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Franco LP, Derakhshandeh-Rishehri SM, Hua Y, Nöthlings U, Wudy SA, Remer T. Phosphorus Intake and Potential Dietary Influences Examined via 24-Hour Urinary Biomarker Measurements in German Children and Adolescents Over 3 Decades. J Acad Nutr Diet 2024; 124:1266-1276. [PMID: 38360183 DOI: 10.1016/j.jand.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Increases in phosphorus intake have been observed over the past years in adult populations. However, biomarker-based data are lacking on whether or not phosphorus intake also increased in children. OBJECTIVE The aim of this study was to examine 24-hour urinary phosphate excretion (PO4-Ex) and diet-related biomarkers potentially influencing phosphorus status in German children and adolescents from 1985 to 2015. DESIGN This longitudinal noninvasive biomarker-based cohort study examined 24-hour urine samples from children and adolescents of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study, collected over 3 decades. PARTICIPANTS/SETTING Examined individuals (n = 1,057) were healthy participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study, situated in Dortmund, Germany, who had been asked to collect one yearly 24-hour urine sample. Six thousand seven hundred thirty-seven samples collected from participants aged 3 to 17 years between 1985 (baseline) and 2015, were included. MAIN OUTCOME MEASURES phosphorus intake was examined biomarker-based by analyzed PO4-Ex in 24-hour urine samples. Whether acid-base status and intakes of protein, salt, and fruits and vegetables, may have relevantly contributed to PO4-Ex levels was assessed by determining 24-hour excretions of net acid, urea-nitrogen, and sodium as well as specific standardized excretions of potassium plus oxalate. STATISTICAL ANALYSES PERFORMED Trend analysis over 30 years and potentially influencing diet factors were examined using linear mixed-effect regression models (PROC-MIXED). Adjustments for sex, age, and body surface area were performed. RESULTS No change was identifiable for PO4-Ex over the 3 decades; neither in 3 to 8, 9 to 13, nor in 14 to 17 year olds. However, sodium excretion increased (P = .001). PROC-MIXED analysis on intraindividual changes in PO4-Ex revealed direct relationships with net acid excretion, urea-nitrogen, and sodium excretion and an inverse relationship with a biomarker of fruit and vegetable intake. CONCLUSIONS Despite a direct relationship between PO4-Ex and a biomarker of industrially processed food consumption; that is, sodium excretion, which showed an increasing time trend, phosphorus intake was found to remain stable over decades in children and adolescents.
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Affiliation(s)
- Luciana Peixoto Franco
- DONALD Study Center, Institute of Nutrition and Food Science, Department of Nutritional Epidemiology, University of Bonn, Dortmund, Germany
| | | | - Yifan Hua
- DONALD Study Center, Institute of Nutrition and Food Science, Department of Nutritional Epidemiology, University of Bonn, Dortmund, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Department of Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - Stefan A Wudy
- Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany
| | - Thomas Remer
- DONALD Study Center, Institute of Nutrition and Food Science, Department of Nutritional Epidemiology, University of Bonn, Dortmund, Germany.
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Mat Nasir N, Md Isa Z, Ismail NH, Ismail R, Mohd Tamil A, Jaafar MH, Mohamed Yassin MS, Zainol Abidin N, Ab Razak NH, Zulkifli A, Yusof KH. A cross-sectional analysis of the PURE study on minerals intake among Malaysian adult population with hypertension. Sci Rep 2024; 14:8590. [PMID: 38615144 PMCID: PMC11016102 DOI: 10.1038/s41598-024-59206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
Hypertension (HPT) is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. Currently, attention is given to various dietary approaches with a special focus on the role of micronutrient intake in the regulation of blood pressure. This study aims to measure the dietary intake of selected minerals among Malaysian adults and its association with HPT. This cross-sectional study involved 10,031 participants from the Prospective Urban and Rural Epidemiological study conducted in Malaysia. Participants were grouped into HPT if they reported having been diagnosed with high blood pressure [average systolic blood pressure (SBP)/average diastolic blood pressure (DBP) ≥ 140/90 mm Hg]. A validated food frequency questionnaire (FFQ) was used to measure participants' habitual dietary intake. The dietary mineral intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc was measured. The chi-square test was used to assess differences in socio-demographic factors between HPT and non-HPT groups, while the Mann-Whitney U test was used to assess differences in dietary mineral intake between the groups. The participants' average dietary intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc was 591.0 mg/day, 3.8 mg/day, 27.1 mg/day, 32.4 mg/day, 0.4 mg/day, 1431.1 mg/day, 2.3 g/day, 27.1 µg/day, 4526.7 mg/day and 1.5 mg/day, respectively. The intake was significantly lower among those with HPT than those without HPT except for calcium and manganese. Continuous education and intervention should be focused on decreasing sodium intake and increasing potassium, magnesium, manganese, zinc, and calcium intake for the general Malaysian population, particularly for the HPT patients.
