary Phosphorus to Protein Ratio for the Mexican Population with Chronic Kidney Disease. J Am Coll Nutr 2018; 38:247-258. [PMID: 30257134 DOI: 10.1080/07315724.2018.1501327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Hyperphosphatemia is a major contributor to poor outcomes among cases of chronic kidney disease. Considering that foods with high protein content are major sources of phosphorus, a more suitable dietary phosphorus measure is the phosphorus to protein ratio. However, Mexican phosphorus to protein ratio tables do not exist. This article aims to estimate the phosphorus to protein ratio in foods commonly used by the Mexican population and to establish its usefulness in the selection of foods for patients with chronic kidney disease. METHODS Six tables with the phosphorus to protein ratio were developed from different data sources concerning Mexican animal food composition. RESULTS Egg whites have the best phosphorus to protein ratio. Partially skimmed milk has the lowest ratio among dairy products. Dairy products have high phosphorus to protein ratio variability. Red meat products have a ratio with an average of 9 mg/g. The phosphorus to protein ratio varies considerably for seafood (1.2-38.3 mg/g). CONCLUSIONS The phosphorus to protein ratio could be a good strategy to choose each food during chronic kidney disease dietary treatment for the Mexican population.
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Affiliation(s)
- María B Puchulu
- a Departamento de Ciencias Biológicas, Cátedra de Fisiología, Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Química y Metabolismo del Fármaco, IQUIMEFA-CONICET , Buenos Aires , Argentina.,b Latin American Society of Renal Nutrition, Mexico City, Mexico
| | - Natalia Ogonowski
- a Departamento de Ciencias Biológicas, Cátedra de Fisiología, Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Instituto de Química y Metabolismo del Fármaco, IQUIMEFA-CONICET , Buenos Aires , Argentina
| | - Fabiola Sanchez-Meza
- c Unidad de Posgrado, Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - María L A Espinosa-Cuevas
- b Latin American Society of Renal Nutrition, Mexico City, Mexico.,d Nephrology and Mineral Metabolism Department , Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
| | - Paola Miranda-Alatriste
- b Latin American Society of Renal Nutrition, Mexico City, Mexico.,d Nephrology and Mineral Metabolism Department , Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico
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Watanabe MT, Barretti P, Caramori JC. Attention to Food Phosphate and Nutrition Labeling. J Ren Nutr 2018; 28:e29-e31. [DOI: 10.1053/j.jrn.2017.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/24/2017] [Accepted: 12/20/2017] [Indexed: 11/11/2022] Open
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Öztürk B, Serdaroğlu M. Effects of Jerusalem Artichoke Powder and Sodium Carbonate as Phosphate Replacers on the Quality Characteristics of Emulsified Chicken Meatballs. Korean J Food Sci Anim Resour 2018; 38:26-42. [PMID: 29725222 PMCID: PMC5932970 DOI: 10.5851/kosfa.2018.38.1.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/31/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022] Open
Abstract
Today incorporation of natural ingredients as inorganic phosphate replacers has come into prominence as a novel research topic due to health concerns about phosphates. In this study, we aimed to investigate the quality of emulsified chicken meatballs produced with Jerusalem artichoke powder (JAP), either alone or in combination with sodium carbonate (SC) as sodium tripolyphosphate (STPP) replacers. The results showed that naturally dried JAP showed favorable technological properties in terms of water-oil binding and gelling. Emulsion batters formulated with JAP-SC mixture showed lower jelly and fat separation, higher water-holding capacity and higher emulsion stability than control samples with STPP. In final product, incorporation of JAP-SC mixture increased moisture and reduced lipid and energy values, and kept the pH value similar to control. Added JAP lead to increments in b* values whereas decreases L* values. Cook yield was similar to control in phosphate-free samples formulated with JAP-SC mix. Either low or medium ratios of JAP in combination with SC managed to protect most of the sensory parameters, while sensory scores tend to decrease in samples containing high levels of JAP. Addition of JAP to formulations presented samples that have equivalent behavior to phosphates in terms of lipid oxidation. In conclusion, our study confirms that utilization of JAP in combination with SC had promising effects as phosphate replacers by presenting natural solutions and providing equivalent quality to standard phosphate containing products.
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Affiliation(s)
- Burcu Öztürk
- Ege University, Engineering Faculty, Food Engineering Department, 35100 Bornova, Izmir, Turkey
| | - Meltem Serdaroğlu
- Ege University, Engineering Faculty, Food Engineering Department, 35100 Bornova, Izmir, Turkey
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Parpia AS, L'Abbé M, Goldstein M, Arcand J, Magnuson B, Darling PB. The Impact of Additives on the Phosphorus, Potassium, and Sodium Content of Commonly Consumed Meat, Poultry, and Fish Products Among Patients With Chronic Kidney Disease. J Ren Nutr 2018; 28:83-90. [DOI: 10.1053/j.jrn.2017.08.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/19/2017] [Accepted: 08/24/2017] [Indexed: 01/09/2023] Open
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Duong QH, Clark KD, Lapsley KG, Pegg RB. Determination of myo -inositol phosphates in tree nuts and grain fractions by HPLC–ESI–MS. J Food Compost Anal 2017. [DOI: 10.1016/j.jfca.2017.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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