Watanabe Marcela T, Araujo Raphael M, Vogt Barbara P, Barretti Pasqual, Caramori Jacqueline C T
Faculdade de Medicina de Botucatu, Departamento de Clínica Médica, Univ Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
Faculdade de Medicina de Botucatu, Departamento de Clínica Médica, Univ Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil.
Clin Nutr ESPEN. 2016 Aug;14:37-41. doi: 10.1016/j.clnesp.2016.05.001. Epub 2016 Jun 1.
Hyperphosphatemia is common in patients with chronic kidney disease (CKD) stages IV and V because of decreased phosphorus excretion. Phosphatemia is closely related to dietary intake. Thus, a better understanding of sources of dietary phosphate consumption, absorption and restriction, particularly inorganic phosphate found in food additives, is key to prevent consequences of this complication. Our aims were to investigate the most commonly consumed processed foods by patients with CKD on hemodialysis, to analyze phosphate and protein content of these foods using chemical analysis and to compare these processed foods with fresh foods.
We performed a cross-sectional descriptive analytical study using food frequency questionnaires to rank the most consumed industrialized foods and beverages. Total phosphate content was determined by metavanadate colorimetry, and nitrogen content was determined by the Kjeldahl method. Protein amounts were estimated from nitrogen content. The phosphate-to-protein ratio (mg/g) was then calculated. Processed meat protein and phosphate content were compared with the nutritional composition of fresh foods using the Brazilian Food Composition Table. Phosphate measurement results were compared with data from the Food Composition Table - Support for Nutritional Decisions. An α level of 5% was considered significant.
Food frequency questionnaires were performed on 100 patients (mean age, 59 ± 14 years; 57% male). Phosphate additives were mentioned on 70% of the product labels analyzed. Proteins with phosphate-containing additives provided approximately twice as much phosphate per gram of protein compared with that of fresh foods (p < 0.0001).
Protein and phosphate content of processed foods are higher than those of fresh foods, as well as phosphate-to-protein ratio. A better understanding of phosphate content in foods, particularly processed foods, may contribute to better control of phosphatemia in patients with CKD.
由于磷排泄减少，高磷血症在慢性肾脏病（CKD）IV期和V期患者中很常见。血磷水平与饮食摄入密切相关。因此，更好地了解膳食磷的摄入来源、吸收和限制，尤其是食品添加剂中的无机磷，是预防该并发症后果的关键。我们的目的是调查接受血液透析的CKD患者最常食用的加工食品，通过化学分析来分析这些食品中的磷和蛋白质含量，并将这些加工食品与新鲜食品进行比较。
我们进行了一项横断面描述性分析研究，使用食物频率问卷对最常食用的工业化食品和饮料进行排名。总磷含量通过偏钒酸盐比色法测定，氮含量通过凯氏定氮法测定。蛋白质含量根据氮含量估算。然后计算磷与蛋白质的比值（mg/g）。使用巴西食物成分表将加工肉类的蛋白质和磷含量与新鲜食品的营养成分进行比较。将磷测量结果与《食物成分表 - 营养决策支持》中的数据进行比较。α水平设定为5%，差异具有统计学意义。
对100名患者（平均年龄59±14岁；57%为男性）进行了食物频率问卷调查。在分析的产品标签中，70%提到了磷添加剂。与新鲜食品相比，含有磷添加剂的蛋白质每克蛋白质提供的磷大约是其两倍（p < 0.0001）。
加工食品中的蛋白质和磷含量高于新鲜食品，磷与蛋白质的比值也是如此。更好地了解食物中的磷含量，尤其是加工食品中的磷含量，可能有助于更好地控制CKD患者的血磷水平。