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Affiliation(s)
- Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia.
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohamed Syarif Mohamed Yassin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Aziemah Zulkifli
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Risk Management Unit, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
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3
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Deng CY, Ke XP, Guo XG. Dietary calcium, phosphorus, and potassium intake associated with erectile dysfunction in the National Health and Nutrition Examination Survey (NHANES) 2001 to 2004. PLoS One 2024; 19:e0297129. [PMID: 38381721 PMCID: PMC10880986 DOI: 10.1371/journal.pone.0297129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/28/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Erectile dysfunction is now a common disorder of sexual function, and its relationship to dietary calcium, phosphorus, and potassium has not been well studied. We set out to determine if dietary intakes of calcium, phosphorus, and potassium are related to erectile dysfunction in U.S. men. METHODS For this cross-sectional investigation, we used data from NHANES 2001-2004. To investigate the connection of dietary calcium, phosphorus, and potassium intake with erectile dysfunction, we employed multivariate logistic regression, smoothed curve fitting, and subgroup analysis. RESULTS This cross-sectional study comprised 3,556 eligible male subjects in total, with a weighted mean age of 49.93±18.13 years. After controlling for race and age, the greatest tertile of calcium consumption was found to have a 34% lower risk of erectile dysfunction than the lowest tertile (OR = 0.66; 95% CI = 0.52-0.84; p = 0.0006). The risk of erectile dysfunction was found to be reduced by 33% (OR = 0.67; 95% CI = 0.52-0.87; p = 0.0024) for the highest tertile of phosphorus intake compared to the lowest tertile of phosphorus intake and by 35% (OR = 0.65; 95% CI = 0.50-0.83; p = 0.0006) for the highest tertile of potassium intake compared to the lowest tertile of potassium intake in the fully adjusted model. CONCLUSION Erectile dysfunction and dietary consumption of calcium, phosphorus, and potassium are inversely associated with the U.S. population. To confirm the accuracy of our findings, additional prospective studies are necessary. Furthermore, it is imperative to do further fundamental research at the molecular level to gain a deeper understanding of the underlying mechanisms.
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Affiliation(s)
- Chen-Yuan Deng
- Department of Clinical Laboratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xin-Peng Ke
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
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Itkonen ST, Lamberg-Allardt C. Phosphorus - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10318. [PMID: 38187803 PMCID: PMC10770706 DOI: 10.29219/fnr.v67.10318] [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: 06/23/2022] [Revised: 09/27/2022] [Accepted: 10/25/2023] [Indexed: 01/09/2024] Open
Abstract
This scoping review aims to describe the totality of evidence for the role of phosphorus for health-related outcomes as a basis for setting and updating dietary reference values (DRVs). Phosphorus is needed in many biological processes, such as cellular metabolism and bone mineralization. Dietary phosphorus intake exceeds the previous Nordic Nutrition Recommendations (NNR2012) 2-3-fold in the Nordic countries. Intake from food additives is unknown but may play a significant role because the use of phosphate additives is common in the food industry. Bioavailability of phosphorus in plant-based products is lower than animal-based products. Nevertheless, bioavailability of phosphorus additives is higher. The main phosphorus-related health outcomes concern high phosphorus intake mainly from food additives with potential adverse effects on kidney, bone, and cardiovascular health.
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Affiliation(s)
- Suvi T. Itkonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Wu Q, Ye Z, Zhou C, Liu M, Zhang Y, Zhang Z, He P, Li R, Li H, Yang S, Zhang Y, Jiang J, Nie J, Liu C, Qin X. A U-shaped association between dietary phosphorus intake and new-onset hypertension: a nationwide cohort study in China. Am Heart J 2023; 259:21-29. [PMID: 36690241 DOI: 10.1016/j.ahj.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/30/2022] [Accepted: 01/16/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The association between dietary phosphorus intake and the risk of hypertension remains uncertain. We aimed to investigate the relation of dietary phosphorus intake with new-onset hypertension among Chinese adults. METHODS A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was measured by 3 consecutive 24-hour dietary recalls combined with a household food inventory. New-onset hypertension was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by a physician or under antihypertensive treatment during the follow-up. RESULTS During a median follow-up of 6.1 years, 4,269 participants developed new-onset hypertension. Overall, the association between dietary phosphorus intake and new-onset hypertension followed a U-shape (P for nonlinearity<.001). Consistently, when dietary phosphorus intake was assessed as quintiles, compared with those in the 3rd to 4th quintiles (912.0-<1089.5 mg/d), a significantly higher risk of new-onset hypertension was found in participants in the 1st to 2nd quintiles (<912.0 mg/d: HR, 1.23; 95% CI, 1.14-1.33), and the fifth quintile (≥1089.5 mg/d: HR, 1.21; 95% CI, 1.10-1.33). CONCLUSION There was a U-shaped association between dietary phosphorus intake and new-onset hypertension in general Chinese adults.
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Affiliation(s)
- Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Rui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Jianping Jiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Jing Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China
| | - Chengzhang Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China.
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Fulgoni K, Fulgoni VL, Wallace TC. Association of Total, Added, and Natural Phosphorus Intakes with Biomarkers of Health Status and Mortality in Healthy Adults in the United States. Nutrients 2022; 14:1738. [PMID: 35565706 PMCID: PMC9104875 DOI: 10.3390/nu14091738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/06/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
The Western diet is high in dietary phosphorus, partially due to added phosphorus, (i.e., phosphates) predominantly present in processed food products. Elevated serum phosphate levels, otherwise known as hyperphosphatemia, have been associated with changes in health status, of note detrimental effects on cardiovascular and renal health. However, the extent to which highly absorbed added phosphorus contributes to these changes is relatively unknown, due to its poor characterization among food composition databases. Industry-provided data on phosphorus source ingredients and ranges of added phosphorus present in food categories to enable a more accurate estimation of the total, added, and natural phosphorus intakes in the U.S. population. Using regression analyses, we then assessed relationships between estimated total, added, and natural phosphorus intakes on biomarkers of health status and mortality in individuals enrolled in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2001-2016 datasets. Total, added, and natural phosphorus intakes were associated with several biomarkers of health status. Added phosphorus intake was consistently inversely associated with HDL cholesterol in both men and women, whereas naturally occurring phosphorus intake was inversely correlated with the risk of elevated blood pressure. However, in most cases, the predicted impact of increases in phosphorus intake would result in small percentage changes in biomarkers. No meaningful associations between phosphorus and mortality were found, but indications of a correlation between mortality with quintiles of naturally occurring phosphorus were present, depending on covariate sets used. The disparate results for natural and added phosphorus intakes within the current study provide increased support for updating current food composition databases to more accurately account for dietary phosphorus intake as total, naturally occurring, and added phosphorus.
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Affiliation(s)
| | | | - Taylor C. Wallace
- Think Healthy Group, LLC, Washington, DC 20001, USA;
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
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Zhang JY, You HZ, Wang MJ, Zhang Q, Dong XY, Liu JF, Chen J. High-phosphorus diet controlled for sodium elevates blood pressure in healthy adults via volume expansion. J Clin Hypertens (Greenwich) 2021; 23:849-859. [PMID: 33486869 PMCID: PMC8678725 DOI: 10.1111/jch.14182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/23/2020] [Accepted: 01/03/2021] [Indexed: 01/26/2023]
Abstract
Whether increasing exposure to dietary phosphorus can lead to adverse clinical outcomes in healthy people is not clear. In this open‐label prospective cross‐over study, we are to explore the impact of various dietary phosphorus intake on mineral, sodium metabolisms and blood pressure in young healthy adults. There were 3 separate study periods of 5 days, each with a 5 days washout period between different diets interventions. Six young healthy male volunteers with normal nutrition status were recruited in Phase I Clinical Research Center and sequentially exposed to the following diets: (a) normal‐phosphorus diet (NPD): 1500 mg/d, (b) low‐phosphorus diet (LPD): 500 mg/d, (c) high‐phosphorus diet (HPD): 2300 mg/d. HPD induced a significant rise in daily average serum phosphate (1.47 ± 0.02 mmol/L [4.56 ± 0.06 mg/dl]) compared to NPD (1.34 ± 0.02 mmol/L [4.15 ± 0.06 mg/dL]) and LPD (1.17 ± 0.02 mmol/L [3.63 ± 0.06 mg/dL]) (p < .05). Daily average levels of serum parathyroid hormone and fibroblast growth factor 23 in HPD were significantly higher, and serum 1,25(OH)2D3 was remarkably lower than those in LPD. HPD induced a significant decrease in daily average serum aldosterone and an increase in daily average atrial natriuretic peptide level compared to LPD. The 24‐hour urine volume in HPD subjects was less than that in LPD subjects. HPD significantly increased daily average systolic blood pressure by 6.02 ± 1.24 mm Hg compared to NPD and by 8.58 ± 1.24mm Hg compared to LPD (p < .05). Our study provides the first evidence that 5‐day high‐phosphorus diet can induce elevation in SBP in young healthy adults, which may due to volume expansion.
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Affiliation(s)
- Jia-Ying Zhang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.,Division of Nutrition, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Huai-Zhou You
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Meng-Jing Wang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qian Zhang
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xin-Yu Dong
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing-Fang Liu
- Division of Nutrition, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Chen
- Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Morato-Martínez M, López-Plaza B, Santurino C, Palma-Milla S, Gómez-Candela C. A Dairy Product to Reconstitute Enriched with Bioactive Nutrients Stops Bone Loss in High-Risk Menopausal Women without Pharmacological Treatment. Nutrients 2020; 12:nu12082203. [PMID: 32722015 PMCID: PMC7468696 DOI: 10.3390/nu12082203] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 01/06/2023] Open
Abstract
Osteoporosis is a multifactorial disease characterized by the loss of bone mass and deterioration of the internal structure of the bone, increasing the risk of fractures, and is becoming an economic and social problem. The main treatment is pharmacological, however, the population demands other therapies, such as foods with nutrients beneficial to bone health. Seventy-eight healthy menopausal women at risk of osteoporosis or untreated osteopenia were recruited for a randomized, parallel, double-blind clinical trial with two intervention groups: one group consumed a serving a day of the experimental enriched product (experimental group (EG)) and the other group (control group (CG)) consumed the same product without enrichment. The main objective was to compare the effect of consuming a dairy preparation to reconstitute, similar to yogurt when prepared, enriched in calcium, vitamin D, vitamin K, vitamin C, zinc, magnesium, L-leucine and probiotic (Lactobacillus plantarum 3547) on bone metabolism markers for 24 weeks. The EG showed a significantly increased bone mass compared to the CG (0.01 ± 0.03 vs. −0.01 ± 0.03 kg; p < 0.05). In addition, the EG maintained their bone mineral density (BMD) compared to the CG, whose BMD significantly decreased at the end of the study. For biochemical markers, the EG significantly increased the serum levels of the N-terminal propeptide of type I collagen (P1NP) bone formation marker (13.19 ± 25.17 vs. −4.21 ± 15.62 ng/mL; p < 0.05), and decreased the carbo-terminal telopeptide of type I collagen (CTx) bone resorption marker compared to the CG (−0.05 ± 0.19 vs. 0.04 ± 0.14 ng/mL; p < 0.05). On the other hand, the EG exhibited a significantly decreased systolic and diastolic blood pressure compared to the start of the study. Finally, the EG significantly increased their dietary calcium and vitamin D intake compared to the CG. In conclusion, the regular consumption of a dairy product to reconstitute enriched with bioactive nutrients improves bone health markers in menopausal women at risk of osteoporosis without pharmacological treatment.
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Affiliation(s)
- Marina Morato-Martínez
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
| | - Bricia López-Plaza
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Correspondence: ; Tel.: +34-917-277-000 (ext. 42507)
| | - Cristina Santurino
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
| | - Samara Palma-Milla
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
| | - Carmen Gómez-Candela
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
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McClure ST, Rebholz CM, Mitchell DC, Selvin E, Appel LJ. The association of dietary phosphorus with blood pressure: results from a secondary analysis of the PREMIER trial. J Hum Hypertens 2019; 34:132-142. [PMID: 31435005 PMCID: PMC7031014 DOI: 10.1038/s41371-019-0231-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/06/2019] [Accepted: 06/21/2019] [Indexed: 12/16/2022]
Abstract
Inconsistent findings exist for the association between dietary phosphorus intake and blood pressure (BP). We examined the longitudinal association between urinary excretion and dietary intake of phosphorus (total, plant, animal, and added) with BP. This is a secondary analysis of PREMIER, a randomized behavioral intervention study in adults (25–79y) with BP, measured at six months, as the primary outcome. We classified total phosphorus intake from dietary recalls into plant, animal, and added phosphorus. We modeled six month change of phosphorus intake (from 24h dietary recalls, N = 622) and excretion (from 24h urine collection, N = 564) on BP, using linear regression crude and adjusted for intervention, age, race, sex, income, education, study site, and change in energy intake (kcal/d), sodium intake (mg/d), fitness (heart rate, bpm), and DASH diet index. Baseline phosphorus intake was 1154 mg/d (95%CI 1126, 1182) with 38%, 53%, and 10% from plant, animal, and added phosphorus, respectively. Total phosphorus intake was not associated with significant changes in BP. Increased urinary phosphorus excretion was associated with a significant increase in DBP [0.14 mmHg/100 mg (0.01, 0.28), adjusted]. In several analyses, phosphorus type (plant, animal, or added) significantly modified the association between phosphorus intake and BP. For example, added phosphorus (but not plant or animal) was associated with increases in SBP and DBP, 1.24 mmHg/100 mg (0.36, 2.12) and 0.83 mmHg/100 mg (0.22, 1.44), respectively, crude. These findings suggest that the type of phosphorus may modify the association between phosphorus intake and BP. Trial registration (clinicaltrials.gov).
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Affiliation(s)
- Scott T McClure
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Diane C Mitchell
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.,Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Iqbal S, Klammer N, Ekmekcioglu C. The Effect of Electrolytes on Blood Pressure: A Brief Summary of Meta-Analyses. Nutrients 2019; 11:nu11061362. [PMID: 31212974 PMCID: PMC6627949 DOI: 10.3390/nu11061362] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
Nutrition is known to exert an undeniable impact on blood pressure with especially salt (sodium chloride), but also potassium, playing a prominent role. The aim of this review was to summarize meta-analyses studying the effect of different electrolytes on blood pressure or risk for hypertension, respectively. Overall, 32 meta-analyses evaluating the effect of sodium, potassium, calcium and magnesium on human blood pressure or hypertension risk were included after literature search. Most of the meta-analyses showed beneficial blood pressure lowering effects with the extent of systolic blood pressure reduction ranging between -0.7 (95% confidence interval: -2.6 to 1.2) to -8.9 (-14.1 to -3.7) mmHg for sodium/salt reduction, -3.5 (-5.2 to -1.8) to -9.5 (-10.8 to -8.1) mmHg for potassium, and -0.2 (-0.4 to -0.03) to -18.7 (-22.5 to -15.0) mmHg for magnesium. The range for diastolic blood pressure reduction was 0.03 (-0.4 to 0.4) to -5.9 (-9.7 to -2.1) mmHg for sodium/salt reduction, -2 (-3.1 to -0.9) to -6.4 (-7.3 to -5.6) mmHg for potassium, and -0.3 (-0.5 to -0.03) to -10.9 (-13.1 to -8.7) mmHg for magnesium. Moreover, sufficient calcium intake was found to reduce the risk of gestational hypertension.
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Affiliation(s)
- Sehar Iqbal
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Norbert Klammer
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
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